Ocular lubricant Pregnancy: SPC §4.6: there are no or limited data from use of ophthalmic hypromellose in pregnant women; systemic exposure following topical ocular administration is negligible and the product has no pharmacological properties. Lactation: it is unknown whether topical hypromellose/metabolites are excreted in human milk, but no effects on the breastfed newborn/infant are anticipated since systemic exposure is negligible and hypromellose is pharmacologically inert. Fertility: no studies performed; hypromellose is pharmacologically inert and would not be expected to affect fertility.

Hypromellose

Brand names: Tears Naturale, Isopto Plain

Hypromellose (hydroxypropyl methylcellulose) is a cellulose-derived ocular lubricant widely used as artificial tears for the symptomatic relief of dry eye and ocular surface dryness.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One or two drops instilled topically into the eye

Route: Ocular use only (topical)

Frequency: Three times daily as needed, or as directed by a physician

SPC §4.2 gives the same recommended dosage for adults, children and the elderly — one or two drops topically instilled into the eye three times daily as needed. No separate paediatric or elderly regimen and no maximum daily dose are stated. May cause transient mild stinging or temporary blurred vision; patients should discontinue and consult a physician or pharmacist if irritation persists or worsens, or if headache, eye pain, vision changes or continued redness occur. To preserve sterility the dropper should not touch the eye or any other surface. This formulation contains benzalkonium chloride 0.1 mg/ml as preservative, which may be deposited in soft contact lenses — lenses should be removed before instillation and not reinserted earlier than 15 minutes after use. Benzalkonium chloride has been reported to cause eye irritation and symptoms of dry eyes and may affect the tear film and corneal surface; use with caution in dry eye patients and where the cornea may be compromised, and monitor patients on prolonged use. Source product: Hypromellose Eye Drops BP.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance hypromellose or to any of the excipients

Side effects

Transient mild stinging or blurred vision (frequency cannot be estimated)
Eye pain
Foreign body sensation in eyes
Eye irritation
Ocular hyperaemia

Interactions

Hypromellose prolongs the contact time of topically applied drugs commonly used in ophthalmology (SPC §4.5)

Clinical monograph

How it works

It is a hydrophilic polymer that increases tear viscosity and forms a stable, moisture-retaining film over the ocular surface, prolonging lubrication of the cornea and conjunctiva.

Prescribing in practice

Preserved multidose preparations can cause ocular surface toxicity or irritation with frequent or long-term use, so use a preservative-free product for chronic or frequent dosing or in sensitive patients.
Effect is relatively short-lived so frequent instillation may be needed, and it may be used as often as required.
Separate the instillation of different eye drops and apply ointments last when more than one product is used.

Monitoring

No systemic monitoring is required; review symptom control and ocular surface health at clinical follow-up.

Counselling the patient

Brief blurring of vision is common after each drop, so wait until vision is clear before driving.
Do not allow the dropper tip to touch the eye and discard the bottle within the period stated after opening.

Evidence & guidelines

Hypromellose is a long-established first-line artificial tear for dry eye disease in routine ophthalmic practice and NICE Clinical Knowledge Summaries.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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