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Benzalkonium chloride is a frequently used preservative in eye drops. Typical concentrations range from 0.004% to 0.01%. [17] Stronger concentrations can be caustic [18] and cause irreversible damage to the corneal endothelium. [19] Avoiding the use of benzalkonium chloride solutions while contact lenses are in place is discussed in the literature.
In addition, benzalkonium chloride has a cellular toxicity on caliciform cells, entailing a reduction in the amount of mucin, an additional reason for disrupting the tear film. [ 1 ] In fact, none of the cycloplegic drops used to treat Spasm of Accommodation in the United States are available without BAK.
The pharmaceutical drug Bilina is a combination of Levocabastine, benzalkonium chloride, and other components and is typically used in a 0.5 mg/ml suspension as eye-drops, dispensed in 4ml bottles for the treatment of allergic conjunctivitis or similar allergic ocular conditions.
Timolol is light-sensitive; it is usually preserved with 0.01% benzalkonium chloride (BAC), but also comes BAC-free. It can also be used in combination with pilocarpine, carbonic anhydrase inhibitors [19] or prostaglandin analogs. [20]
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The most commonly used penetration enhancers in ocular formulations are benzalkonium chloride and ethylenediamine tetraacetate (EDTA). Benzalkonium chloride is often used as an antimicrobial preservative in eye drops [ 7 ] and EDTA is used as a chelating agent.
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