Olopatadine: Once-daily dosing benefit

Dr. Scoper related two important points that ophthalmologists should consider when treating patients who have allergic conjunctivitis. First, the symptoms of eyes red and itchy from seasonal allergic conjunctivitis are related directly to the level of the pollen count on a specific day. By the time the patients arrive for their appointments, the pollen count may have decreased, the patients may no longer have red, itchy eyes, and they may feel better, with no symptoms.

"The majority of patients who come to my office are not actually having symptoms at the time of the examination," said Dr. Scoper, associate professor of ophthalmology, Eastern Virginia Medical School, Norfolk, VA, and in private practice at Virginia Eye Consultants, Norfolk, VA. "When a diagnosis is made, it is based on the patients' history at the time they experience the symptoms. Because of this, allergic conjunctivitis is a diagnosis that is missed frequently, preventing the patient from receiving the best possible treatment. Ophthalmologists should remember to ask about a history of symptoms."

"This tells us the diagnosis," he said. "However, by using prescription medications, we generally can do a better job than the OTC products."

The story of olopatadine

Olopatadine 0.2% is a newer formulation of olopatadine hydrochloride ophthalmic solution 0.1% (Patanol, Alcon Laboratories) and is taken once rather than twice daily.

"[Olopatadine 0.2%] is the same molecule . . . in a different concentration and with a different vehicle for once-daily instillation," he said. "[Olopatadine 0.1%] has been the gold standard for treating allergic conjunctivitis for 13 years."

The molecule is a combination therapy comprising a mast cell stabilizer and an antihistamine.

"This combination is a better molecule for the eye than the other combination drugs, which were developed from systemic drugs and converted into eye drops," Dr. Scoper said. "The [olopatadine 0.1%] molecule was originally formulated as an eye drop and was never a systemic formulation."

He has used olopatadine 0.1% successfully in his practice for years but said prefers the newer formulation because of its once-daily dosing compared with the older version, which is instilled twice daily.

"Once-daily dosing is a big advantage of [olopatadine 0.2%], which works just as well as [olopatadine 0.1%]," he emphasized. Instillation in the morning prevents the development of red, itchy eyes throughout the day-especially important for patients who wear contact lenses.