Giaral Plus

General characteristics. Structure:

Active ingredient: sodium hyalrunate – 15 mg/ml.

Excipients: sodium dihydrophosphate monohydrate, sodium hydrophosphate heptahydrate, sodium chloride, water for injections.

Pharmacological properties:

Sodium hyalrunate – natural polysaccharide, a component of the extracellular connective tissue matrix which is a physiological component of intraocular liquid. Osmolarity of the drug GIARAL PLYuS®/NYARAL PLUS® is close to osmolarity of intraocular liquid. During ophthalmologic operations provides effective protection of the bared fabrics, protects endothelial cells of a cornea and promotes preservation of quantity of cells, prevents traumatizing an anterior chamber and other tissues of an eye. Facilitates intra-and postoperative inspection of a retina, providing transparency of a field of vision. Reduces a reactive postoperative hyperemia of a wound and accelerates its healing. The sodium hyalrunate which remained in an eye after operation is removed through trabecular system.

Indications to use:

During surgical interventions in the field of an anterior chamber of an eye, in particular operations for treatment of a cataract (establishment of transplants of a crystalline lens), establishment of transplants of a cornea and operations for glaucoma.

Route of administration and doses:

Surgery of a cataract and implantation of an artificial crystalline lens. From 0,2 to 0,4 ml of the drug GIARAL PLYuS®/NYARAL PLUS® slowly and carefully enter into an anterior chamber of an eye by means of a thin cannula or a needle. The injection can be carried out to or after removal of a crystalline lens. The injection before removal of a crystalline lens has additional benefit as protects a cornea endothelium from an injury. PLUS® GIARAL PLYuS®/NYARAL is also used for a covering of operational tools and a crystalline lens before its implantation. For compensation of losses of drug at surgical intervention it is possible to administer additional amount of the drug.

Filtrational surgery at glaucoma. From 0,3 to 0,5 ml of the drug GIARAL PLYuS®/NYARAL PLUS® are entered slowly and carefully for recovery of an anterior chamber during a trabekuloektomiya. It is possible to carry out an additional injection which will allow liquid to get freely into the site of subconjunctival filtering about the sewn external scleral rag.

Keratoplasty. From 0,2 to 0,6 ml of the drug GIARAL PLYuS®/NYARAL PLUS® enter into an anterior chamber of an eye after removal of a small knot of a cornea. Then on a layer of solution place a donor transplant and fix it on the appropriate place by means of seams.

Features of use:

Careful control of intraocular pressure right after operation is especially important; in case of increase in intraocular pressure it is necessary to apply the corresponding way of treatment.

At the end of operation it is desirable to remove drug by an irrigation as it is possible more carefully.

GIARAL PLYuS®/NYARAL of PLUS®не should be entered into a blood vessel.

To store GIARAL PLYuS®/NYARAL of PLUS®необходимо in the refrigerator and to use after upholding at the room temperature within 30 minutes.

The remains of solution should be deleted by means of the syringe in which it is delivered. After disclosure of the syringe drug can be used only disposable.

If drug is mixed with air, it is necessary to adhere to care that air did not get to a zone behind an iris of the eye.

GIARAL PLYuS®/NYARAL of PLUS®должен to be entered slowly and carefully.

In case of administration of drug in an anterior chamber it should not be overflowed with solution.
Use at pregnancy and feeding by a breast

Researches are absent.

Side effects:

In certain cases increase in intraocular pressure can be observed, and in rare instances there can be an inflammatory reaction, cornea hypostasis, opacification of a cornea, bleeding from an anterior chamber, vascularization of an iris of the eye, insufficiency of conjunctival correction, a mydriasis, a cataract, pain, an itch, blurring of a field of vision, the disturbances connected with compensatory function of a cornea and others.

In rare instances opacification of an artificial  crystalline lens can be observed.

Interaction with other medicines:

GIARAL PLYuS®/NYARAL of PLUS®может to cause sedimentation of quaternary ammonium salts, such as a benzalkoniya chloride and others, and also хлоргексидин. Not to use together with hyaluronidase.

Contraindications:

Hypersensitivity to hyalrunate of sodium or medicines on the basis of proteins.

Overdose:

It is not known.

Storage conditions:

In the place protected from light at a temperature from 2 to 8 ºС. Not to freeze. To store in the place, unavailable to children. Period of validity 3 years. Not to use after the termination of a period of validity.

Issue conditions:

According to the recipe

Packaging:

On 0,85 ml in the filled syringe. On one syringe and one needle, enclosed in the blister from polymeric material. On 1 syringe in a set with a sterile needle in blisters and the instruction about use, enclosed in a cardboard box.