Preservatives are often found in multidose topical ophthalmic medications to ensure their sterility, with Benzalkonium chloride (BAK) being one of the most widely used ophthalmic preservatives and has been linked with surface toxicity in glaucoma patients taking long-term therapies with multiple drops.
Glaucoma medications now come with options without preservatives that may be better tolerated by some patients with dry eye conditions, including Purite and SofZia as alternate preservatives.
Food
If you want to avoid preservatives in your food, the first step should be reading labels. Here, you should find a list of approved chemical additives and their intended use on each package label. Alternatively, visit your country’s public health or agriculture website to understand its policy on additives.
Step two is identifying which additives you want to eliminate from your diet, then scanning label ingredients that contain them. Avoid foods containing propionates, nitrates, ascorbic acid and sulphur dioxide additives as well as heavily processed items like deli meats, canned food sauces and salad dressing.
At its best, it is ideal to prepare meals from scratch and purchase unprocessed grains, fruits, vegetables, nuts and seeds that contain no added sweeteners or additives; you should opt for organic products if possible and shop along the walls of your grocery store for fresh produce, freshly-pressed juice and organic kombucha beverages.
Eye drops
Eye drops are liquid medications designed to be instilled directly into the eyes for various treatments, such as treating conjunctivitis or glaucoma. Preservatives are often added to multidose bottles of eye drops to ensure sterility and extend shelf life once opened; BAK (Benzalkonium chloride) is one such preservative commonly found in these drops and has been known to irritate some patient eye surfaces while potentially leading to corneal damage over time.
Eye drops that do not contain preservatives are available over-the-counter for home use, and can be purchased directly from CVS Health in single use vials to prevent bacteria contamination between uses. For your convenience, this package can be picked up same day at most locations.
If you frequently use eye drops, switching to preservative-free options may be in your best interests for their sake and that of your eyes. Benzalkonium chloride may irritate eye surfaces over time and this may become especially bothersome if you experience severe dry eye syndrome or are using electronic devices for extended periods.
Medications
Many medications used during neuraxial anesthesia contain preservatives to protect them against contamination of catheters and act as antioxidants for their medications, including Marcaine with Epinephrine and Sulfites for intrathecal nebulized drugs such as Amikacin. Preservatives add an additional level of safety by helping avoid infection of catheters while protecting medication itself from degradation over time.
Though benzalkonium chloride (BAK) is commonly found as a preservative in ophthalmic solutions, numerous studies have demonstrated its detrimental effect on glaucoma patients over time. As a result, several new formulations of antiglaucoma medications without BAK have been developed in response to this fact.
The FDA has recently approved several topical glaucoma medications without preservatives, such as Zioptan (tafluprost ophthalmic solution 0.0015%), Cosopt PF (dorzolamide/timolol ophthalmic solution 2%/0.5%) and Timoptic in Ocudose (timolol maleate 0.1% and 0.5%). Unfortunately these options aren’t universally covered by insurance plans; expanding availability will improve patient compliance and satisfaction. Disclaimers: KSL has received grants, travel support as well as lecture/consultancy fees from Thea pharmaceuticals; KSL has received grants, travel support as well as lecture/consultancy fees from Thea pharmaceuticals; see Disclosures section for details.
