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boric acid

S02AA03

Forms & Strengths

0.5% ophthalmic solution (eye drops)
2% ophthalmic solution (eye wash)
5% topical solution for skin
600 mg vaginal capsules (boric acid)
Powder for wound irrigation (10% solution)

Adult Dosing

Eye drops 0.5%: 1‑2 drops into conjunctival sac QID
Eye wash 2%: rinse eyes for 1‑2 min QID
Topical skin: apply 5% solution to affected area BID
Vaginal: 600 mg capsule inserted nightly for 14 days for recurrent candidiasis
Wound irrigation: 10% solution applied once daily

Pediatric Dosing

Eye drops 0.5%: 1 drop QID for children ≥2 yr
Eye wash 2%: rinse eyes for 30 sec QID for children ≥2 yr
Topical skin: 5% solution applied once daily for children >12 kg
Vaginal use not recommended <18 yr
Avoid systemic ingestion; if needed, 0.5% solution 1‑2 drops QID

Indications

Acute bacterial conjunctivitis
Keratitis prophylaxis post‑surgery
Topical antisepsis of minor cuts and abrasions
Vulvovaginal candidiasis (recurrent)
Fungal otitis externa

Mechanism of Action

Weak acid dissociates, penetrates microbial cell wall
Lowers intracellular pH, denatures proteins
Inhibits bacterial and fungal enzyme systems
Creates hostile environment for microorganisms

Contraindications

Known hypersensitivity to boric acid
Corneal ulcer or severe keratitis
Pregnancy (category X) – systemic use
Breastfeeding – avoid vaginal capsules
Children <2 yr for ocular or vaginal use

Adverse Reactions

Burning, stinging, or irritation at application site
Conjunctival hyperemia
Allergic contact dermatitis
Systemic toxicity if ingested: renal failure, metabolic acidosis
Rare corneal edema with prolonged use

Drug Interactions

Concurrent use with other ocular irritants may increase discomfort
May potentiate toxicity of aminoglycoside eye drops
Systemic boric acid may augment nephrotoxic drugs (e.g., NSAIDs)
Avoid simultaneous use with alcohol‑containing ear drops

Curated Content: Needs Vetting Before Put to Clinical Use