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Mydriatics/Cycloplegics
- Mydriatics/Cycloplegics
Prescribing Atropine
Indication
Cycloplegia, Mydriasis, pupil dilation in acute iritis and uveitis, penalization of the healthy eye in amblyopia
Mechanism of Action
Atropine sulfate is a competitive muscarinic acetylcholine receptor antagonist. It blocks the action of acetylcholine, leading to pupil dilation (mydriasis) and paralysis of the ciliary muscle (cycloplegia). This action is utilized in cycloplegic refraction and reducing inflammation in uveitis/iritis.
Available Quantities
2 ml, 5 ml, 15 ml
Dosage/Instructions
For cycloplegia: 1 drop 0.5% to 1% bid for 1 or 2 days before examination. For uveitis/iritis: 1 or 2 drops up to 4 times daily (1% bid typically)Safety Info for Atropine
Pregnancy & Nursing
It is not known whether topically administered atropine sulfate can cause fetal harm
Pediatric Use
≥3 months
Contraindications, side effects, etc.
Contraindications: Allergic reaction to atropine or related compounds. Warnings: Caution in patients with narrow-angle glaucoma. Common Side Effects: Blurred vision, light sensitivity, stinging or burning sensation.Atropine sulfate 0.5%, 1%, 2%ophthalmic solution - Mydriatics/Cycloplegics
Prescribing Atropine Ointment
Indication
Cycloplegic refraction, pupil dilation in acute inflammatory conditions of the iris and uveal tractMechanism of Action
Atropine sulfate is a competitive muscarinic acetylcholine receptor antagonist. It blocks the action of acetylcholine, leading to pupil dilation (mydriasis) and paralysis of the ciliary muscle (cycloplegia). This action is utilized in cycloplegic refraction and reducing inflammation in uveitis/iritis.Available Quantities
3.5 gmDosage/Instructions
For uveitis/iritis: Apply a half-inch strip twice daily. For cycloplegia: Apply a half-inch strip twice daily for 1 to 3 days before examinationSafety Info for Atropine Ointment
Pregnancy & Nursing
Use with caution during pregnancy and nursing; safety profile unknownPediatric Use
≥3 monthsContraindications, side effects, etc.
Contraindications: Allergic reaction to atropine or related compounds. Warnings: Caution in patients with narrow-angle glaucoma. Common Side Effects: Blurred vision, light sensitivity, stinging or burning sensation.Atropine sulfate 1%ophthalmic ointment - Mydriatics/Cycloplegics
Prescribing Cyclogyl®
Indication
Cycloplegic refraction, pupil dilation in acute inflammatory conditions of the iris and uveal tractMechanism of Action
Atropine sulfate is a competitive muscarinic acetylcholine receptor antagonist. It blocks the action of acetylcholine, leading to pupil dilation (mydriasis) and paralysis of the ciliary muscle (cycloplegia). This action is utilized in cycloplegic refraction and reducing inflammation in uveitis/iritis.Available Quantities
2 ml, 5 ml, 15 mlDosage/Instructions
For cycloplegia: 1 drop 1% repeated once in five minutes about 30 minutes before refraction. For infants, 1 drop 0.05% with nasolacrimal pressure for 2-3 minutes. For uveitis/iritis: 1 or 2 drops twice dailySafety Info for Cyclogyl®
Pregnancy & Nursing
Use with caution during pregnancy; animal reproduction studies have not been conductedPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Allergy to cyclopentolate or related drugs. Warnings: Caution in patients with narrow-angle glaucoma and those at risk for increased intraocular pressure. Common Side Effects: Blurred vision, light sensitivity, stinging or burning sensation.Cyclopentolate 0.5%, 1%, 2%ophthalmic solution - Mydriatics/Cycloplegics
Prescribing Homatropine
Indication
Cycloplegic refraction, pupil dilation in acute inflammatory conditions of the iris and uveal tractMechanism of Action
Homatropine sulfate is a competitive muscarinic acetylcholine receptor antagonist. It blocks the action of acetylcholine, leading to pupil dilation (mydriasis) and paralysis of the ciliary muscle (cycloplegia). This action is utilized in cycloplegic refraction and reducing inflammation in uveitis/iritis.Available Quantities
5 mlDosage/Instructions
For uveitis/iritis: 1 or 2 drops of 5% up to every 3 or 4 hours (twice to four times daily is common). For children: 1 drop of 2% twice or three times daily. For cycloplegia: Instill 1 or 2 drops of 2%, repeat in 5 to 10 minutes if necessarySafety Info for Homatropine
Pregnancy & Nursing
Use with caution during pregnancy; animal reproduction studies have not been conductedPediatric Use
≥3 monthsContraindications, side effects, etc.
Contraindications: Allergic reaction to homatropine or related drugs. Warnings: Use with caution in patients with narrow-angle glaucoma. Common Side Effects: Blurred vision, light sensitivity, stinging or burning sensation.Homatropine HBr 2%, 5%ophthalmic solution - Mydriatics/Cycloplegics
Prescribing Mydcombi®
Indication
Induce mydriasis for diagnostic proceduresMechanism of Action
Phenylephrine stimulates the dilator muscle of the iris, causing pupil dilation; Tropicamide blocks the responses of the sphincter muscle of the iris and the ciliary muscle to cholinergic stimulation, causing pupil dilation and paralysis of accommodationAvailable Quantities
2-mL vial in dispenser cartridgeDosage/Instructions
Dosage as directed by a healthcare professionalSafety Info for Mydcombi®
Pregnancy & Nursing
No teratogenicity in rats at clinically relevant dosesPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Hypersensitivity to tropicamide, phenylephrine, or related substances. Warnings: This combination medication may cause transient blurred vision, light sensitivity, and should be used with caution in patients with narrow-angle glaucoma. Common Side Effects: Common side effects include blurred vision, photophobia, stinging or burning sensation, and temporary increases in intraocular pressure.Tropicamide 1%, Phenylephrine Hydrochloride 2.5%ophthalmic spray - Mydriatics/Cycloplegics
Prescribing Mydriacyl®
Indication
Mydriasis, CycloplegiaMechanism of Action
Tropicamide is an antimuscarinic agent that binds to and blocks M4 muscarinic receptors in the iris sphincter and ciliary muscle. This action leads to pupil dilation (mydriasis) and paralysis of accommodation (cycloplegia), facilitating diagnostic procedures and aiding in the management of uveitis.Available Quantities
2, 3, 15 mlDosage/Instructions
1 or 2 drops of 0.5% 15 or 20 minutes before examinationSafety Info for Mydriacyl®
Pregnancy & Nursing
Use with caution during pregnancy; animal reproduction studies have not been conductedPediatric Use
All agesContraindications, side effects, etc.
Contraindications: Hypersensitivity to tropicamide or related drugs. Warnings: Tropicamide may cause temporary blurred vision and sensitivity to light. Prolonged or excessive use should be avoided. Common Side Effects: Common side effects include blurred vision, photophobia (sensitivity to light), stinging or burning sensation, and increased intraocular pressure.Tropicamide 0.5%, 1%ophthalmic solution - Mydriatics/Cycloplegics
Prescribing Paremyd®
Indication
Mydriasis for diagnostic proceduresMechanism of Action
Hydroxyamphetamine causes the release of norepinephrine at the nerve terminal, resulting in mydriasis. Tropicamide blocks the response of the iris sphincter and the ciliary body, aiding in mydriasis and partial cycloplegia. The combination of these two agents provides effective pupil dilation with a slightly less intense effect than tropicamide 1% with phenylephrine 2.5%.Available Quantities
15 mlDosage/Instructions
1 or 2 drops in the conjunctival sacSafety Info for Paremyd®
Pregnancy & Nursing
Use with caution during pregnancy; animal reproduction studies not conducted with ParemydPediatric Use
≥18 yearsContraindications, side effects, etc.
Contraindications: Allergic reaction to hydroxyamphetamine, tropicamide, or related compounds. Warnings: This combination medication may elevate intraocular pressure. Caution is needed in patients with narrow-angle glaucoma. Common Side Effects: Common side effects may include blurred vision, light sensitivity, stinging or burning sensation, and transient increases in intraocular pressure.Hydroxyamphetamine 1%, Tropicamide 0.25%ophthalmic solution - Mydriatics/Cycloplegics
Prescribing Phenylephrine Hydrochloride
Indication
Mydriasis, breaking posterior synechiae, diagnostic test for Horner’s syndromeMechanism of Action
Phenylephrine is an α-1 adrenergic receptor agonist used for dilation of the pupil due to its vasoconstrictor and mydriatic action. Phenylephrine possesses predominantly α-adrenergic effects. In the eye, phenylephrine acts locally as a potent vasoconstrictor and mydriatic, by constricting ophthalmic blood vessels and the radial muscle of the iris.Maximal mydriasis occurs in 20-90 minutes with recovery after 3 to 8 hours.Systemic absorption of sufficient quantities of phenylephrine may lead to systemic α-adrenergic effects, such as rise in blood pressure which may be accompanied by a reflex atropine-sensitive bradycardia.Available Quantities
2 ml, 3 ml, 5 ml, 10 ml, 15 mlDosage/Instructions
Instill 1 drop of 2.5% or 10% solution every 3 to 5 minutes with a max of 3 drops per eye. If <1 year, do not use 10%.Safety Info for Phenylephrine Hydrochloride
Pregnancy & Nursing
No teratogenicity in rats at clinically relevant dosesPediatric Use
All ages (2.5%)Contraindications, side effects, etc.
Contraindications: Allergic reaction to phenylephrine or related compounds. Warnings: Phenylephrine can elevate blood pressure and may increase intraocular pressure. Use cautiously in patients with narrow-angle glaucoma. Common Side Effects: Common side effects include transient blurred vision, photophobia, stinging or burning sensation, and temporary increases in blood pressure and intraocular pressure.Phenylephrine Hydrochloride 2.5%, 10%ophthalmic solution
