- Mydriatics/Cycloplegics
Prescribing Phenylephrine Hydrochloride
Indication
Mydriasis, breaking posterior synechiae, diagnostic test for Horner’s syndrome
Mechanism 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 ml
Dosage/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 doses
Pediatric 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 - Antiglaucoma
Prescribing Pilocarpine
Indication
Lowers IOP in acute angle closure glaucoma. Ineffective at pressures above 40 – 50 mm Hg due to sphincter ischemia. Used postoperatively in laser surgery and for exfoliative glaucoma.Mechanism of Action
Pilocarpine is a muscarinic agent that increases aqueous outflow through the trabecular meshwork by contracting the pupillary and iris sphincter muscles, inducing miosis. It stimulates various exocrine glands and has full and partial agonism at the muscarinic M3 receptor, expressed in smooth muscle cells in the pupillary sphincter and ciliary bodies, leading to increased smooth muscle tone
Available Quantities
15 mlDosage/Instructions
For acute angle closure: 1 drop of 2% solution every 15-60 minutes up to 4 doses, when IOP is below 40-50 mm HgFor children <2 years old, use 1% only.Safety Info for Pilocarpine
Pregnancy & Nursing
Use cautiously during pregnancy; no adequate studies conducted with pilocarpine.
Pediatric Use
≥2 yearsContraindications, side effects, etc.
Contraindications: COPD, peptic ulcer disease, arrhythmias, coronary vascular disease, angle-closure glaucoma, hyperthyroidism. Warnings: May cause difficulty in reading or other vision problems, especially at night. It may also cause some people to become dizzy. Common side effects: Sweating, nausea, runny nose, chills, flushing, frequent urge to urinate, dizziness, weakness, diarrhea, and blurred vision.
Pilocarpine HCL 1%, 2%, 4%ophthalmic solution - Antibiotic
Prescribing Polycin® Ointment
Indication
bacterial conjunctivitis, blepharitisMechanism of Action
Combination inhibits bacterial cell wall synthesis and increases cell membrane permeability, effective against Gram-positive and some Gram-negative bacteria.Available Quantities
3.5 gDosage/Instructions
Apply 1/2 inch ribbon in affected eye(s) 2-3 times/daySafety Info for Polycin® Ointment
Pregnancy & Nursing
Limited data; use only if clearly needed in pregnancy and nursingPediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Hypersensitivity to bacitracin, polymyxin B, or any component of the product. Warnings: Not for use in the eye or in conjunction with other eye medications unless directed by a physician. Common Side Effects: Itching, rash, allergic reactions, and possible overgrowth of nonsusceptible organisms with prolonged use.Bacitracin Zinc and Polymyxin B Sulfateophthalmic ointment - Antibiotic
Prescribing Polytrim®
Indication
bacterial conjunctivitisMechanism of Action
Polymyxin B disrupts bacterial cell membrane, Trimethoprim inhibits folic acid synthesis, effective against a range of bacteria.Available Quantities
10 mlDosage/Instructions
1 drop in affected eye(s) every 3 hours, up to 6 times dailySafety Info for Polytrim®
Pregnancy & Nursing
Limited data; use with caution in pregnancy and nursingPediatric Use
>2 monthsContraindications, side effects, etc.
Contraindications: Allergy to polymyxin B or trimethoprim. Not for use in children <2 months. Warnings: Use caution when driving or performing tasks requiring clear vision. Common Side Effects: Eye irritation, burning, stinging, itching, serious side effects include severe discomfort and signs of infection.Polymyxin B and Trimethoprimophthalmic solution - Steroid
Prescribing Pred Forte®
Indication
Steroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globeMechanism of Action
Suppresses inflammatory response, delays or slows healingAvailable Quantities
5ml, 10ml, 15mlDosage/Instructions
1-2 drops 2-4 times/daySafety Info for Pred Forte®
Pregnancy & Nursing
Teratogenic in mice at normal human ophthalmic dosePediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Hypersensitivity to prednisolone or related corticosteroids. Contraindicated in patients with untreated bacterial, fungal, or viral eye infections. Warnings: Prednisolone acetate is a corticosteroid and may increase the risk of elevated intraocular pressure, cataracts, and secondary eye infections. It should be used cautiously and under supervision. Common Side Effects: Common side effects include increased eye pressure, eye discomfort, and transient blurred vision.Prednisolone Acetate 1.0%ophthalmic suspension - Antibiotic/Steroid
Prescribing Pred-G®
Indication
Steroid-responsive inflammatory conditions with superficial bacterial infection or risk thereofMechanism of Action
Aminoglycosides inhibit bacterial protein synthesis. Corticosteroids inhibit arachidonic acid release, reducing inflammation. Extended use may increase risk of glaucoma and cataractsAvailable Quantities
5 mlDosage/Instructions
Up to 1 drop every hour for the first 24-48 hours, then 1 drop 2-4 times dailySafety Info for Pred-G®
Pregnancy & Nursing
Systemic use during pregnancy can cause fetal hearing loss, limited ophthalmic use is unlikely to cause harm. Fetal harm shown in rats at 500x the ophthalmic human dosePediatric Use
No studiesContraindications, side effects, etc.
Contraindicated in most viral diseases of the cornea and conjunctiva, mycobacterial infection, and fungal diseases of ocular structures. May cause increased intraocular pressure, cataract formation, delayed healing, and secondary ocular infections.Gentamicin sulfate 0.3%, prednisolone acetate 1%ophthalmic solution - Antibiotic/Steroid
Prescribing Pred-G® Ointment
Indication
Ocular surface and palpebral conjunctival inflammation where a risk of bacterial infection existsMechanism of Action
Aminoglycosides inhibit bacterial protein synthesis. Corticosteroids inhibit arachidonic acid release, reducing inflammation. Extended use may increase risk of glaucoma and cataractsAvailable Quantities
3.5gDosage/Instructions
1/2″ ribbon, one to three times dailySafety Info for Pred-G® Ointment
Pregnancy & Nursing
Systemic use of gentamycin can cause fetal hearing loss. Prednisolone is teratogenic in mice at 1-10 times the human ocular dosePediatric Use
No studiesContraindications, side effects, etc.
Contraindicated in most viral diseases of the cornea and conjunctiva, mycobacterial infection, and fungal diseases of ocular structures. May cause increased intraocular pressure, cataract formation, delayed healing, and secondary ocular infections.gentamicin sulfate 0.3%, prednisolone acetate 1%ophthalmic ointment - Steroid
Prescribing Prednisone
Indication
Anterior uveitis, intermediate and posterior uveitisMechanism of Action
Inhibits phospholipase, reducing arachidonic acid and inflammatory mediatorsAvailable Quantities
1, 2.5, 5, 10, 20, 50 mg tabletsDosage/Instructions
Anterior uveitis: 10-20 mg orally twice daily for 5 days; Posterior/panuveitis: Up to 30 mg orally twice dailySafety Info for Prednisone
Pregnancy & Nursing
Teratogenic in many species in doses equivalent to the human dose; no well-controlled human studiesPediatric Use
≥1 monthContraindications, side effects, etc.
Contraindications: Hypersensitivity to prednisone or related corticosteroids. Contraindicated in patients with systemic fungal infections and certain medical conditions such as live vaccines during therapy. Warnings: Prednisone is a systemic corticosteroid with various potential side effects. It should be used cautiously and under the guidance of a healthcare professional. Common Side Effects: Common side effects may include increased appetite, weight gain, mood changes, and potential systemic side effects depending on the dose and duration of use.Prednisoneoral tablet - NSAID
Prescribing Prolensa®
Indication
Treatment of inflammation and reduction of ocular pain post cataract extractionMechanism of Action
Inhibits prostaglandin synthesis by blocking cyclooxygenase (COX) 1 and 2Available Quantities
1.6ml, 3mlDosage/Instructions
1 drop daily beginning 24 hours before cataract surgery, repeat the day of surgery, and then 2 weeks post surgerySafety Info for Prolensa®
Pregnancy & Nursing
Limited data available; potential risks to the fetus or nursing infant not well establishedPediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Hypersensitivity to bromfenac or related NSAIDs. It is also contraindicated in patients with a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Warnings: Bromfenac may cause stinging or burning upon instillation and may temporarily blur vision. Systemic absorption can occur, potentially leading to systemic side effects. Prolonged use should be avoided. Common Side Effects: Common side effects include stinging or burning sensation, transient blurred vision, and increased redness in the eye.Bromfenac Solution 0.07%ophthalmic solution - Aesthetics/Presbyopia
Prescribing Qlosi®
Indication
Treatment of Presbyopia in adults.Mechanism of Action
Pilocarpine hydrochloride is a cholinergic muscarinic agonist which activates muscarinic receptors located at smooth muscles such as the iris sphincter muscle and ciliary muscle. QLOSI contracts the iris sphincter muscle, constricting the pupil to enhance the depth of focus and improve near visual acuity while maintaining some pupillary response to light.Available Quantities
30 pack of 0.4mL single-use vialsDosage/Instructions
Instill one drop of QLOSI in each eye. This can be repeated a second time after 2 to 3 hours for an effect up to 8 hours. QLOSI can be administered on a daily basis, or as needed, up to twice each day.Safety Info for Qlosi®
Pregnancy & Nursing
There are no adequate and well-controlled studies of QLOSI administration in pregnant women to inform a drug associated risk. Oral administration of pilocarpine to pregnant rats throughout organogenesis and lactation did not produce adverse effects at clinically relevant doses.Pediatric Use
≥45 yearsContraindications, side effects, etc.
Advise patients to not drive or operate machinery if vision is not clear (e.g., blurred vision). Exercise caution in night driving and other hazardous occupations in poor illumination. Rare cases of retinal detachment have been reported with miotics. Examination of the retina is advised in all patients prior to initiation of therapy. Advise patients to seek immediate medical care with sudden onset of flashes of lights, floaters, or vision loss. QLOSI is not recommended to be used when iritis is present. QLOSI should not be administered while wearing contact lenses. Remove lenses prior to the installation of QLOSI and wait 10 minutes before reinsertion. Avoid touching the tip of the vial to the eye or any other surface. Contraindicated in cases of hypersensitivity to any ingredients.pilocarpine hydrochlorideophthalmic solution - Antibiotic
Prescribing Quixin®
Indication
bacterial conjunctivitisMechanism of Action
Inhibits DNA gyrase and topoisomerase IV, effective against various Gram-positive and Gram-negative bacteria.Available Quantities
5 mlDosage/Instructions
1-2 drops in affected eye(s) every 2 hours, up to 8 times dailySafety Info for Quixin®
Pregnancy & Nursing
Limited data; use with caution during pregnancy and nursingPediatric Use
≥1 yearContraindications, side effects, etc.
Contraindications: Hypersensitivity to quinolones. Warnings: Caution in tasks requiring clear eyesight, avoid contact lenses unless advised by a doctor. Common Side Effects: Eye-related issues like blurred vision, ocular pain, burning, photophobia; General: Headache, taste disturbances.Levofloxacin 0.5%ophthalmic solution - Dry Eye/OSD
Prescribing Restasis®
Indication
Increase tear production in keratoconjunctivitis sicca due to ocular inflammationMechanism of Action
Cyclosporine is a calcineurin inhibitor immunosuppressant. It modulates T-cell function and increases goblet cell density in the conjunctiva, contributing to increased tear production and decreased ocular inflammation in dry eye disease.Available Quantities
0.4 ml vials (30 or 60 vials per tray), 5.5 ml in 10 ml bottleDosage/Instructions
1 drop twice daily, 12 hours apart (Shake emulsion)Safety Info for Restasis®
Pregnancy & Nursing
Category C. Teratogenic in rats at 5000x the human dose. Use cautiously during pregnancyPediatric Use
≥16 yearsContraindications, side effects, etc.
Contraindications: Known hypersensitivity to cyclosporine or any of the ingredients in the formulation. Warnings/Precautions: Not recommended for use in patients with active ocular infections or with a history of herpes viral infections of the eye. Contact lens wearers should remove lenses prior to application and wait 15 minutes before reinsertion. Common Side Effects: Ocular burning, conjunctival hyperemia, discharge, epiphora, eye pain, foreign body sensation, pruritus, stinging, and visual disturbance.Cyclosporine 0.05%ophthalmic emulsion - Antiglaucoma
Prescribing Rhopressa®
Indication
Indicated for lowering IOP with open-angle glaucoma or ocular hypertensionMechanism of Action
Rhopressa® is an effective inhibitor of Rho kinase and a noradrenaline transporter that may relax the trabecular meshwork, increase the outflow of aqueous humor, reduce scleral venous pressure, and directly decrease IOP.Available Quantities
2.5mlDosage/Instructions
1 drop in the eveningSafety Info for Rhopressa®
Pregnancy & Nursing
Rat embryofetal lethality was shown at 126X normal human dose but not at 40X.Pediatric Use
No studiesContraindications, side effects, etc.
Warnings: May cause eye discomfort, redness, tearing, temporary blurred vision, eyelid redness, or corneal staining. Common side effects: Conjunctival hyperemia, corneal verticillata, instillation site pain, and conjunctival hemorrhage.netarsudil dimesylate 0.02%ophthalmic solution - Antiglaucoma
Prescribing Rocklatan®
Indication
Indicated for lowering IOP with open-angle glaucoma or ocular hypertensionMechanism of Action
Netarsudil inhibits Rho kinase, which is believed to reduce the production of aqueous humor. Latanoprost, a prostaglandin F2α analogue, increases the outflow of aqueous humor.Available Quantities
2.5mlDosage/Instructions
1 drop in the affected eye(s) once daily in the eveningSafety Info for Rocklatan®
Pregnancy & Nursing
Embryofetal lethality in rabbits was demonstrated at 80x the normal human dose but not at 15x.Pediatric Use
No studiesContraindications, side effects, etc.
Warnings: May cause eye discomfort/redness/itching, increased tears, temporary blurred vision, changes in eyelash number/color/length/thickness, eyelid changes/skin darkening, or corneal staining. Common side effects: Unusual redness or swelling of the eyes/eyelids.netarsudil 0.02%, latanoprost 0.005%ophthalmic solution - Diagnostic Dye
Prescribing Rose Bengal
Indication
Diagnosis of ocular surface disease, dry eye syndromes, corneal and conjunctival lesionsMechanism of Action
Stains devitalized cells, mucus, and corneal nerves; photoreactive, generating singlet oxygen; stains healthy cells in a dose-dependent manner. Potential for toxicity/cell death especially with light exposure. Commonly used to identify viral dendrites, but antiviral activity may make it an ineffective choice for identifying suspected herpetic uclers.Available Quantities
Sterile impregnated paper stripsDosage/Instructions
To insure full fluorescence and patient comfort, the impregnated tip should be moistened before application. 1 or 2 drops of sterile irrigating or saline solution should be used for this purpose. Touch conjunctiva or fornix as required with moistened tip. It is recommended that the patient blink several times after application.Safety Info for Rose Bengal
Pregnancy & Nursing
Limited data; potential risks to the fetus not well establishedPediatric Use
All agesContraindications, side effects, etc.
ommon Side Effects: Can include local irritation and discomfort.Rose Bengalophthalmic strip - Misc.
Prescribing Ryzumvi®
Indication
Treatment of pharmacologically-induced mydriasis produced by adrenergic agonists (e.g., phenylephrine) or parasympatholytic (e.g., tropicamide) agents.Mechanism of Action
Ryzumvi is a relatively non-selective alpha-1 and alpha-2 adrenergic antagonist. Dilation of the pupil is primarily controlled by the radial iris dilator muscles surrounding the pupil; these muscles are activated by the alpha-1 adrenergic receptors. Phentolamine reversibly binds to these receptors on the iris dilator muscle, thereby reducing pupil diameter. Phentolamine directly antagonizes the mydriatic effect of an α-1 adrenergic agonist, and indirectly reverses mydriasis induced by muscarinic antagonist effects on the iris sphincter muscle.Available Quantities
30 single use 0.31 mL vialsDosage/Instructions
• Adults and pediatric patients aged 12 years and older: Instill 1 to 2 drops in each dilated eye following the completion of the ophthalmic examination or procedure to reverse mydriasis. (2) • Pediatric patients aged 3 to 11 years: Instill 1 drop in each dilated eye following the completion of the ophthalmic examination or procedure to reverse mydriasis.Safety Info for Ryzumvi®
Pregnancy & Nursing
There are no available data with Ryzumvi administration in pregnant women to inform a drug-associated risk. In animal toxicology studies, when phentolamine was administered orally to pregnant mice and rats during the period of organogenesis skeletal immaturity and decreased growth was observed in the offspring at doses at least 24-times the recommended clinical dose. Additionally, a lower rate of implantation was seen in pregnant rats treated with phentolamine administered at least 60- times the recommended clinical dose. No malformations or embryofetal deaths were observed in the offspring of pregnant mice, rats, and rabbits administered phentolamine during the period of organogenesis at doses of at least 24-, 60-, and 20-times, respectively, the recommended clinical dose. There is no information regarding the presence of phentolamine in human milk, the effects on the breastfed infants, or the effects on milk production during lactation to inform risk of phentolamine ophthalmic solution 0.75% to an infant.Pediatric Use
≥3 yearsContraindications, side effects, etc.
Uveitis: Ryzumvi is not recommended to be used in patients with active ocular inflammation.phentolamine 0.75%ophthalmic solution - Antiglaucoma
Prescribing Simbrinza®
Indication
Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertensionMechanism of Action
Brinzolamide inhibits carbonic anhydrase II in the ciliary processes, which is believed to slow the formation of bicarbonate ions. This reduction leads to decreased sodium and fluid transport, subsequently lowering aqueous humor secretion and reducing intraocular pressure. Brimonidine is a clonidine derivative and a relatively selective α2 adrenergic receptor agonist. It reduces intraocular pressure by decreasing aqueous humor production and increasing uveoscleral outflow. The inhibition of adenylate cyclase leads to reduced cAMP, which modulates aqueous humor dynamics.Available Quantities
8 mLDosage/Instructions
1 drop in the affected eye(s) 3 times dailySafety Info for Simbrinza®
Pregnancy & Nursing
Rabbit studies showed maternal toxicity and fetal abnormalities at 120X the normal human dose. There are no adequate and well-controlled studies in pregnant women. Use cautiously during pregnancy.Pediatric Use
≥2 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to any component of this product. Warnings: May cause fatigue and/or drowsiness in some patients. Use with caution in patients with depression, cerebral or coronary insufficiency, Raynaud’s phenomenon, orthostatic hypotension, or thromboangiitis obliterans. Common Side Effects: Eye discomfort/itching/redness/discharge, temporary blurred vision, dry eyes, feeling as if something is in your eye, dry mouth, bitter/sour/unusual taste in mouth.Brinzolamide 1%/brimonidine tartrate 0.2%ophthalmic suspension - Injections/Infusions
Prescribing Tepezza®
Indication
Treatment of Thyroid Eye DiseaseMechanism of Action
Binds to IGF-1R and blocks its activation and signaling.Available Quantities
500 mg/vialDosage/Instructions
Initial dose: 10 mg/kg intravenous infusion, followed by 20 mg/kg every three weeks for 7 additional infusions.Safety Info for Tepezza®
Pregnancy & Nursing
No adequate and well-controlled studies in pregnant women. Animal studies showed external and skeletal abnormalities at clinically relevant doses.Pediatric Use
≥18 yearsContraindications, side effects, etc.
Warnings: possible infusion reactions, exacerbation of inflammatory bowel disease (IBD), and elevated blood sugar levels. It may cause severe hearing problems, including permanent hearing loss. Common side effects include muscle cramps, nausea, hair loss, diarrhea, fatigue, high blood sugar, hearing issues, taste changes, headaches, dry skin, weight loss, nail problems, and menstrual changes.Teprotumumab-trbwintravenous infusion - Local Anesthetic
Prescribing Tetcaine®, Opticaine®
Indication
Topical anesthesia for ocular proceduresMechanism of Action
Blocks sodium ion channels required for initiation and conduction of neuronal impulsesAvailable Quantities
VariesDosage/Instructions
1 drop topically in the eye as neededSafety Info for Tetcaine®, Opticaine®
Pregnancy & Nursing
Limited data; potential risks to the fetus not well establishedPediatric Use
≥1 monthContraindications, side effects, etc.
Contraindications: Should not be used in patients with hypersensitivity to any component of this preparation. Warnings/Precautions: Not for injection or intraocular use; may damage corneal endothelial cells if used intracamerally. Prolonged use or abuse can lead to corneal epithelial toxicity, potentially resulting in permanent corneal damage. After using the anesthetic, patients should avoid touching their eye for 10-20 minutes to prevent accidental injuries. Common Side Effects: Transient stinging, burning, conjunctival redness, eye irritation, eye pain, and ocular discomfort.Tetracaine Hydrochloride 0.5%ophthalmic solution - Antiglaucoma
Prescribing Timoptic XE®
Indication
Elevated intraocular pressure in ocular hypertension or open-angle glaucomaMechanism of Action
Reduces aqueous formation by blocking beta2 receptors on nonpigmented ciliary epithelium. Reduces elevated and normal intraocular pressure.Available Quantities
2.5 ml, 5 mlDosage/Instructions
1 drop 0.25% or 0.5% every morningSafety Info for Timoptic XE®
Pregnancy & Nursing
Increased fetal resorptions in rabbits at high doses. Use only if the potential benefit justifies the potential risk to the fetus.Pediatric Use
No studiesContraindications, side effects, etc.
Contraindicated in asthma, severe COPD, sinus bradycardia, heart block greater than first degree, cardiac failure, cardiogenic shock. Warnings include systemic absorption, cardiac failure, vascular insufficiency, obstructive pulmonary disease, diabetes mellitus, thyrotoxicosis, choroidal detachment. Adverse reactions: ocular burning, stinging, blepharoconjunctivitis, heart rate and blood pressure decrease, iridocyclitis, headache, ataxia, dizziness, lethargy, urticaria, pruritus.Timolol Maleate 0.25% or 0.5%ophthalmic gel forming solution - Antiglaucoma
Prescribing Timoptic®
Indication
Lowering of intraocular pressure in patients with open-angle glaucoma or ocular hypertensionMechanism of Action
Timolol is a non-selective beta-adrenergic receptor blocker that reduces intraocular pressure by decreasing the production of aqueous humor in the ciliary bodyAvailable Quantities
5 ml, 10 ml, 15 ml, 60 ct 0.2 ml vialsDosage/Instructions
1 drop in the affected eye(s) twice daily Also commonly dosed 1 drop every morning (0.5%).Safety Info for Timoptic®
Pregnancy & Nursing
Use cautiously during pregnancy. No adequate and well-controlled studies in pregnant women.Pediatric Use
No studiesContraindications, side effects, etc.
Contraindicated in asthma, severe COPD, sinus bradycardia, heart block greater than first degree, cardiac failure, cardiogenic shock. Warnings include systemic absorption, cardiac failure, vascular insufficiency, obstructive pulmonary disease, diabetes mellitus, thyrotoxicosis, choroidal detachment. Adverse reactions: ocular burning, stinging, blepharoconjunctivitis, heart rate and blood pressure decrease, iridocyclitis, headache, ataxia, dizziness, lethargy, urticaria, pruritus.Timolol Maleate 0.25% or 0.5%ophthalmic solution - Antibiotic/Steroid
Prescribing Tobradex ST®
Indication
Indicated for steroid-responsive inflammatory conditions with superficial bacterial infection or risk thereofMechanism of Action
Aminoglycosides inhibit bacterial protein synthesis. Corticosteroids inhibit arachidonic acid release, reducing inflammation. Xanthan gum allows reduction of dexamethasone concentration to 0.05% without reducing efficacy. Extended use may increase risk of glaucoma and cataractsAvailable Quantities
2.5 ml, 5 ml, 10 mlDosage/Instructions
1 or 2 drops every 4-6 hours, every 2 hours for the first 24 or 48 hours if needed, then taperSafety Info for Tobradex ST®
Pregnancy & Nursing
Category C. Ocular administration of dexamethasone is teratogenic in rabbitsPediatric Use
≥2 yearsContraindications, side effects, etc.
Contraindicated in most viral diseases of the cornea and conjunctiva, mycobacterial infection, and fungal diseases of ocular structures. May cause increased intraocular pressure, cataract formation, delayed healing, and secondary ocular infections.Tobramycin 0.3%, Dexamethasone 0.05%ophthalmic suspension - Antibiotic/Steroid
Prescribing Tobradex®
Indication
Indicated for steroid-responsive inflammatory conditions with superficial bacterial infection or risk thereofMechanism of Action
Aminoglycosides inhibit bacterial protein synthesis. Corticosteroids inhibit arachidonic acid release, reducing inflammation. Extended use may increase risk of glaucoma and cataractsAvailable Quantities
2.5 ml, 5 ml, 10 mlDosage/Instructions
1 or 2 drops every 4-6 hours, every 2 hours for the first 24 or 48 hours if needed, then taperSafety Info for Tobradex®
Pregnancy & Nursing
Ocular administration of 0.1% dexamethasone is teratogenic in rabbits. Caution advised in severe or unresponsive keratitis as steroids can exacerbate many nonbacterial infectionsPediatric Use
≥2 years ≥2 years≥2 years≥2 years≥2 years≥2 years≥2 years≥2 years≥2 years≥2 years≥2 yearsContraindications, side effects, etc.
Contraindicated in most viral diseases of the cornea and conjunctiva, mycobacterial infection, and fungal diseases of ocular structures. May cause increased intraocular pressure, cataract formation, delayed healing, and secondary ocular infections.Tobramycin 0.3%, Dexamethasone 0.1%ophthalmic suspension - Antibiotic/Steroid
Prescribing Tobradex® Ointment
Indication
Indicated for steroid-responsive inflammatory conditions with superficial bacterial infection or risk thereofMechanism of Action
Aminoglycosides prevent bacterial protein synthesis. Corticosteroids inhibit arachidonic acid release, reducing inflammation. Extended use may increase risk of glaucoma and cataractsAvailable Quantities
3.5 gm tubeDosage/Instructions
1/2″ ribbonSafety Info for Tobradex® Ointment
Pregnancy & Nursing
Ocular administration of 0.1% dexamethasone has shown teratogenic effects in animal studies. Use with caution in pregnancyPediatric Use
≥2 yearsContraindications, side effects, etc.
Contraindicated in most viral diseases of the cornea and conjunctiva, mycobacterial infection, and fungal diseases of ocular structures. May cause increased intraocular pressure, cataract formation, delayed healing, and secondary ocular infections.Tobramycin 0.3%, Dexamethasone 0.1%ophthalmic ointment - Antibiotic
Prescribing Tobrex®
Indication
bacterial conjunctivitis, bacterial keratitisMechanism of Action
Inhibits bacterial protein synthesis by binding to 30S ribosomal subunit, effective against various Gram-negative and some Gram-positive bacteria.Available Quantities
5 mlDosage/Instructions
1-2 drops in affected eye(s) every 4 hoursSafety Info for Tobrex®
Pregnancy & Nursing
Use with caution in pregnancy and nursing; not well studiedPediatric Use
>2 monthsContraindications, side effects, etc.
Contraindications: Allergy to tobramycin, viral or fungal eye infection. Not for use in children <2 months. Warnings: Impaired vision and reactions, avoid contact lenses. Common Side Effects: Eye itching or redness, mild burning, stinging, irritation, itchy or puffy eyelids, blurred vision.Tobramycin 0.3%ophthalmic solution - Antibiotic
Prescribing Tobrex® Ointment
Indication
bacterial conjunctivitis, blepharitisMechanism of Action
Inhibits protein synthesis by binding to 30S ribosomal subunit of bacteria, effective against various Gram-negative and some Gram-positive bacteria.Available Quantities
3.5 gDosage/Instructions
Apply 1/2 inch ribbon in the affected eye(s) 2-3 times/daySafety Info for Tobrex® Ointment
Pregnancy & Nursing
Use with caution in pregnancy and nursing; not well studiedPediatric Use
>2 monthsContraindications, side effects, etc.
Contraindications: Allergy to tobramycin, viral or fungal eye infection. Not for use in children <2 months. Warnings: Impaired vision and reactions, avoid contact lenses. Common Side Effects: Eye itching or redness, mild burning, stinging, irritation, itchy or puffy eyelids, blurred vision.Tobramycin 0.3%ophthalmic ointment - Antiglaucoma
Prescribing Travatan Z®
Indication
Lowering IOP in open-angle glaucoma or ocular hypertension, for those intolerant or insufficiently responsive to other IOP lowering medicationsMechanism of Action
Travoprost free acid, a selective FP prostanoid receptor agonist, is believed to reduce IOP by increasing uveoscleral outflow.Available Quantities
2.5 ml, 5 mlDosage/Instructions
1 drop in the affected eye(s) once daily in the eveningSafety Info for Travatan Z®
Pregnancy & Nursing
Embryo-fetal lethality shown in rats with low dose subcutaneous injections. Use only if the potential benefit justifies the potential risk to the fetus.Pediatric Use
≥16 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to dorzolamide. Warnings: Use with caution in patients with renal impairment or a history of kidney stones. Common Side Effects: Temporary blurred vision, temporary burning/stinging/itching/redness of the eye, watery eyes, dry eyes, sensitivity of eyes to light, bitter taste, or headacheTravoprost 0.004%ophthalmic solution - Antiglaucoma
Prescribing Travatan®
Indication
Lowering IOP in open-angle glaucoma or ocular hypertension, for those intolerant or insufficiently responsive to other IOP lowering medicationsMechanism of Action
Believed to increase uveoscleral aqueous outflow.Available Quantities
2.5 ml, 5 mlDosage/Instructions
1 drop in the affected eye(s) every eveningSafety Info for Travatan®
Pregnancy & Nursing
Embryo-fetal lethality shown in rats with low dose subcutaneous injections. Use only if the potential benefit justifies the potential risk to the fetus.Pediatric Use
≥16 yearsContraindications, side effects, etc.
Contraindications: Hypersensitivity to travoprost or any inactive ingredients. Warnings: May cause a gradual change in the color of your eyes or eyelids and lashes, usually an increase in brown pigment. Changes may be permanent even after your treatment ends. Common Side Effects: Eye swelling, redness, severe discomfort, crusting or drainage (may be signs of infection); red, swollen, or itchy eyelids; increased sensitivity to light; vision changes; severe burning, stinging, or irritation after using this medicine.Travoprost 0.004%ophthalmic solution - Antiglaucoma
Prescribing Trusopt®
Indication
Elevated intraocular pressure in patients with ocular hypertension or open-angle glaucomaMechanism of Action
Inhibits carbonic anhydrase in the ciliary processes of the eye, decreasing aqueous humor secretion, reducing intraocular pressureAvailable Quantities
10 mLDosage/Instructions
1 drop in the affected eye(s) 3 times dailySafety Info for Trusopt®
Pregnancy & Nursing
No adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.Pediatric Use
≥3 monthsContraindications, side effects, etc.
Warnings: May cause eye discomfort/redness/itching, increased tears, temporary blurred vision, changes in eyelash number/color/length/thickness, eyelid changes/skin darkening, or corneal staining. Common side effects: Unusual redness or swelling of the eyes/eyelids.Dorzolamide 2%ophthalmic solution - Analgesics & Anesthetics
Prescribing Tylenol 3®
Indication
Management of mild to moderate pain, including post-operative pain following ocular surgeryMechanism of Action
Acetaminophen is thought to work by reducing the production of prostaglandins in the brain. Codeine is an opioid that alters the perception and response to pain by binding to opioid receptors in the CNSAvailable Quantities
VariesDosage/Instructions
The usual adult dosage is 1 or 2 tablets every 4 to 6 hours as needed for pain. Do not exceed 4 grams of acetaminophen per daySafety Info for Tylenol 3®
Pregnancy & Nursing
Use during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. Caution should be exercised when administered to a nursing womanPediatric Use
≥12 yearsContraindications, side effects, etc.
Contraindications: Not suitable for those with a hypersensitivity to any of the ingredients. Warnings/Precautions: Risk of opioid addiction, abuse, and misuse; life-threatening respiratory depression; ultra-rapid metabolism of codeine, particularly in children and post-tonsillectomy/adenoidectomy patients; neonatal opioid withdrawal syndrome when used during pregnancy. Common Side Effects: Drowsiness, dizziness, nausea, vomiting, constipation, abdominal pain, and respiratory depression.Acetaminophen 300 mg, Codeine 30 mgoral tablet - Dry Eye/OSD
Prescribing Tyrvaya®
Indication
Treatment of the signs and symptoms of dry eye diseaseMechanism of Action
Tyrvaya activates the trigeminal parasympathetic pathway, resulting in increased tear production. It is a partial nicotinic acetylcholine receptor agonist of α4β2, α4α6β2, α3β4, and α3α5β4 receptors and a full α7 receptor agonist.Available Quantities
Carton contains 2 spray bottles – 4.2ml each (60 sprays per bottle)Dosage/Instructions
1 spray in each nostril twice dailySafety Info for Tyrvaya®
Pregnancy & Nursing
At high doses (4864 times the normal dose), rats exhibited reduced body weight. Use cautiously during pregnancyPediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Allergic reactions to varenicline or other ingredients in the formulation. Warnings/Precautions: Patients should inform their healthcare provider if they are pregnant, planning a pregnancy, or breastfeeding. The medication is for nasal use only. Common Side Effects: Sneezing, cough, throat irritation, nose irritation. Most side effects are mild, and less than 2% of patients in clinical trials discontinued treatment due to side effects.0.6 mg/mL (0.06%) varenicline solutionnasal spray - Analgesics & Anesthetics
Prescribing Ultracet®
Indication
Short-term (five days or less) management of acute painMechanism of Action
Tramadol is a centrally acting synthetic opioid analgesic that binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin, which may contribute to its analgesic effects. Acetaminophen is a non-opioid, non-salicylate analgesic and antipyretic. It works by inhibiting the synthesis of prostaglandins in the central nervous system and peripherally blocking pain impulse generation, producing antipyresis from inhibition of the hypothalamic heat-regulating centerAvailable Quantities
37.5mg tramadol and 325mg acetaminophenDosage/Instructions
2 tablets every 4 to 6 hours as needed for pain relief up to a maximum of 8 tablets per daySafety Info for Ultracet®
Pregnancy & Nursing
Use during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. Caution should be exercised when administered to a nursing womanPediatric Use
≥12 yearsContraindications, side effects, etc.
Contraindications: Allergies to tramadol or acetaminophen, severe respiratory issues, drug dependence, concurrent use of MAOIs, and gastrointestinal blockage. Warnings/Precautions: Doctors should be aware of potential addiction risks, respiratory depression, and the need for liver function monitoring. Patients with a history of seizures or those at risk should be closely monitored. Be cautious about potential serotonin syndrome when used with other serotonin-increasing medications. Common Side Effects: Nausea, dizziness, constipation, headache, and drowsiness are common side effects of Ultracet.Tramadol and Acetaminophenoral tablet - Analgesics & Anesthetics
Prescribing Ultram®
Indication
Management of moderate to moderately severe pain, including post-operative pain following ocular surgeryMechanism of Action
Tramadol and its active metabolite bind to μ-opioid receptors. Tramadol also affects the reuptake of norepinephrine and serotoninAvailable Quantities
VariesDosage/Instructions
Start at 25 mg/day and titrate in 25 mg increments as separate doses every 3 days to reach 100 mg/day (25 mg four times a day). Thereafter the total daily dose may be increased by 50 mg as tolerated every 3 days to reach 200 mg/day (50 mg four times a day). For ophthalmic applications such as iritis and corneal abrasion, 25 to 50mg every 4 to 6 hours, not to exceed 400mg daily. May be increased to 100mg every 6 hoursSafety Info for Ultram®
Pregnancy & Nursing
Use during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. Caution should be exercised when administered to a nursing womanPediatric Use
≥12 yearsContraindications, side effects, etc.
Contraindications: Severe breathing problems, blockages in the stomach or intestines, recent use of alcohol, sedatives, tranquilizers, narcotic medication, or MAO inhibitors. Warnings/Precautions: Risk of addiction, abuse, misuse, and life-threatening respiratory depression. Avoid using in patients with increased intracranial pressure, head injury, or in those prone to seizure. Caution advised in patients with renal or hepatic impairment, and those with a history of drug or alcohol dependence. Common Side Effects: Constipation, nausea, vomiting, dizziness, drowsiness, and headache.Tramadol Hydrochlorideoral tablet - Aesthetics/Presbyopia
Prescribing Upneeq®
Indication
Treatment of acquired blepharoptosis in adultsMechanism of Action
Targets adrenoreceptors in Mueller’s muscle of the eyelid, causing elevation of the upper eyelid.Available Quantities
30 and 45 single patient-use containersDosage/Instructions
Instill 1 drop into 1 or both ptotic eye(s) once daily. Discard the single patient-use container immediately after dosing. Contact lenses should be removed prior to instillation and may be reinserted 15 minutes following administration.Safety Info for Upneeq®
Pregnancy & Nursing
No data on use in pregnant women. Animal studies showed no adverse developmental effects at clinically relevant doses.Pediatric Use
≥13 yearsContraindications, side effects, etc.
Contraindications: Information not available. Warnings: Information not available. Side Effects: Less common side effects include blurred vision, painful irritation of the eye, redness of the white part of the eyes or the inside of the eyelids. Other side effects include dry eye, headache, and pain at the instillation site.Oxymetazoline Hydrochloride 0.1%ophthalmic solution - Antiviral
Prescribing Valtrex®
Indication
Herpes zoster ophthalmicus, herpes simplex ophthalmicusMechanism of Action
Inhibits viral DNA polymerase, preventing viral replication.Available Quantities
500 mg, 1000 mg tabletsDosage/Instructions
HSV: Take 1 1000 mg tablet 3 times daily for 7 days HZV: Take 1 500 mg tablet 3 times daily for 7 daysSafety Info for Valtrex®
Pregnancy & Nursing
Limited data; use with cautionPediatric Use
No studiesContraindications, side effects, etc.
Contraindications: Allergy to valacyclovir or acyclovir. Common Side Effects: Nausea, stomach pain, headache. Serious side effects can include allergic reactions, kidney problems, and effects on red blood cells like fever, easy bruising or bleeding, pale skin. It may harm the kidneys, especially when used with other medicines that can harm the kidneys. Patients with HIV/AIDS, kidney disease, or those who have had a kidney or bone marrow transplant should use it with caution.valcycloviroral tablet - Antibiotic/Steroid
Prescribing Vasocidin®
Indication
Indicated for ocular surface inflammation where superficial bacterial infection or risk thereof existsMechanism of Action
Sulfonamides inhibit bacterial folate synthesis. Corticosteroids inhibit the release of arachidonic acid, reducing inflammationAvailable Quantities
5 mlDosage/Instructions
2 drops every 4 hours, evaluate after 2 days, then taperSafety Info for Vasocidin®
Pregnancy & Nursing
Prednisolone is teratogenic in animals at the normal human ophthalmic dosePediatric Use
≥6 yearsContraindications, side effects, etc.
Contraindicated in most viral diseases of the cornea and conjunctiva, mycobacterial infection, and fungal diseases of ocular structures. May cause increased intraocular pressure, cataract formation, delayed healing, and secondary ocular infections.Sulfacetamide 10%, Prednisolone phosphate (solution) 0.23%ophthalmic solution
