atropine ophthalmic (IsoptoAtropine)

Dosing and uses of IsoptoAtropine (atropine ophthalmic)

• Adult
• Pediatric

 

Adult dosage forms and strengths

ointment

• 1%

solution

• 1%

 

Mydriasis/Cycloplegia

1-2 gtts solution, cycloplegia 1 hour before refraction & mydriasis 7-14 days

 

Uveitis

1-2 gtt up to four times daily

 

Overdose Management

Ocular: Flush eyes with water

Ingestion: Emesis, lavage

 

Pediatric dosage forms and strengths

ointment

• 1%

solution

• 1%

 

Uveitis (Off-label)

1 gtts (0.5%) qDay to three times daily

 

IsoptoAtropine (atropine ophthalmic) adverse (side) effects

Frequency not defined

Local irritation

Hyperemia

Edema

Dry eyes

Exudate

Follicular conjunctivitis

Vascular congestion

Dermatitis

Blurred vision

Hyperreactive response in Down's syndrome children (atropine)

Drowsiness

Increased intraocular pressure

Physostigmine

 

Warnings

Contraindications

Narrow angle glaucoma, adhesions between iris and lens

 

Cautions

Although, mydriatic/cycloplegic effects last for up to 2 wk in an uninflammed eye, an inflammed eye may require 2-4 times DAILY dosing to see an effective pharmacologic effect

Nor for injection; topical use only

While pupils are dialated patients are advised not to engage in hazardous activities like driving

Administration to infants requires caution; may produce systemic symptoms (discontinue medication if this occurs

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Trace amounts enter breast milk; use with caution (AAP Committee states "compatible with nursing")

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of IsoptoAtropine (atropine ophthalmic)

Absorption: transconjunctivally

Excretion: urine

 

Mechanism of action

Blocks the action of acetylcholine resulting in relaxation of the cholinergically innervated sphincter muscle of the iris

Cholinergic stimulation of the accommodative ciliary muscle of the lens is also blocked

Anticholinergic effects of atropine sulfate in the eye produce dilation of the pupil (mydriasis) and paralysis of accommodation (cycloplegia)

 

Pharmacokinetics

Absorption: TransconjunctivaL

Excretion: Urine