cyclopentolate (Cyclogyl, AK-Pentolate)

Dosing and uses of Cyclogyl (cyclopentolate)

• Adult
• Pediatric

 

Adult dosage forms and strengths

solution

• 0.5%
• 1%
• 2%

 

Mydriasis/Cycloplegia Diaganosis

1-2 gtt of 1% solution in eye; may repeat in 5 minutes PRN; cycloplegia & mydriasis may last for 24 hours

Use 2% in heavily pigmented iris

 

Overdose Management

Ocular: Flush eyes w/water

Ingestion: Emesis, lavage

Severe systemic ADR's: Physostigmine

 

Pediatric dosage forms and strengths

solution

• 0.5%
• 1%
• 2%

 

Mydriasis/Cycloplegia

1-2 gtt of 0.5%, 1% or 2% solution in eye; may repeat 5 minutes later by second application of 0.5% or 1% solution if necessary

 

Cyclogyl (cyclopentolate) adverse (side) effects

Frequency not defined

Blurred vision

Burning sensation in eye

Light intolerance

Tachycardia

Conjunctivitis

Raised intraocular pressure

Hyperreactive response in Down's syndrome children (atropine)

Drowsiness

 

Warnings

Contraindications

Hypersensitivity, untreated narrow angle glaucoma or increased IOP; untreated anatomically narrow angles

Sulfite sensitivity and other hypersensitivities; children with previous systemic reaction to atropine

 

Cautions

Wait 5 min between drops

Transient elevatin in intraocular pressure may occur

Use caution in patients with Down syndrome (predisposed to angle-closure glaucoma)

Remove contact lenses prior to administration and wait 15 min before reinserting

The eldrely may be predisposed to increased intraocular pressure

The 2% solution may result in psychotic reactions and behavioral disturbances in children 30-45 min following instillation

Minimize absorption by using 1 drop of solution per eye and applying presure over the nasolacrimal sac for 2-3 min

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Excretion in milk unknown; use with caution

 

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 Cyclogyl (cyclopentolate)

Onset: rapid; max effect not for 30 min

Excretion: urine

 

Mechanism of action

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

Cholinergic stimulation of accommodative ciliary muscle of lens is also blocked

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

 

Pharmacokinetics

Onset of action: 25-75 min (cycloplegia); 30-60 min (mydriasis)

Duration: < 24hr

Absorption: Minimal systemic