Dosing and uses of Iopidine (apraclonidine)
Adult dosage forms and strengths
ophthalmic solution
- 0.5%
- 1%
Inhibition of Perioperative Intraocular Pressure (IOP) Increase
1 gtt of a 1% solution onto the eye undergoing surgery 1 hour before surgery & repeated immediately upon completion of surgery
Glaucoma
1-2 gtt of a 0.5% solution in the affected eye(s) q8hr
Pediatric dosage forms and strengths
Safety & efficacy not established
Iopidine (apraclonidine) adverse (side) effects
Varies with strength & application
Ocular adverse effects:
Frequency not defined
Discomfort
Hyperemia
Pruritus
Blanching
Blurred vision
Conjunctivitis
Discharge
Dry eyeForeign body sensationLid edema
Tearing
Abnormal vision
Blepharitis, blepharo
Conjunctivitis
ConjunctivaL
Edema, conjunctival follicles
Corneal erosion
Corneal infiltrate
Corneal staining
EdemaIrritation
Keratitis
Keratopathy
Lid disorder
Lid erythema
Lid margin crusting
Lid retraction
Lid scales
Pain
Photophobia
Nonocular adverse effects:
Frequency not defined
Dry mouth
Arrhythmia
Facial edema
Abnormal coordination
Asthenia
Depression
Dizziness
Headache
Insomnia
Malaise
Nervousness
Paresthesia
Parosmia
Peripheral edema
Somnolence
Contact dermatitis,
Dry nose
Constipation
Nausea
Taste perversion
Myalgia
Asthma
Chest pain
Dyspnea
Pharyngitis
Rhinitis
Warnings
Contraindications
Hypersensitivity to apraclonidine, clonidine, or components
Within 14 days of MAO inhibitors administration
Cautions
Caution in active cardiac disease, including HTN, coronary insufficiency, recent MI, cerebrovascular disease, chronic renal failure, Raynaud's disease, thromboangiitis obliterans, history of vasovagal attacks
Discontinue if ocular allergic-type reactions develop
Monitor closely if excessive IOP reduction
May impair mental alertness & ability to perform hazardous activities
Pregnancy and lactation
Pregnancy category: C
Lactation: It is not known if Iopidine is excreted in milk. Decision should be made to discontinue nursing temporarily for the one day on which Iopidine is used.
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 Iopidine (apraclonidine)
Mechanism of action
Alpha-1 & alpha-2 adrenergic receptor agonist; may reduce acqueous humor formation
Pharmacokinetics
Peak Plasma Time: 3-5 hr (reduction in intraocular pressure)
Peak Plasma Concentration (0.5% admin): 0.9 ng/mL
Half-Life (0.5% admin): 8 hr
Onset: 1 hr
Abslorption: Systemically absorbed
