scopolamine/phenylephrine (Murocoll-2)

Dosing and uses of Murocoll-2 (scopolamine/phenylephrine)

• Adult
• Pediatric

 

Adult dosage forms and strengths

scopolamine/phenylephrine

ophthalmic solution

• 0.3%/10%

 

Mydriasis

1-2 gtt in the conjunctival sac

Repeat in 5 minutes, if necessary

 

Postoperative Use

For cycloplegia and to break posterior synechiae in iritis

Postoperatively instill 1-2 gtt into eye(s) TID-QID when desirable to maintain dilation and rest ciliary body

 

Other Information

Combinations induce mydriasis that is considerably greater than that of either drug alone

 

Pediatric dosage forms and strengths

<18 safety and efficacy not established

 

Murocoll-2 (scopolamine/phenylephrine) adverse (side) effects

Frequency not defined

Headache or browache

Reactive hyperemia

Blurred vision

Sensitivity to light

Transient burning or stinging

Transient keratitis

Hypersensitivity reactions such as allergic conjunctivitis or dermatitis

 

Rare (Systemic)

Hypertension

Increased perspiration

Occipital headache

Pallor or blanching

Tachycardia

Trembling or tremors

Palpitation

Premature ventricular contractions

 

Warnings

Contraindications

Aneurysm

Hypersensitivity to either component

Known or suspected angle-closure glaucoma

Soft contact lenses

 

Cautions

Reduce dose if used within 21 d of MAO inhibitors or TCAs

Wait 5 minutes between multiple drops (no >3 drops needed)

May cause false-normal tonometry readings, tonometry should be performed before phenylephrine is administered

 

Pregnancy and lactation

Pregnancy category: C

Lactation: unknown if excreted in breast milk, use 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 Murocoll-2 (scopolamine/phenylephrine)

Onset: 15 min

Absorption: some systemic

Maximum effect: 60 min

Duration: 3 hr

Recovery (usual): 3-7 hr

 

Mechanism of action

Phenylephrine acts directly on alpha-adrenergic receptors in eye producing contraction of dilator muscle of pupil and constriction of arterioles in conjunctiva

Ophthalmic scopolamine blocks the responses of iris sphincter muscle and the accommodative muscle of the ciliary body to cholinergic stimulation, thereby producing mydriasis and cycloplegia