scopolamine/phenylephrine (Murocoll-2)
Classes: Cycloplegics/Mydriatics; Anticholinergic Agents, Ophthalmic
Dosing and uses of Murocoll-2 (scopolamine/phenylephrine)
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