Adult Dosing

Mydriasis

• 1-2 gtt in the conjunctival sac

Note:

• Onset of action takes place within 15 minutes; Maximum effect occurs within 60 minutes
• Clinically significant dilation, inhibition of pupillary light response, and partial cycloplegia last for 3 hrs
• As time progresses, mydriasis reverses spontaneously, typically in 6 to 8 hrs
• Complete recovery may require up to 24 hrs in some patients

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• For mydriasis in routine diagnostic procedures and in conditions requiring short-term pupil dilation

• Hypersensitivity to any of the ingredients of the product
• Angle-closure glaucoma
• Patients with narrow angles in whom pupil dilation may precipitate an attack of angle-closure glaucoma

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

See Supplemental Patient Information

• For topical ophthalmic use only. Avoid using as an injection
• In patients with open-angle glaucoma, mydriatics may result in a transient elevation of intraocular pressure
• This combination rarely may cause CNS disturbances, and may be especially dangerous in infants, children or the elderly
• Psychotic reactions, behavioral disturbances, and vasomotor or cardio-respiratory collapse have been reported with this combination
• Monitor patients with hypertension, hyperthyroidism, diabetes or cardiac disease (arrhythmias or chronic ischemic heart disease), elderly patients, and those in whom glaucoma or increased intraocular pressure may be encountered

Cautions: Use cautiously in

• Open-angle glaucoma
• Infants or children
• Elderly
• Hypertension
• Hyperthyroidism
• Diabetes mellitus
• Cardiac arrhythmias
• Coronary artery disease

Supplemental Patient Information

• Advise patients to avoid touching the dropper tip to any surface, as this may contaminate the solution
• Advise patients to use the medication cautiously when driving or engaging in other hazardous activities while pupils are dilated
• Instruct patients to protect eyes in bright illumination during dilation
• Instruct parents to prevent accidental ingestion by their child, and to wash their own hands and the child’s hands following instillation

Pregnancy Category:C

Breastfeeding: Safety unknown; however, single ophthalmic tropicamide dose is not likely to interfere with breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 24 October 2013). It is unknown whether this drug is excreted in human milk; manufacturer advises caution while administering to nursing women.

• EENT: Increased IOP, transient stinging, dryness of the mouth, blurred vision, photophobia, corneal staining
• CV: Tachycardia, myocardial infarction, ventricular fibrillation, hypotensive episodes, cardiorespiratory collapse
• CNS: Headache, CNS disturbances, vasomotor collapse
• GI: Nausea, vomiting
• PSCHIATRY: Psychotic reactions, behavioral disturbances
• MUSC: Muscle rigidity
• HYPERSENSITIVITY: Allergic reactions
• MISC: Pallor, death

Hydroxyamphetamine

• Adrenergic agent; releases norepinephrine from intact adrenergic nerve terminals resulting in mydriasis
• Metabolism: Unknown
• Excretion: Unknown
• Half-life: Unknown

Tropicamide

• Anticholinergic; inhibits the responses of the iris sphincter and ciliary muscles to cholinergic stimulation, producing dilation of the pupil and paralysis of the ciliary muscles
• Metabolism: Unknown
• Excretion: Unknown
• Half-life: Unknown

US Trade Name(s)

• Paremyd

US Availability

Paremyd (hydroxyamphetamine/tropicamide)

• OPTH SOLN: 1%/ 0.25%

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Antimicrobials

Antiviral Agents

Anti-Herpetics/Anti-CMV Agents

Infectious Disease

Antiviral Agents

Anti-Herpetics/Anti-CMV Agents