Yes

Alpha₂ Agonist, Ophthalmic

Prevention and treatment of postsurgical intraocular pressure elevation

C

Known hypersensitivity to apraclonidine or clonidine

Closely monitor patients who develop exaggerated reductions in intraocular pressure; use with caution in patients with cardiovascular disease and in patients with a history of vasovagal reactions

1% to 10%:

Central nervous system: Lethargy

Gastrointestinal: Xerostomia

Ocular: Upper lid elevation, conjunctival blanching, mydriasis, burning and itching eyes, discomfort, conjunctival microhemorrhage, blurred vision

Respiratory: Dry nose

<1%: Allergic response, some systemic effects have also been reported including GI, CNS, and cardiovascular symptoms (arrhythmias)

Increased effect: Topical beta-blockers, pilocarpine additive intraocular pressure

Store in tight, light-resistant containers

Apraclonidine is a potent alpha-adrenergic agent similar to clonidine; relatively selective for alpha₂-receptors but does retain some binding to alpha₁-receptors; appears to result in reduction of aqueous humor formation; its penetration through the blood-brain barrier is more polar than clonidine which reduces its penetration through the blood-brain barrier and suggests that its pharmacological profile is characterized by peripheral rather than central effects.

Onset of action: 1 hour

Maximum IOP: 3-5 hours

Adults: Ophthalmic:

1%: Instill 1 drop in operative eye 1 hour prior to anterior segment laser surgery, second drop in eye immediately upon completion of procedure

Dosing adjustment in renal impairment: Although the topical use of apraclonidine has not been studied in renal failure patients, structurally related clonidine undergoes a significant increase in half-life in patients with severe renal impairment; close monitoring of cardiovascular parameters in patients with impaired renal function is advised if they are candidates for topical apraclonidine therapy

Dosing adjustment in hepatic impairment: Close monitoring of cardiovascular parameters in patients with impaired liver function is advised because the systemic dosage form of clonidine is partially metabolized in the liver

Closely monitor patients who develop exaggerated reductions in intraocular pressure

May cause drowsiness

Dry mouth may be exacerbated by concurrent use of psychotropics

No information available to require special precautions

No effects or complications reported

May sting on instillation, do not touch dropper to eye; visual acuity may be decreased after administration; night vision may be decreased; distance vision may be altered; read package instructions for insertion

Wait 5 minutes between instillation of other ophthalmic agents to avoid washout of previous dose; after topical instillation, finger pressure should be applied to lacrimal sac to decrease drainage into the nose and throat and minimize possible systemic absorption

Solution, ophthalmic, as hydrochloride: 0.5% (5 mL); 1% (0.1 mL, 0.25 mL)