Yes

Anticholinergic Agent, Ophthalmic; Ophthalmic Agent, Mydriatic

Producing cycloplegia and mydriasis for refraction; treatment of acute inflammatory conditions of the uveal tract

C

Narrow-angle glaucoma, acute hemorrhage or hypersensitivity to the drug or any component in the formulation

Use with caution in patients with hypertension, cardiac disease, or increased intraocular pressure; safety and efficacy not established in infants and young children, therefore, use with extreme caution due to susceptibility of systemic effects; use with caution in obstructive uropathy, paralytic ileus, ulcerative colitis, unstable cardiovascular status in acute hemorrhage

>10%: Ocular: Blurred vision, photophobia

1% to 10%:

Local: Stinging, local irritation

Ocular: Increased intraocular pressure

Respiratory: Congestion

<1%: Vascular congestion, edema, drowsiness, exudate, eczematoid dermatitis, follicular conjunctivitis

Symptoms of overdose include blurred vision, urinary retention, tachycardia

Anticholinergic toxicity is caused by strong binding of the drug to cholinergic receptors. For anticholinergic overdose with severe life-threatening symptoms, physostigmine 1-2 mg (0.5 mg or 0.02 mg/kg for children) S.C. or I.V., slowly may be given to reverse these effects.

Protect from light

Blocks response of iris sphincter muscle and the accommodative muscle of the ciliary body to cholinergic stimulation resulting in dilation and loss of accommodation

Onset of accommodation and pupil effect: Ophthalmic:

Maximum mydriatic effect: Within 10-30 minutes

Maximum cycloplegic effect: Within 30-90 minutes

Duration:

Mydriasis: 6 hours to 4 days

Cycloplegia: 10-48 hours

Children:

Mydriasis and cycloplegia for refraction: Instill 1 drop of 2% solution immediately before the procedure; repeat at 10-minute intervals as needed

Uveitis: Instill 1 drop of 2% solution 2-3 times/day

Adults:

Mydriasis and cycloplegia for refraction: Instill 1-2 drops of 2% solution or 1 drop of 5% solution before the procedure; repeat at 5- to 10-minute intervals as needed; maximum of 3 doses for refraction

Uveitis: Instill 1-2 drops of 2% or 5% 2-3 times/day up to every 3-4 hours as needed

Ophthalmic instillation: Finger pressure should be applied to lacrimal sac for 1-2 minutes after instillation to decrease risk of absorption and systemic reactions

May cause drowsiness

None reported

No information available to require special precautions

No effects or complications reported

May cause blurred vision; if irritation persists or increases, discontinue use

Finger pressure should be applied to lacrimal sac for 1-2 minutes after instillation to decrease risk of absorption and systemic reactions

Solution, ophthalmic, as hydrobromide:

AK-Homatropine®: 5% (15 mL)

Isopto® Homatropine 2% (5 mL, 15 mL); 5% (5 mL, 15 mL)

Barker DB and Solomon DA, "The Potential for Mental Status Changes Associated With Systemic Absorption of Anticholinergic Ophthalmic Medications: Concerns in the Elderly," DICP Ann Pharmacother, 1990, 24(9):847-50.