Drugs List

Therapeutic Indications

Uses

Chronic glaucoma - short-term adjunctive treatment

Contraindications

Children under 12 years
Breastfeeding
History of severe cardiovascular disorder
History of uncontrolled cardiovascular disorder
Pregnancy

Precautions and Warnings

History of vasovagal attack
Soft contact lenses
Cardiac failure
Cardiovascular disorder
Cerebrovascular disorder
Depression
Hepatic impairment
History of angina
Hypertension
Parkinsonism
Raynaud's syndrome
Recent myocardial infarction
Renal impairment
Severe ischaemic heart disease
Thromboangiitis obliterans

Advise ability to drive/operate machinery may be affected by side effects
Contains benzalkonium chloride
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Monitor intra-ocular pressure
Monitor patients with hepatic impairment
Monitor patients with renal impairment
Discontinue or interrupt treatment with acute/worsening ocular disorders
Only recommended for short term use
If soft contact lenses worn,insert them 15 minutes after using eye drops

Pregnancy and Lactation

Pregnancy

Apraclonidine hydrochloride eye drops 5mg/ml are contraindicated in pregnancy.

The manufacturer notes that there is little data from the use of apraclonidine hydrochloride 5mg/ml eye drops in pregnant women and that this medication is not recommended in pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Apraclonidine hydrochloride eye drops 5mg/ml are contraindicated in breastfeeding.

The manufacturer notes that it is not known if apraclonidine is excreted in human milk when topically applied. As a risk to newborns and infants cannot be excluded, breastfeeding should be discontinued whilst taking this medication.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abnormal vision
Arrhythmias
Asthenia
Asthma
Blepharitis
Blepharospasm
Blurred vision (transient)
Chest pain
Conjunctival follicles
Conjunctival oedema
Conjunctival vascular congestion
Conjunctivitis
Constipation
Contact dermatitis
Corneal erosion
Corneal infiltrates
Corneal staining
Depression
Dermatitis
Dizziness
Dry mouth
Dryness and irritation of eyes
Dryness of nasal mucosa
Dysgeusia
Dyspnoea
Eye pain
Eyelid erythema
Eyelid oedema
Eyelid reaction
Eyelid retraction
Eyelid scales
Facial oedema
Fatigue
Headache
Hypersensitivity reactions
Impaired co-ordination
Increased lacrimation
Insomnia
Irritability
Keratitis
Keratopathy
Lid margin crusting
Malaise
Myalgia
Mydriasis
Nausea
Nervousness
Ocular discharge
Ocular discomfort
Ocular hyperaemia
Ocular oedema
Ocular pruritus
Paraesthesia
Parosmia
Peripheral oedema
Photophobia
Ptosis
Reduced visual acuity
Rhinitis
Rhinorrhoea
Sensation of foreign body in eye
Somnolence
Throat irritation
Vasodilatation

Presentation

Eye drops containing apraclonidine hydrochloride (preservative containing).

Drugs List

Therapeutic Indications

Uses

Chronic glaucoma - short-term adjunctive treatment

Dosage

Adults

Children

Contraindications

Children under 12 years
Breastfeeding
History of severe cardiovascular disorder
History of uncontrolled cardiovascular disorder
Pregnancy

Precautions and Warnings

History of vasovagal attack
Soft contact lenses
Cardiac failure
Cardiovascular disorder
Cerebrovascular disorder
Depression
Hepatic impairment
History of angina
Hypertension
Parkinsonism
Raynaud's syndrome
Recent myocardial infarction
Renal impairment
Severe ischaemic heart disease
Thromboangiitis obliterans

Advise ability to drive/operate machinery may be affected by side effects
Contains benzalkonium chloride
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Monitor intra-ocular pressure
Monitor patients with hepatic impairment
Monitor patients with renal impairment
Discontinue or interrupt treatment with acute/worsening ocular disorders
Only recommended for short term use
If soft contact lenses worn,insert them 15 minutes after using eye drops

Pregnancy and Lactation

Pregnancy

Apraclonidine hydrochloride eye drops 5mg/ml are contraindicated in pregnancy.

The manufacturer notes that there is little data from the use of apraclonidine hydrochloride 5mg/ml eye drops in pregnant women and that this medication is not recommended in pregnancy.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Apraclonidine hydrochloride eye drops 5mg/ml are contraindicated in breastfeeding.

The manufacturer notes that it is not known if apraclonidine is excreted in human milk when topically applied. As a risk to newborns and infants cannot be excluded, breastfeeding should be discontinued whilst taking this medication.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abnormal vision
Arrhythmias
Asthenia
Asthma
Blepharitis
Blepharospasm
Blurred vision (transient)
Chest pain
Conjunctival follicles
Conjunctival oedema
Conjunctival vascular congestion
Conjunctivitis
Constipation
Contact dermatitis
Corneal erosion
Corneal infiltrates
Corneal staining
Depression
Dermatitis
Dizziness
Dry mouth
Dryness and irritation of eyes
Dryness of nasal mucosa
Dysgeusia
Dyspnoea
Eye pain
Eyelid erythema
Eyelid oedema
Eyelid reaction
Eyelid retraction
Eyelid scales
Facial oedema
Fatigue
Headache
Hypersensitivity reactions
Impaired co-ordination
Increased lacrimation
Insomnia
Irritability
Keratitis
Keratopathy
Lid margin crusting
Malaise
Myalgia
Mydriasis
Nausea
Nervousness
Ocular discharge
Ocular discomfort
Ocular hyperaemia
Ocular oedema
Ocular pruritus
Paraesthesia
Parosmia
Peripheral oedema
Photophobia
Ptosis
Reduced visual acuity
Rhinitis
Rhinorrhoea
Sensation of foreign body in eye
Somnolence
Throat irritation
Vasodilatation

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: July 2017

Reference Sources

Summary of Product Characteristics: Iopidine 5mg/ml Eye Drops, Solution. Novartis Pharmaceuticals UK Ltd. Revised July 2018.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 12 July 2018