Apraclonidine hydrochloride preservative free eye drops 1%
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Preservative eye drops containing apraclonidine
Drugs List
Therapeutic Indications
Uses
Ophthalmic surgery - adjunctive treatment
Control or prevent post-surgical elevations in intraocular pressure that occur in patients after anterior segment laser surgery.
Dosage
Adults
Instil one drop into the eye due for operation one hour before initiating anterior segment laser surgery. Instil a second drop into the same eye immediately after laser surgical procedure.
If the drop does not remain in the eye, repeat the dose by placing another drop in the eye.
To reduce systemic absorption compress the lacrimal sac during administration and for one minute afterwards.
Elderly
(See Dosage; Adult)
Contraindications
History of severe cardiovascular disorder
History of uncontrolled cardiovascular disorder
Precautions and Warnings
Children under 18 years
History of vasovagal attack
Breastfeeding
Cardiac failure
Cardiovascular disorder
Cerebrovascular disorder
Chronic renal failure
Depression
Hepatic impairment
History of angina
Hypertension
Ischaemic heart disease
Parkinsonism
Pregnancy
Raynaud's syndrome
Recent myocardial infarction
Thromboangiitis obliterans
Advise patient drowsiness may affect ability to drive or operate machinery
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Monitor hepatic function
Monitor intra-ocular pressure
Monitor renal function
Pregnancy and Lactation
Pregnancy
Use apraclonidine with caution in pregnancy.
At the time of writing there is limited published information regarding the use of apraclonidine during pregnancy.
The manufacturer states that preclinical studies using apraclonidine have shown embryotoxicity.
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
Use apraclonidine with caution in breastfeeding.
At the time of writing there is limited published information regarding the use of apraclonidine during breastfeeding.
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
Abdominal discomfort
Abdominal pain
Abnormal vision
Arrhythmias
Asthenia
Asthma
Blepharitis
Blurred vision (transient)
Bradycardia
Chest pain
Conjunctival blanching
Conjunctival follicles
Conjunctival haemorrhage
Conjunctival hyperaemia
Conjunctival swelling
Conjunctivitis
Constipation
Contact dermatitis
Corneal erosion
Corneal infiltrates
Corneal staining
Depression
Dermatitis
Diarrhoea
Dizziness
Dream abnormalities
Dry mouth
Dryness and irritation of eyes
Dryness of nasal mucosa
Dysgeusia
Dyspnoea
Eye pain
Eyelid erythema
Eyelid oedema
Eyelid reaction
Eyelid retraction
Facial oedema
Fatigue
Headache
Heat sensation
Hyperhidrosis
Hypoaesthesia
Impaired co-ordination
Increased nasopharyngeal secretions
Insomnia
Irritability
Keratitis
Keratopathy
Lacrimation
Lid margin crusting
Malaise
Myalgia
Mydriasis
Nasal congestion
Nausea
Nervousness
Ocular discharge
Ocular discomfort
Ocular hyperaemia
Ocular hypotony
Ocular inflammation
Ocular pruritus
Painful extremities
Palpitations
Paraesthesia
Parosmia
Peripheral oedema
Pharyngitis
Photophobia
Reduced libido
Rhinitis
Sensation of cold
Sensation of foreign body in eye
Somnolence
Taste disturbances
Vasovagal syncope
Vomiting
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: January 2017.
Reference Sources
The Renal Drug Handbook. Fourth Edition (2014) ed. Ashley, C and Dunleavy, A, Radcliffe Publishing Ltd, London.
Joint Formulary Committee. British National Formulary(online) London: BMJ Group and Pharmaceutical Press [Accessed on 05 January 2017].
Paediatric Formulary Committee. BNF for Children 2016-2017. London: BMJ Group, Pharmaceutical Press, and RCPCH Publications; 2016.
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