phenylephrine ophthalmic (Rx, OTC)

Brand and Other Names:Altafrin, Neofrin, more...Refresh Redness Relief
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.12% (OTC; Refresh Redness Relief)
  • 2.5% (Rx; Altafrin, Neofrin)
  • 10% (Rx; Altafrin, Neofrin)
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Mydriasis Production

Ophthalmoscopy: 1-2 gtt 2.5% solution or 10% solution, may repeat in 10-60 min, mydriasis persists >3 hr, no cycloplegia

Ocular Surgery: 1-2 gtt 2.5% or 10% solution administered 30-60 min preop

Irrigation: 1-2 gtt 0.12% solution into affected eye up to four times daily; not to exceed 72 hr of therapy

Posterior Synechiae Prevention

Anterior Uveitis: 1 gtt of 10% solution three times daily or more (with atropine);

Post-iridectomy: 1 gtt of 10% solution qDay or twice daily

Eye Redness

OTC strength (0.12%) may be used to decrease appearance of eye redness (bloodshot eyes)

Instill 1-2 gtt in affected eye(s) BID/TID

Dosage Forms & Strengths

ophthalmic solution

  • 2.5% (Rx; Altafrin, Neofrin)
  • 10% (Rx; Altafrin, Neofrin)
more...

Ocular Procedures

Indicated to provide mydriasis (pupil dilation) needed for ophthalmic procedures

<1 year: 1 gtt of 2.5% solution 15-20 min before procedure

≥1 yr

  • Ophthalmoscopy: 1-2 gtt 2.5% solution or 10% solution, may repeat in 10-60 min, mydriasis persists >3 hr, no cycloplegia
  • Ocular Surgery: 1-2 gtt 2.5% or 10% solution administered 30-60 min pre-op
  • Irrigation: 1-2 gtt 0.12% solution into affected eye up to four times daily; not to exceed 72 hr of therapy
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Interactions

Interaction Checker

and phenylephrine ophthalmic

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Frequent: transient burning or stinging

            Arrhythmia

            Myocardial infarction

            Subarachnoid hemorrhage

            Headache or browache

            Blurred vision

            Syncope

            Rebound myosis

            Reactive hyperemia

            Transient keratitis

            Hypersensitivity reactions such as allergic conjunctivitis or dermatitis

            Sensitivity to light

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            Warnings

            Contraindications

            Hypersensitivity, narrow-angle glaucoma, ventricular tachycardia, hypertension

            Cautions

            Reduce dose if used within 21 d of MAO inhibitors or TCAs

            Wait 5 min between multiple drops (no >3 drops needed)

            Rebound miosis may occur in elderly people 1 day after treatmentwith phenylephrine

            Notify healthcare provider if vision changes, worsening of symptoms, or continued redness occur

            Caution with marked hypertension, cardiac disorders, advanced arteriosclerotic changes, type 1 diabetes mellitus, hyperthyroidism; in children of low body weight; elderly

            May cause false-normal tonometry readings, tonometry should be performed before phenylephrine is administered

            Presence of sulfites in some products may cause allergic reactions in susceptible patients

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Not known if distributed in milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Acts directly on alpha-adrenergic receptors in eye producing contraction of dilator muscle of pupil & constriction of arterioles in conjunctiva

            Pharmacokinetics

            Onset of action: 15-30 min (mydriasis)

            Duration: 1-3 hr (mydriasis)

            Peak plasma time: <20 min

            Absorption: Minimal (systemic)

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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