Dosing & Uses
Dosage Forms & Strengths
ophthalmic solution
- 0.12% (OTC; Refresh Redness Relief)
- 2.5% (Rx; Altafrin, Neofrin)
- 10% (Rx; Altafrin, Neofrin)
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)
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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
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
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.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)
Images
Patient Handout
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
