cyclopentolate (Rx)

Frequency Not Defined

Blurred vision

Burning sensation in eye

Light intolerance

Tachycardia

Conjunctivitis

Raised intraocular pressure

Hyperreactive response in Down's syndrome children (atropine)

Drowsiness

Contraindications

Hypersensitivity to drug or components

Cautions

Remove contact lenses prior to administration and wait 15 min before reinserting

The elderly may be predisposed to increased intraocular pressure

Mydriatics may produce transient elevation of intraocular pressure; patients with untreated narrow-angle glaucoma or anatomically narrow angles may be susceptible to angle-closure following administration

Dropper tip is not to touch any surface, as this may contaminate the solution

A transient burning sensation may occur upon instillation

Patients should be advised not to drive or engage in other hazardous activities while pupils are dilated

Patients may experience sensitivity to light and should protect eyes in bright illumination during dilation

Parents should be warned not to get this preparation in their child's mouth and to wash their own hands and the child's hands following administration

Feeding intolerance may follow ophthalmic use of this product in infants; it is recommended that feeding be withheld for 4 hours after examination

CNS effects

• May cause central nervous system (CNS) disturbances, especially in younger age groups but may occur at any age, especially with stronger solutions
• Infants are especially prone to CNS and cardiopulmonary side effects; to minimize absorption, use only 1 drop of 0.5% solution per eye, followed by pressure applied over nasolacrimal sac for two to three minutes; observe infants closely for at least 30 minutes following instillation

Pregnancy

Animal reproduction studies have not been conducted; not known whether cyclopentolate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity; administer to a pregnant woman only if clearly needed

Lactation

Not known whether this drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution when drug is administered to a nursing woman

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.

Onset: rapid; max effect not for 30 min

Excretion: urine

Mechanism of Action

Blocks action of acetylcholine resulting in relaxation of the cholinergically innervated iris sphincter muscle

Cholinergic stimulation of accommodative ciliary muscle of lens is also blocked

Anticholinergic effects of cyclopentolate in eye produce dilation of the pupil (mydriasis) and paralysis of accommodation (cycloplegia)

Pharmacokinetics

Onset of action: 25-75 min (cycloplegia); 30-60 min (mydriasis)

Duration: < 24hr

Absorption: Minimal systemic