apraclonidine (Rx)

Brand and Other Names:Iopidine
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.5%
  • 1%

Inhibition of Perioperative Intraocular Pressure (IOP) Increase

1 gtt of a 1% solution onto the eye undergoing surgery 1 hour before surgery & repeated immediately upon completion of surgery

Glaucoma

1-2 gtt of a 0.5% solution in the affected eye(s) q8hr

Safety & efficacy not established

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Interactions

Interaction Checker

and apraclonidine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (7)

            • isocarboxazid

              apraclonidine, isocarboxazid. Mechanism: unknown. Contraindicated. Contraindicated in mfr. prescribing info.

              isocarboxazid, apraclonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • linezolid

              apraclonidine, linezolid. Mechanism: unknown. Contraindicated. Contraindicated in mfr. prescribing info.

              linezolid, apraclonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • phenelzine

              apraclonidine, phenelzine. Mechanism: unknown. Contraindicated. Contraindicated in mfr. prescribing info.

              phenelzine, apraclonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • rasagiline

              rasagiline, apraclonidine. Mechanism: unknown. Contraindicated. Apraclonidine should not be used in patients receiving MAO inhibitors.

            • selegiline

              selegiline, apraclonidine. Mechanism: unknown. Contraindicated. Risk of selegiline-induced hypertension may be increased. Coadministration is contraindicated. Do not coadminister within 14 days of each other.

            • selegiline transdermal

              selegiline transdermal, apraclonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • tranylcypromine

              apraclonidine, tranylcypromine. Mechanism: unknown. Contraindicated. Contraindicated in mfr. prescribing info.

              tranylcypromine, apraclonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            Serious - Use Alternative (1)

            • abametapir

              abametapir will increase the level or effect of apraclonidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

            Monitor Closely (0)

              Minor (0)

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                Adverse Effects

                Varies with strength & application

                Ocular adverse effects:

                Frequency Not Defined

                Discomfort

                Hyperemia

                Pruritus

                Blanching

                Blurred vision

                Conjunctivitis

                Discharge

                Dry eyeForeign body sensationLid edema

                Tearing

                Abnormal vision

                Blepharitis, blepharo

                Conjunctivitis

                Conjunctival

                Edema, conjunctival follicles

                Corneal erosion

                Corneal infiltrate

                Corneal staining

                EdemaIrritation

                Keratitis

                Keratopathy

                Lid disorder

                Lid erythema

                Lid margin crusting

                Lid retraction

                Lid scales

                Pain

                Photophobia

                Nonocular adverse effects:

                Frequency Not Defined

                Dry mouth

                Arrhythmia

                Facial edema

                Abnormal coordination

                Asthenia

                Depression

                Dizziness

                Headache

                Insomnia

                Malaise

                Nervousness

                Paresthesia

                Parosmia

                Peripheral edema

                Somnolence

                Contact dermatitis,

                Dry nose

                Constipation

                Nausea

                Taste perversion

                Myalgia

                Asthma

                Chest pain

                Dyspnea

                Pharyngitis

                Rhinitis

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                Warnings

                Contraindications

                Hypersensitivity to apraclonidine, clonidine, or components

                Within 14 days of MAO inhibitors administration

                Cautions

                Caution in active cardiac disease, including HTN, coronary insufficiency, recent MI, cerebrovascular disease, chronic renal failure, Raynaud's disease, thromboangiitis obliterans, history of vasovagal attacks

                Discontinue if ocular allergic-type reactions develop

                Monitor closely if excessive IOP reduction

                May impair mental alertness & ability to perform hazardous activities

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: It is not known if Iopidine is excreted in milk. Decision should be made to discontinue nursing temporarily for the one day on which Iopidine is used.

                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

                Alpha-1 & alpha-2 adrenergic receptor agonist; may reduce acqueous humor formation

                Pharmacokinetics

                Peak Plasma Time: 3-5 hr (reduction in intraocular pressure)

                Peak Plasma Concentration (0.5% admin): 0.9 ng/mL

                Half-Life (0.5% admin): 8 hr

                Onset: 1 hr

                Abslorption: Systemically absorbed

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                apraclonidine ophthalmic (eye)
                -
                0.5 % drops
                apraclonidine ophthalmic (eye)
                -
                0.5 % drops
                apraclonidine ophthalmic (eye)
                -
                0.5 % drops
                apraclonidine ophthalmic (eye)
                -
                0.5 % drops
                Iopidine ophthalmic (eye)
                -
                1 % liquid
                Iopidine ophthalmic (eye)
                -
                0.5 % drops
                Iopidine ophthalmic (eye)
                -
                0.5 % drops

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                apraclonidine ophthalmic (eye)

                APRACLONIDINE SOLUTION 0.5% - OPHTHALMIC

                (A-pra-KLOE-ni-deen)

                COMMON BRAND NAME(S): Iopidine

                USES: Apraclonidine is used along with other medications to treat serious high pressure inside the eye (glaucoma) for a short time (e.g., 1 month) to help delay or prevent the need for eye surgery. Decreasing high pressure inside the eye may help to prevent decreased vision or blindness. Apraclonidine is thought to work by decreasing the amount of fluid within the eye.

                HOW TO USE: This medication is given as an eye drop, usually 3 times daily or as directed by your doctor.If you are wearing contact lenses, remove them before using eye drops. Wait at least 15 minutes before replacing your contact lenses.To apply eye drops, wash your hands first. To avoid contamination, be careful not to touch the dropper tip or let it touch your eye or any other surface.Tilt your head back, look up, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place 1 drop into the pouch. Release the eyelid and gently close your eyes. Place one finger at the corner of your eye (near the nose) and apply gentle pressure for 1 to 2 minutes. This will prevent the medication from draining out. Try not to blink and do not rub your eye. Repeat these steps for your other eye if so directed or if your dose is for more than 1 drop.Remove extra solution around the eye with a tissue and wash your hands to remove any medicine that may be on them.If you are using another kind of eye medication (e.g., drops or ointments), wait at least 5 minutes before using the other medication. Use eye drops before ointments to allow the eye drops to enter the eye.Dosage is based on your medical condition and response to treatment. Do not increase your dose or use it more frequently than prescribed. When used for an extended time, this medication may not work as well and may require different dosing. Your doctor will monitor your progress with regular eye exams.

                SIDE EFFECTS: Eye discomfort/redness/burning, blurred vision, dry mouth/nose, dizziness, drowsiness, upset stomach, or unusual tiredness may occur. Eye itching/watering or eyelid swelling may be symptoms of an allergic reaction of the eye. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes (e.g., depression, irritability), slow/irregular heartbeat.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using apraclonidine, tell your doctor or pharmacist if you are allergic to it; or to clonidine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood vessel disease (e.g., cerebrovascular disease, Raynaud's disease), high blood pressure, heart problems (e.g., recent heart attack), kidney disease, mental/mood disorders (e.g., depression).After you apply this drug, your vision may become temporarily blurred or unstable. This drug may also rarely make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this medication passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Before receiving this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: beta blockers (e.g., atenolol, metoprolol), high blood pressure medications, tricyclic antidepressants (e.g., amitriptyline, nortriptyline).Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that may cause drowsiness. Ask your pharmacist about using those products safely.This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow heartbeat, drowsiness, cold/clammy skin.

                NOTES: Do not share this medication with others.Laboratory and/or medical tests (e.g., pulse, blood pressure, eye exams) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store between 36-80 degrees F (2-27 degrees C) away from light. Do not freeze. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

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                • View the formulary and any restrictions for each plan.
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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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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.