apraclonidine (Rx)

Brand and Other Names:Iopidine

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

            All Interactions Sort By:
             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 (0)

              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

                  Pricing & Images are not currently available for this monograph.
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                  Patient Handout

                  Patient Education
                  apraclonidine ophthalmic (eye)

                  APRACLONIDINE SOLUTION 1% - OPHTHALMIC

                  (A-pra-KLOE-ni-deen)

                  COMMON BRAND NAME(S): Iopidine

                  USES: This medication is used to treat or prevent high pressure inside the eye that may occur during and after laser eye surgery. Decreasing high pressure inside the eye may help to prevent decreased vision or blindness in the eye treated by laser surgery. 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 by a health care professional. It should not be taken by mouth or injected into the eye. For laser eye surgery, it is usually given 1 hour before laser treatment and repeated at the end of treatment.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.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 (such as 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.

                  SIDE EFFECTS: Eye discomfort/redness/burning, blurred vision, upset stomach, dizziness, or drowsiness may occur. Eye itching/watering or eyelid swelling may be symptoms of an allergic reaction of the eye. If any of these effects last or get worse, 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 you have any serious side effects, including: fainting, mental/mood changes (such as depression), slow/irregular heartbeat.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: 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 (such as cerebrovascular disease, Raynaud's disease), high blood pressure, heart problems (such as recent heart attack), kidney disease, mental/mood disorders (such as depression), fainting after emotional stress (vasovagal attack).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 unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

                  DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.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.Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that may cause drowsiness. Ask your pharmacist about using those products safely.

                  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.Lab and/or medical tests (such as pulse, blood pressure, eye exams) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

                  MISSED DOSE: Not applicable.

                  STORAGE: Store in the refrigerator or at room temperature away from light. Do not freeze. Keep all medications 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.

                  Information last revised May 2023. Copyright(c) 2023 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

                  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.

                  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.