alcaftadine ophthalmic (OTC)

Brand and Other Names:Lastacaft

Dosing & Uses


Dosing Form & Strengths

ophthalmic solution

  • 0.25%

Allergic Conjunctivitis

Indicated for prevention of itching associated with allergic conjunctivitis

Instill 1 gtt to each eye daily

Dosing Form & Strengths

ophthalmic solution

  • 0.25%

Allergic Conjunctivitis

Indicated for prevention of itching associated with allergic conjunctivitis

<2 years: Safety and efficacy not established

≥2 years: As adults, instill 1 gtt to each eye daily


Adverse Effects



  • Irritation
  • Burning
  • Stinging
  • Redness
  • Pruritus
  • Eye discharge
  • Eye swelling
  • Erythema of eyelid
  • Eyelid edema


  • Nasopharyngitis
  • Headache
  • Influenza
  • Somnolence

Postmarketing reports

Lacrimation increased

Vision blurred

Hypersensitivity reactions including swelling of the face or allergic dermatitis






To minimize eye injury and contamination of dropper tip and solution, care should be taken not to touch eyelids or surrounding areas with dropper tip of bottle; keep bottle tightly closed when not in use

Keep bottle tightly closed when not in use

Do not use for contact lens–related irritation

Remove contact lenses before instillation


Pregnancy & Lactation


There are no adequate and well-controlled studies in pregnant women to inform a drug associated risk; there are limited data with use of drug in pregnant women; advise pregnant women of potential risk to fetus and mother; treatment should only be administered during pregnancy if potential benefit justifies potential risk to fetus and mother

Animal data

  • In embryofetal studies in rats and rabbits, oral administration of alcaftadine during period of organogenesis did not produce maternal or embryofetal toxicity at clinically relevant doses;


There is no information regarding presence of drug in human milk, effects on breastfed infants, or on milk production to inform risk to an infant during lactation; the developmental and health benefits of breastfeeding should be considered, along with the mother’s clinical need for treatment, and any potential adverse effects on breastfed infant from therapy

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.



Mechanism of Action

H1-receptor antagonist; inhibits histamine release from mast cells, decreases chemotaxis, and inhibits eosinophil activation


Absorption: Minimal

Half-Life: 2 hr

Peak Plasma Time: 0.25 hr; active metabolite 1 hr

Peak Plasma Concentration: 60 pg/mL (levels fell below limit of quantification by 3 hr); active metabolite 3 ng/mL

Protein Bound: 39.2%; active metabolite 62.7%

Metabolism: Non-CYP450 cytosolic enzymes to active metabolite carboxylic acid




If more than 1 topical ophthalmic medicinal product is being used, each one should be administered at least 5 minutes apart



No images available for this drug.

Patient Handout

Patient Education
alcaftadine ophthalmic (eye)




USES: This medication is used to prevent itching of the eyes due to allergies. Alcaftadine is an antihistamine. It works by blocking a certain natural substance (histamine) that causes allergic symptoms.Do not use this medication to treat red or irritated eyes due to wearing contact lenses. Contact your doctor for further instructions if this occurs.

HOW TO USE: If you are using the over-the-counter product to self-treat, read and follow all directions on the product package before taking this medication. If you have any questions, consult your pharmacist. If your doctor has prescribed this medication, take it as directed.Apply this medication in both eyes as directed by your doctor, usually once a day.Wash your hands before each use. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.The preservative in this product may be absorbed by contact lenses. If you wear contact lenses, remove them before using this medication and keep them out of your eyes for at least 10 minutes after each dose. Do not wear contact lenses if your eyes are red.Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place one drop into the pouch as directed by your doctor. Look downward, gently close your eyes, and place one finger at the corner of your eye (near the nose). Apply gentle pressure for 1 to 2 minutes before opening your eyes. This will prevent the medication from draining out. Try not to blink or rub your eye. Repeat these steps for your other eye.Do not rinse the dropper. Replace the dropper cap after each use.If you are using another kind of eye medication (for example, other drops or ointments), wait at least 5 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.Do not use this product if it becomes contaminated (for example, drops turn a dark color). Using contaminated eye medication can cause infection, serious damage to the eye, and loss of vision. Contact your doctor or pharmacist for more information.Tell your doctor if your condition does not improve in a few days or if it worsens.

SIDE EFFECTS: Mild and temporary burning/stinging of the eyes may occur when you apply this medication. If this effect lasts or gets worse, tell your doctor or pharmacist promptly.If your doctor has prescribed this medication, remember that 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.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 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 alcaftadine, tell your doctor or pharmacist if you are allergic to it; 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: contact lens use.After you apply this drug, your vision may become temporarily blurred. Do not drive, use machinery, or do any activity that requires clear vision until you can do it safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you develop an eye infection or eye injury, or require eye surgery, ask your doctor if you should continue to use your current bottle of alcaftadine eye drops or start a new bottle.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug 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.

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.

NOTES: Do not share this medication with others.Ask your doctor about additional ways to reduce your symptoms (such as minimizing your exposure to allergens, using cold compresses and lubricating eye drops).

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: Keep the bottle tightly closed and store at room temperature. Do not store in the bathroom. 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 December 2022. 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.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.