Mydriacyl, Tropicacyl (tropicamide) dosing, indications, interactions, adverse effects, and more

Sections

Sections tropicamide
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

0.5%
1%

Refraction (Mydriasis)

1-2 gtt of 1% solution in eye(s), repeat in 5 min, perform exam within 30 min of second instillation

Funduscopic Exam (Cycloplegia)

1-2 gtt of 0.5% solution in eyes 15-20 min before exam, may repeat q30minutes PRN

Dosage Forms & Strengths

ophthalmic solution

0.5%
1%

Refraction (Mydriasis)

As adult; 1-2 gtt of 1% solution in eye(s), repeat in 5 min, perform exam within 30 min of second instillation

Funduscopic Exam (Cycloplegia)

As adult; 1-2 gtt of 0.5% solution in eyes 15-20 min before exam, may repeat q30minutes PRN

Frequency Not Ddefined

Increased IOP

Transient stinging

Dry mouth

Blurred vision

Photophobia with or without corneal staining

Tachycardia

Headache

Parasympathetic stimulation

Allergic reactions

Contraindications

Hypersensitivity

Known or suspected angle-closure glaucoma, presence of a shallow anterior chamber unless gonioscopic observation of the chamber angle is possible

Cautions

Hypertension, hyperthyroidism, diabetes mellitus, cardiac disorders

Remove contact lenses before instilling drops

Possibility of undiagnosed glaucoma should be considered

Risk of potentially dangerous CNS disturbances in Peds

May cause increased IOP

0.5% solution incapable of producing satisfactory cycloplegia

Pregnancy & Lactation

Pregnancy Category: C

Lactation: not known if distributed in milk

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

Peak: 20-40 min (mydriasis), 20-35 min (cycloplegia)

Recovery: 6 hr

Mechanism of Action

Blocks acetylcholine resulting in relaxation of cholinergically innervated iris sphincter muscle

Adrenergic innervation to radial muscle is therefore unopposed and pupil becomes dilated

BRAND	FORM.	UNIT PRICE	PILL IMAGE
Mydriacyl ophthalmic (eye) -	1 % drops
tropicamide ophthalmic (eye) -	0.5 % drops
tropicamide ophthalmic (eye) -	1 % drops
tropicamide ophthalmic (eye) -	0.5 % drops
tropicamide ophthalmic (eye) -	0.5 % drops
tropicamide ophthalmic (eye) -	1 % drops
tropicamide ophthalmic (eye) -	1 % drops
tropicamide ophthalmic (eye) -	1 % drops
tropicamide ophthalmic (eye) -	1 % drops
tropicamide ophthalmic (eye) -	1 % drops

Patient Handout

TROPICAMIDE - OPHTHALMIC

(tro-PICK-uh-mide)

COMMON BRAND NAME(S): Mydriacyl

USES: This medication is used to widen (dilate) the pupil of the eye in preparation for certain eye examinations. It belongs to a class of drugs known as anticholinergics. Tropicamide works by relaxing certain eye muscles.

HOW TO USE: To apply eye drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.If you are wearing contact lenses, remove them before using this medication. Ask your doctor when you may replace your contact lenses.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 1 or 2 drops into the pouch, usually 15 to 20 minutes before an eye examination or as directed by your doctor. Look downward and gently close your eyes for 1 to 2 minutes. Place one finger at the corner of your eye (near the nose) and apply gentle pressure for 2 to 3 minutes. This will prevent the medication from draining out and being absorbed by your body. Try not to blink and do not rub your eye. Repeat these steps for your other eye if so directed.Do not rinse the dropper. Replace the dropper cap after each use.If you are using another kind of eye medication (such as drops or ointments), wait at least 5 to 10 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.Wash your hands after using this medication. If giving this medication to a child, do not let the medication get into the child's mouth. Also wash the child's hands after giving this medication.

SIDE EFFECTS: Eye stinging, temporary blurred vision, dry mouth, or eye sensitivity to light may occur. 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: feeling as if something is in the eye, fast heartbeat, muscle stiffness, mental/mood changes.Get medical help right away if you have any very serious side effects, including: eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night).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 tropicamide, 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: personal or family history of glaucoma (angle-closure type), high blood pressure, overactive thyroid (hyperthyroidism), diabetes, heart disease (such as irregular heart rhythm, coronary artery disease), Down syndrome, brain damage or spastic paralysis (in children).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.This medication may make your eyes more sensitive to light. Protect your eyes in bright light. Use dark sunglasses when outdoors.Older adults may be more sensitive to the side effects of this drug, especially mental/mood changes (such as agitation).Children may be more sensitive to the side effects of this drug, especially mental/mood changes (such as agitation).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.

MISSED DOSE: Not applicable.

STORAGE: Store at room temperature away from light. Do not refrigerate. 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.

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.

Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

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Create Your List of Plans

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.

View explanations for tiers and restrictions

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.

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

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