Note: Individuals with heavily pigmented eyes may require higher strength or additional doses. Mydriasis will reverse spontaneously with time, typically in 4 to 8 hours. However, in some cases, complete recovery may take up to 24 hours.
Cycloplegia: Ophthalmic: Instill 1 to 2 drops (1%) in the eye(s); repeat in 5 minutes. If the patient is not examined within 20 to 30 minutes, instill an additional drop to prolong effect.
Mydriasis: Ophthalmic: Instill 1 to 2 drops (0.5%) in the eye(s) 15 to 20 minutes before exam.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Tropicamide: Pediatric drug information")
Note: Individuals with heavily pigmented eyes may require higher strength or additional doses.
Cycloplegia: Infants, Children, and Adolescents: Ophthalmic (1%): Instill 1 to 2 drops; repeat in 5 minutes. If the patient is not examined within 20 to 30 minutes, instill an additional drop to prolong effect.
Mydriasis: Infants, Children, and Adolescents: Ophthalmic (0.5%): Instill 1 to 2 drops (0.5%) 15 to 20 minutes before exam
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Mydriacyl: 1% (15 mL)
Generic: 0.5% (15 mL); 1% (2 mL, 3 mL, 15 mL)
Yes
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Mydriacyl: 0.5% (15 mL); 1% (15 mL) [contains benzalkonium chloride, edetate (edta) disodium]
Generic: 1% (0.3 mL, 0.5 mL, 15 mL)
Ophthalmic: For topical ophthalmic use only. Remove contact lenses prior to instillation. To avoid excessive systemic absorption, apply gentle finger pressure to lacrimal sac for 2 to 3 minutes following application. Do not touch dropper tip to eyelids or any surface. Wash hands following administration.
Ophthalmic: For topical ophthalmic use only. Remove contact lenses prior to instillation. Do not touch dropper tip to eyelids or any surface. Apply gentle pressure to lacrimal sac during and immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration, to decrease systemic absorption of ophthalmic drops (Urrti 1993; Zimmerman 1984). Wash hands following administration.
Mydriasis/Cycloplegia: For mydriasis and cycloplegia in diagnostic procedures
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Cardiovascular: Central nervous system dysfunction, tachycardia
Central nervous system: Headache
Dermatologic: Pallor
Gastrointestinal: Nausea, vomiting, xerostomia
Hypersensitivity: Hypersensitivity reaction
Neuromuscular & skeletal: Muscle rigidity
Ophthalmic: Blurred vision, photophobia, stinging of eyes (transient), superficial punctate keratitis
Hypersensitivity to tropicamide or any component of the formulation.
Canadian labeling: Additional contraindications (not in US labeling): Known or suspected narrow angle glaucoma; small infants (<3 months of age).
Documentation of allergenic cross-reactivity for belladonna alkaloids is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.
Concerns related to adverse effects:
• CNS effects: May cause drowsiness and/or blurred vision, which may impair physical or mental abilities; patients must be cautioned about performing tasks that require mental alertness (eg, operating machinery, driving).
• Increased intraocular pressure: May cause a transient increase in intraocular pressure.
Special populations:
• Contact lens wearers: Contains benzalkonium chloride, which may be absorbed by soft contact lenses; remove lenses prior to administration.
• Pediatric: Use with caution in infants and children; may cause potentially dangerous CNS disturbances. Psychotic reactions, behavioral disturbances, and vasomotor or cardiorespiratory collapse in children have been reported with the use of anticholinergic drugs.
Other warnings/precautions:
• Appropriate use: For topical ophthalmic use only. Remove contact lenses prior to administration. To avoid excessive systemic absorption, apply gentle finger pressure to lacrimal sac for 2 to 3 minutes following application. Do not touch dropper tip to eyelids or any surface.
May cause increased blood pressure in premature neonates: The use of tropicamide 1% solution in combination with phenylephrine has been associated with significant increases in mean blood pressure (Chew 2005).
None known.
There are no known significant interactions.
Animal reproduction studies have not been conducted. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples 1988).
It is not known if tropicamide is excreted in breast milk. The manufacturer recommends that caution be used if administered to nursing women.
Ophthalmic exam, intraocular pressure, CNS reactions (especially in pediatric patients).
Prevents the sphincter muscle of the iris and the muscle of the ciliary body from responding to cholinergic stimulation; produces dilation and prevents accommodation.
Onset of action: Cycloplegic effect: Peak: 20 to 35 minutes; Mydriatic effect: ~20 to 40 minutes
Duration: Cycloplegic effect: <6 hour; Mydriatic effect: ~6 to 7 hours
Solution (Mydriacyl Ophthalmic)
1% (per mL): $7.63
Solution (Tropicamide Ophthalmic)
0.5% (per mL): $0.67 - $1.78
1% (per mL): $0.71 - $3.17
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