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SENSORY ORGANS › OPHTHALMOLOGICALS › MYDRIATICS AND CYCLOPLEGICS › Anticholinergics
cyclopentolate, combinations
S01FA54
Forms & Strengths
- Ophthalmic solution: Cyclopentolate hydrochloride 0.2% / Phenylephrine hydrochloride 1% (exact ratios vary by specific combination product)
Adult Dosing
- Diagnostic procedures: Instill 1 drop into the eye(s) 40 to 50 minutes prior to the examination
- Uveitis/Inflammation: 1 drop into affected eye(s) up to TID as needed for cycloplegia and mydriasis
Pediatric Dosing
- Children > 1 year: Instill 1 drop into the eye(s) 40 to 50 minutes prior to examination; repeat in 5-10 minutes if necessary
- Infants: Use lowest effective concentration; monitor closely for systemic anticholinergic toxicity
Indications
- Induction of mydriasis and cycloplegia for diagnostic procedures (e.g., refraction, funduscopy)
- Short-term management of inflammatory conditions of the uveal tract
Mechanism of Action
- Cyclopentolate is an antimuscarinic agent that blocks responses of the sphincter muscle of the iris and the ciliary muscle to cholinergic stimulation, inducing mydriasis and cycloplegia
- Phenylephrine is a sympathomimetic agent that stimulates alpha-1 adrenergic receptors, causing contraction of the dilator muscle of the pupil and vasoconstriction
Contraindications
- Known hypersensitivity to cyclopentolate, phenylephrine, or any component of the formulation
- Patients with untreated angle-closure glaucoma or narrow angles at risk of precipitating acute angle-closure glaucoma
Adverse Reactions
- Transient stinging, burning, and blurred vision upon instillation
- Increased intraocular pressure
- Systemic anticholinergic effects (dry mouth, flushing, tachycardia, urinary retention, CNS disturbances)
- Cardiovascular effects from sympathomimetic component (hypertension, tachycardia, arrhythmias)
Drug Interactions
- Concomitant use with other anticholinergic drugs may potentiate systemic anticholinergic adverse effects
- Monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants may potentiate the cardiovascular effects of the sympathomimetic component, risking severe hypertension
- Beta-blockers or other antiglaucoma agents may antagonize the mydriatic or intraocular pressure-lowering effects
Curated Content: Needs Vetting Before Put to Clinical Use