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Ciliary spasm: Relief of ciliary spasm.
Iritis/iridocyclitis: Treatment of iritis and iridocyclitis.
Mydriasis and cycloplegia for refraction: Producing cycloplegia and mydriasis for refraction; for pre- and postoperative states when cycloplegic and mydriasis is required.
Optical aid: Use as an optical aid in some cases of axial lens opacities.
Uveitis: Treatment of inflammatory conditions of the uveal tract.
Primary glaucoma or tendency toward glaucoma (eg, narrow anterior chamber angle); hypersensitivity to homatropine or any of the components of the formulation.
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.
Note: Patients with heavily pigmented irides may require increased dose.
Ciliary spasm/iritis/iridocyclitis/uveitis: Ophthalmic:
2% or 5% solution: 1-2 drops 2-3 times daily, up to every 4 hours for severe uveitis (Alexander, 2004)
Refraction: Ophthalmic:
2% solution: 1-2 drops into eye(s); repeat every 10-15 minutes if necessary; maximum: 5 doses
5% solution: 1-2 drops into eye(s); repeat dose in 15 minutes.
Refer to adult dosing.
Note: Children (>3 months of age) should only use the 2% strength solution; patients with heavily pigmented irides may require increased dose.
Ciliary spasm/iritis/iridocyclitis/uveitis: Ophthalmic: 2% solution: 1-2 drops 2-3 times daily, up to every 4 hours for severe uveitis (Alexander, 2004)
Refraction: Ophthalmic: 2% solution: 1-2 drops into eye(s); repeat every 10-15 minutes if necessary; maximum: 5 doses
No dosage adjustment provided in manufacturer 's labeling.
No dosage adjustment provided in manufacturer 's labeling.
Ophthalmic instillation: Wash hands before and after use. Do not touch tip of container to eye. Contact lenses should be removed before instillation; do not reinsert contact lenses within 15 minutes of drops. Finger pressure should be applied to lacrimal sac for 1-3 minutes after instillation to decrease risk of absorption and systemic reactions
Isopto homatropine: Store at 8 ‚ °C to 24 ‚ °C (46 ‚ °F to 75 ‚ °F).
Other preparations: Store at 15 ‚ °C to 30 ‚ °C (59 ‚ °F to 86 ‚ °F).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Ophthalmic, as hydrobromide:
Homatropaire: 5% (5 mL)
Isopto Homatropine: 2% (5 mL [DSC]); 5% (5 mL [DSC])
Generic: 5% (5 mL)
AbobotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of AbobotulinumtoxinA. Monitor therapy
Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Monitor therapy
Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Analgesics (Opioid): Anticholinergic Agents may enhance the adverse/toxic effect of Analgesics (Opioid). Specifically, the risk for constipation and urinary retention may be increased with this combination. Monitor therapy
Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Monitor therapy
Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Exceptions: Cannabidiol. Monitor therapy
Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Avoid combination
Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Avoid combination
Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Monitor therapy
Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Avoid combination
Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Avoid combination
Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Monitor therapy
Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Avoid combination
Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Monitor therapy
OnabotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. Monitor therapy
Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Consider therapy modification
Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Monitor therapy
RimabotulinumtoxinB: Anticholinergic Agents may enhance the anticholinergic effect of RimabotulinumtoxinB. Monitor therapy
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid using drugs with substantial anticholinergic effects in patients receiving secretin whenever possible. If such agents must be used in combination, monitor closely for a diminished response to secretin. Consider therapy modification
Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Monitor therapy
Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Avoid combination
Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Monitor therapy
Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Frequency not defined.
Cardiovascular: Edema
Central nervous system: Burning sensation, stinging sensation
Dermatologic: Eczema
Endocrine & metabolic: Increased thirst
Gastrointestinal: Xerostomia
Local: Local irritation
Ophthalmic: Blurred vision, follicular conjunctivitis, increased intraocular pressure, ocular exudate, photophobia, vascular congestion of the eye
Concerns related to adverse effects:
- CNS effects: Excessive use may cause CNS disturbances, including confusion, delirium, agitation, and coma (rare). May occur with any age group, although children and the elderly are more susceptible. Patients should be cautioned about performing tasks which require mental alertness (eg, operating machinery, driving).
- Light sensitivity (ocular): May cause sensitivity to light; appropriate eye protection should be used.
Disease-related concerns:
- Down syndrome: Patients with Down syndrome are predisposed to angle-closure glaucoma; use with caution.
- Keratoconus: May result in fixed pupil dilation in patients with keratoconus; use with caution.
Special populations:
- Elderly: Use with caution in the elderly due to susceptibility to systemic effects.
- Pediatric: Safety and efficacy have not been established in infants and young children, therefore, use with extreme caution due to susceptibility of systemic effects. Avoid use during the first 3 months of life.
Dosage form specific issues:
- Contact lens wearers: Some strengths may contain benzalkonium chloride which may be adsorbed by contact lenses; remove contacts prior to administration and wait 15 minutes before reinserting.
Other warnings and precautions:
- Appropriate use: For topical ophthalmic use only; discontinue use if pain within the eye occurs. To minimize systemic absorption, apply pressure over the lacrimal sac for 1-3 minutes after instillation. To avoid contamination, do not touch dropper tip to any surface. To avoid precipitating angle closure glaucoma, an estimation of the depth of the anterior chamber angle should be made prior to use.
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Animal reproduction studies have not been conducted.
Blocks response of iris sphincter muscle and the accommodative muscle of the ciliary body to cholinergic stimulation resulting in dilation (mydriasis) and paralysis of accommodation (cycloplegia)
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Patient may experience burning, stinging, or blurred vision. Have patient report immediately to prescriber vision changes, eye pain, severe eye irritation, urinary retention, change in amount of urine passed, dry mouth, thirst, dry skin, flushing, tachycardia, arrhythmia, or change in balance (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.