Drug Detail:Apraclonidine ophthalmic (Apraclonidine ophthalmic [ a-pra-klon-i-deen-off-thal-mik ])
Drug Class: Ophthalmic glaucoma agents
Usual Adult Dose for Glaucoma
0.5% Solution: 1 to 2 drops instilled in the affected eye(s) 3 times per day
Comments:
- When used concomitantly with other ophthalmic drugs, an approximate 5-minute interval between instillation of each medication should be followed to prevent washout of the previous dose.
- Use of this drug may not significantly reduce intraocular pressure (IOP) if this drug is added to a regimen already containing 2 drugs as part of the maximally tolerated medical therapy.
- Patients on maximally tolerated medical therapy who are treated to delay surgery should have frequent follow up examinations and treatment should be discontinued if the IOP rises significantly.
Use: Short-term adjunctive therapy in patients on maximally tolerated medical therapy who require additional IOP reduction
Usual Adult Dose for Postoperative Increased Intraocular Pressure
1% Ophthalmic Solution: 1 drop instilled into the eye scheduled for operation 1 hour before initiating anterior segment laser surgery, AND THEN 1 drop should be instilled into the same eye immediately upon completion of the laser surgical procedure
Comment: A separate container should be used for each dose and discarded after use.
Use: Control or prevent post-surgical elevations in IOP that occur in patients after argon laser trabeculoplasty, argon laser iridotomy, or neodymium-doped yttrium aluminum garnet (Nd:YAG) posterior capsulotomy
Renal Dose Adjustments
0.5% Solution:
- Renal dysfunction: Frequent cardiovascular system monitoring recommended.
- Chronic renal failure: Use with caution.
1% Ophthalmic Solution:
- Renal dysfunction: Data not available
- Chronic renal failure: Use with caution.
Liver Dose Adjustments
0.5% Solution:
- Liver dysfunction: Frequent cardiovascular system monitoring recommended.
1% Ophthalmic Solution: Data not available
Precautions
CONTRAINDICATIONS:
0.5% Solution:
- Hypersensitivity to the active component, systemic clonidine, or to any of the ingredients
- Patients receiving MAO inhibitors
1% Ophthalmic Solution:
- Hypersensitivity to the active component, clonidine, or to any of the ingredients
- Patients receiving MAO inhibitor therapy
Safety and efficacy have not been established in pediatric patients.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- This drug is for topical ophthalmic use only.
- Care should be taken not to touch the eyelids, surrounding areas or other surfaces with the dropper tip of the bottle.
- Patients requiring the use of more than one ophthalmic drug should separate administration of each product by at least 5 minutes; eye ointments should be administered last.
Storage requirements:
- Protect from light.
- Do not refrigerate or freeze.
General:
- The intraocular pressure lowering efficacy of this drug usually decreases over time, with benefit in most patients occurring in less than 1 month.
Monitoring:
- CARDIOVASCULAR: Blood pressure and heart rate, especially initially and in patients with renal or liver dysfunction
- OCULAR: Periodic visual field examinations in patients with glaucoma
Patient advice:
- To minimize systemic absorption, pressure should be applied to the tear duct after administration.
- Inform patients that this drug may cause dizziness or drowsiness/somnolence, and they should avoid driving or operating machinery if these side effects occur.
- Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
