Mydcombi is a combination eye spray that contains phenylephrine hydrochloride and tropicamide and may be used to dilate the pupils before an eye examination or when short-term pupil dilation is required.

Mydcombi contains two common medications routinely used for pupil dilation before a comprehensive eye examination. It uses the Optejet dispenser which allows the medication to be delivered horizontally in microdroplets while standing or sitting, unlike traditional eye droppers that rely on gravity, and require a person to have their head tilted back or lying down.

Mydcombi is not for injection and is only for topical use in the eye.

Other warnings and precautions associated with Mydcombi include:

• Rarely, significant elevations in blood pressure may occur. Be cautious when using in children less than 5 years of age, and in patients with cardiovascular disease or hyperthyroidism. Blood pressure should be monitored post-treatment
• Rare incidences of central nervous system disturbances have been reported in children
• May produce a transient increase in intraocular pressure
• Rebound Miosis (small or constricted pupils) has been reported 1 day after administration.

The Mydcombi dispenser should be held upright during use.

• Firmly press the fill button down until the light turns blue, then, slowly release, while counting to three.
• Bring the MydCombi dispenser close to the patient's eye with the mirror facing the eye. Gently pull the lower lid down with your other hand to prevent blinking.
• Aim mist opening toward the center of the eye.
• Ask the patient to confirm when their eye is centered on the blue mirror.
• Press the mist button firmly then release. The drug solution should gently wet the eye. Repeat if needed.

• Adults and children over the age of 1 year: Administer one metered spray to the cornea of each eye to be dilated, and repeat after 5 minutes.
• Children younger than 1 year of age: Administer one metered spray to the cornea of each eye to be dilated, up to a maximum of 3 sprays per eye per day.

The Optejet® dispenser uses high-precision piezo-print technology to deliver 0.008 mL of solution, which is less than 20% of that delivered using conventional eyedroppers, thus reducing overdosing and exposure to drugs and preservatives. The solution is dispensed to the ocular surface in approximately 80 milliseconds, which is faster than the ocular blink reflex.

Mydcombi should not be used by people who are hypersensitive to any of the ingredients contained in the spray.

What is Mydcombi used to treat?

Mydcombi dilates the pupils in preparation for a diagnostic eye examination or when short-term pupil dilation is required. It has been designed to improve the efficiency of office-based comprehensive eye exams and pre-surgery mydriasis (pupil dilation) before cataract surgery. Previously, healthcare providers have had to use two separate eye drop preparations.

Mydcombi was FDA approved on May 5th, 2023.

Common side effects of Mydcombi include temporarily blurred vision and eyesight, sensitivity to light, disturbances to the cells on the surface of the eye (superficial punctate keratitis), and mild eye discomfort. Increased pressure within the eye (intraocular pressure) has been reported following the use of mydriatics.

Common systemic adverse reactions may include mouth dryness, tachycardia, headache, allergic reactions, nausea, vomiting, pallor, central nervous system disturbances, and muscle rigidity.

You may experience sensitivity to light and blurred vision while your pupils are dilated.

Do not drive, use machinery, or do any activity that requires clear vision until you are sure you can perform such activities safely.

Mydcombi may interact with:

• Atropine-like medications: May exaggerate the adrenergic pressor response
• Cholinergic agonists and ophthalmic cholinesterase inhibitors: may interfere with the antihypertensive action of carbachol, pilocarpine, or ophthalmic cholinesterase inhibitors
• Potent inhalation anesthetic agents: These may potentiate the cardiovascular depressant effects of these agents.