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Mydriatic 3 (cyclopentolate / phenylephrine / tropicamide ophthalmic) Disease Interactions

There are 5 disease interactions with Mydriatic 3 (cyclopentolate / phenylephrine / tropicamide ophthalmic):

Major

Anticholinergics (applies to Mydriatic 3) glaucoma

Major Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension

Anticholinergic agents are contraindicated in patients with primary glaucoma, a tendency toward glaucoma (narrow anterior chamber angle), or adhesions (synechiae) between the iris and lens, as well as for the elderly and others in whom undiagnosed glaucoma or excessive pressure in the eye may be present. Because anticholinergics cause mydriasis, they may exacerbate these conditions.

References

  1. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  2. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  3. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  5. Goldstein JH "Effects of drugs on cornea, conjunctiva, and lids." Int Ophthalmol Clin 11 (1971): 13-34
  6. Clearkin LG "Angle closure glaucoma precipitated by atropine." Arch Intern Med 152 (1992): 880
  7. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmaceutical Company, St. Louis, MO.
  8. Holland MG "Autonomic drugs in ophthalmology: some problems and promises. Section II: Anticholinergic drugs." Ann Ophthalmol 6 (1974): 661-4
  9. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  10. "Product Information. Thorazine (chlorpromazine)." SmithKline Beecham, Philadelphia, PA.
  11. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  12. O'Connor PS, Mumma JV "Atropine toxicity." Am J Ophthalmol 99 (1985): 613-4
  13. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  14. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
  15. Berdy GJ, Berdy SS, Odin LS, Hirst LW "Angle closure glaucoma precipitated by aerosolized atropine." Arch Intern Med 151 (1991): 1658-60
  16. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
  17. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  18. Pecora JL "Malignant glaucoma worsened by miotics in a postoperative angle- closure glaucoma patient." Ann Ophthalmol 11 (1979): 1412-4
  19. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham, Philadelphia, PA.
  20. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  21. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, NJ.
  22. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  23. Kanto J "New aspects in the use of atropine." Int J Clin Pharmacol Ther Toxicol 21 (1983): 92-4
View all 23 references
Major

Ophthalmic sympathomimetics (applies to Mydriatic 3) narrow angles

Major Potential Hazard, High plausibility. Applicable conditions: Glaucoma (Narrow Angle)

The use of nonspecific ophthalmic sympathomimetic agents is contraindicated in patients with narrow-angle glaucoma or anatomically narrow angles. These agents stimulate both alpha-1 and alpha-2 adrenergic receptors, thus topical administration can induce transient mydriasis. In patients with narrow angles, pupillary dilation can provoke an acute attack of angle-closure glaucoma. If possible, these agents (except for phenylephrine 2.5% or 10%) should also be avoided in patients with other forms of glaucoma, since mydriasis may occasionally increase intraocular pressure.

References

  1. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  4. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
View all 4 references
Moderate

Topical sympathomimetics (applies to Mydriatic 3) BPH

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Benign Prostatic Hyperplasia, Prostate Tumor

Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In patients with prostate enlargement, urinary difficulty may develop or worsen due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with topical sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate. It is important that the recommended dosages of the individual products not be exceeded.

References

  1. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  3. "Product Information. Afrin (oxymetazoline nasal)" Schering-Plough, Liberty Corner, NJ.
  4. "Product Information. Neo-Synephrine Nasal (phenylephrine nasal)" Southwood Pharmaceuticals Inc, Irvine, CA.
  5. "Product Information. Pretz-D (ephedrine nasal)" Parnell Pharmaceuticals Inc, San Rafael, CA.
  6. "Product Information. Benzedrex (propylhexedrine nasal)" Menley and James Laboratories Inc, Horsham, PA.
  7. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  8. "Product Information. Otriviv (xylometazoline nasal)" Novartis Pharmaceuticals, East Hanover, NJ.
  9. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
  10. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
  11. "Product Information. Tyzine (tetrahydrozoline)." Kenwood Laboratories, Fairfield, NJ.
  12. "Product Information. Vicks Vapor Inhaler (desoxyephedrine nasal)" Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  13. "Product Information. Privine (naphazoline nasal)" Novartis Consumer Health, Summit, NJ.
  14. Lansche RK "Systemic reactions to topical epinephrine and phenylephrine." Am J Ophthalmol 61 (1966): 95-8
View all 14 references
Moderate

Topical sympathomimetics (applies to Mydriatic 3) cardiovascular

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease, Cerebrovascular Insufficiency, Hyperthyroidism, Corneal Abrasion

Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta-1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, and coronary occlusion have been reported rarely during the use of ophthalmic and nasal sympathomimetic agents, but may be more likely if the corneal epithelium is damaged or if an excessive amount of drug is swallowed during nasal administration. Therapy with topical sympathomimetic agents should be administered cautiously in patients with corneal abrasion, sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders, especially coronary insufficiency, cardiac arrhythmia, or hypertension. The potent ophthalmic formulations (e.g., phenylephrine 2.5% or 10%) that are used for diagnostic and pre-surgical purposes should not be used in such patients. For other preparations, it is important that the recommended dosages of the individual products not be exceeded.

References

  1. "Product Information. Tyzine (tetrahydrozoline)." Kenwood Laboratories, Fairfield, NJ.
  2. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
  3. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Benzedrex (propylhexedrine nasal)" Menley and James Laboratories Inc, Horsham, PA.
  5. "Product Information. Afrin (oxymetazoline nasal)" Schering-Plough, Liberty Corner, NJ.
  6. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  7. "Product Information. Pretz-D (ephedrine nasal)" Parnell Pharmaceuticals Inc, San Rafael, CA.
  8. "Product Information. Neo-Synephrine Nasal (phenylephrine nasal)" Southwood Pharmaceuticals Inc, Irvine, CA.
  9. "Product Information. Vicks Vapor Inhaler (desoxyephedrine nasal)" Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  10. Lansche RK "Systemic reactions to topical epinephrine and phenylephrine." Am J Ophthalmol 61 (1966): 95-8
  11. "Product Information. Otriviv (xylometazoline nasal)" Novartis Pharmaceuticals, East Hanover, NJ.
  12. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
  13. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  14. "Product Information. Privine (naphazoline nasal)" Novartis Consumer Health, Summit, NJ.
View all 14 references
Moderate

Topical sympathomimetics (applies to Mydriatic 3) diabetes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus

Topically applied sympathomimetic agents are systemically absorbed, particularly during prolonged or indiscriminate use. Slight increases in blood glucose concentrations may occur with the use of these drugs. Therapy with topical sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. It is important that the recommended dosages of the individual products not be exceeded.

References

  1. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
  2. "Product Information. Vicks Vapor Inhaler (desoxyephedrine nasal)" Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  3. "Product Information. Otriviv (xylometazoline nasal)" Novartis Pharmaceuticals, East Hanover, NJ.
  4. Lansche RK "Systemic reactions to topical epinephrine and phenylephrine." Am J Ophthalmol 61 (1966): 95-8
  5. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
  6. "Product Information. Privine (naphazoline nasal)" Novartis Consumer Health, Summit, NJ.
  7. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  8. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. "Product Information. Benzedrex (propylhexedrine nasal)" Menley and James Laboratories Inc, Horsham, PA.
  10. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  11. "Product Information. Tyzine (tetrahydrozoline)." Kenwood Laboratories, Fairfield, NJ.
  12. "Product Information. Afrin (oxymetazoline nasal)" Schering-Plough, Liberty Corner, NJ.
  13. "Product Information. Neo-Synephrine Nasal (phenylephrine nasal)" Southwood Pharmaceuticals Inc, Irvine, CA.
  14. "Product Information. Pretz-D (ephedrine nasal)" Parnell Pharmaceuticals Inc, San Rafael, CA.
View all 14 references

Mydriatic 3 (cyclopentolate / phenylephrine / tropicamide ophthalmic) drug interactions

There are 104 drug interactions with Mydriatic 3 (cyclopentolate / phenylephrine / tropicamide ophthalmic)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.