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AK-Pro Disease Interactions

There are 2 disease interactions with AK-Pro (dipivefrin ophthalmic).

Major

Ophthalmic epinephrine (applies to AK-Pro) aphakia

Major Potential Hazard, High plausibility.

Up to 30% of aphakic patients treated chronically with ophthalmic epinephrine (of which dipivefrin is a prodrug) may develop cystoid macular edema, which is generally reversible following withdrawal of the medication. Ophthalmic epinephrine preparations should be administered cautiously with appropriate monitoring in patients with aphakia. Therapy should be discontinued if blurred or distorted vision, central scotoma, and/or loss of visual acuity occur. Slight visual impairment may respond to a reduction in the concentration or frequency of administration of the drug.

References (10)
  1. American Medical Association, Division of Drugs and Toxicology (1994) "Drug evaluations annual 1994." Chicago, IL: American Medical Association;
  2. Thomas JV, Gragoudas ES, Blair NP, Lapus JV (1978) "Correlation of epinephrine use and macular edema in aphakic glaucomatous eyes." Arch Ophthalmol, 96, p. 625-8
  3. Mackool RJ, Muldoon T, Fortier A, Nelson D (1977) "Epinephrine-induced cystoid macular edema in aphakic eyes." Arch Ophthalmol, 95, p. 791-3
  4. Kolker AE, Becker B (1968) "Epinephrine maculopathy." Arch Ophthalmol, 79, p. 552-62
  5. Cerasoli JR (1971) "Effects of drugs on the retina." Int Ophthalmol Clin, 11, p. 121-35
  6. Obstbaum SA, Galin MA, Poole TA (1976) "Topical epinephrine and cystoid macular edema." Ann Ophthalmol, 8, p. 455-8
  7. Mehelas TJ, Kollarits CR, Martin WG (1982) "Cystoid macular edema presumably induced by dipivefrin hydrochloride (Propine)." Am J Ophthalmol, 94, p. 682
  8. Benjamin KW (1979) "Toxicity of ocular medications." Int Ophthalmol Clin, 19, p. 199-255
  9. (2022) "Product Information. Propine (dipivefrin ophthalmic)." Allergan Inc
  10. (2022) "Product Information. Epifrin (EPINEPHrine ophthalmic)." Allergan Inc
Major

Ophthalmic epinephrine (applies to AK-Pro) narrow angles

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

The use of ophthalmic preparations of epinephrine, including dipivefrin (a prodrug of epinephrine), 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, either with or without the use of concomitant miotic agents. In patients with narrow angles, any degree of pupillary dilation can provoke an acute attack of angle-closure glaucoma. In contrast, sympathomimetic agents with relative alpha-2 adrenergic selectivity such as apraclonidine and brimonidine produce little to no mydriasis at normally recommended dosages.

References (3)
  1. Benjamin KW (1979) "Toxicity of ocular medications." Int Ophthalmol Clin, 19, p. 199-255
  2. (2022) "Product Information. Propine (dipivefrin ophthalmic)." Allergan Inc
  3. (2022) "Product Information. Epifrin (EPINEPHrine ophthalmic)." Allergan Inc

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AK-Pro drug interactions

There are 43 drug interactions with AK-Pro (dipivefrin ophthalmic).

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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

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