Rev-eyes sterile ophthalmic eyedrops 0.5%
Description : For ophthalmic use only.
Dapiprazole hydrochloride is an alpha-adrenergic blocking agent.
Dapiprazole hydrochloride is 5,6,7,8-tetrahydro-3-[2-(4- o .tolyl-1-piperazinyl)ethyl]- s -triazolo[4,3-a]pyridine hydrochloride.
Dapiprazole hydrochloride has the empirical formula C 19 H 27 N 5 ·HCl and a molecular weight of 361.93.
Dapiprazole hydrochloride is a sterile, white, lyophilized powder soluble in water.
REV-EYES™ (dapiprazole hydrochloride ophthalmic solution) Ophthalmic Eyedrops is a clear, colorless, slightly viscous solution for topical application. Each mL (when reconstituted as directed) contains 5 mg of dapiprazole hydrochloride as the active ingredient.
The reconstituted solution has a pH of approximately 6.6 and an osmolarity of approximately 415 mOsm.
The inactive ingredients include: mannitol (2%), sodium chloride, hydroxypropyl methylcellulose (0.4%), edetate sodium (0.01%), sodium phosphate dibasic, sodium phosphate monobasic, water for injection, and benzalkonium chloride (0.01%) as a preservative.
REV-EYES™ Ophthalmic Eyedrops, 0.5% is supplied in a kit consisting of one vial of dapiprazole hydrochloride (25 mg), one vial of diluent (5 mL) and one dropper for dispensing.
Clinical Pharmacology : Dapiprazole hydrochloride ophthalmic solution acts through blocking the alpha-adrenergic receptors in smooth muscle. Dapiprazole hydrochloride ophthalmic solution produces miosis through an effect on the dilator muscle of the iris.
Dapiprazole hydrochloride ophthalmic solution does not have any significant activity on ciliary muscle contraction and, therefore does not induce a significant change in the anterior chamber depth or the thickness of the lens.
Dapiprazole hydrochloride ophthalmic solution has demonstrated safe and rapid reversal of mydriasis produced by phenylephrine and to a lesser degree tropicamide. In patients with decreased accommodative amplitude due to treatment with tropicamide, dapiprazole hydrochloride ophthalmic solution partially restores the accommodative amplitude. This activity is not only due to its miotic effect but also to a direct effect on accommodation.
Eye color affects the rate of pupillary constriction. In individuals with brown irides, the rate of pupillary constriction may be slightly slower than in individuals with blue or green irides. Eye color does not appear to affect the final pupil size.
Dapiprazole hydrochloride ophthalmic solution does not significantly alter intraocular pressure in normotensive eyes or in eyes with elevated intraocular pressure.
Indications and Usage : Dapiprazole hydrochloride ophthalmic solution is indicated in the treatment of iatrogenically induced mydriasis produced by adrenergic (phenylephrine) or parasympatholytic (tropicamide) agents. Dapiprazole hydrochloride ophthalmic solution is not indicated for the reduction of intraocular pressure or in the treatment of open angle glaucoma.
Contraindications : Miotics are contraindicated where constriction is undesirable; such as acute iritis, and in those subjects showing hypersensitivity to any component of this preparation.
Warning : For Topical Ophthalmic Use Only. NOT FOR INJECTION. Do not touch the dropper up to lids or any surface, as this may contaminate the solution. Dapiprazole hydrochloride ophthalmic solution should not be used in the same patient more frequently than once a week.
Information to Patients: Miosis may cause difficulty in dark adaptation and may reduce the field of vision. Patients should exercise caution when involved in night driving or other activities in poor illumination.
Carcinogenesis, Mutagenesis, Impairment of Fertility: Dapiprazole has been shown to significantly increase the incidence of liver tumors in rats after continuous dietary administration for 104 weeks. This effect was found only in male rats treated with the highest dose administered in the study, i.e., 300 mg/kg/day, (80,000 times the human dose) and was not observed in male and female rats at doses of 30 and 100 mg/kg/day and female rats at doses of 300 mg/kg/day.
Negative results have been reported on the mutagenicity and impairment of fertility studies with dapiprazole hydrochloride.
Pregnancy: Pregnancy Category B. Reproduction studies have been performed in rats and rabbits at doses up to 128,000 (rat) and 27,000 (rabbit) times the human ophthalmic dose and revealed no evidence of impaired fertility or harm to the fetus due to dapiprazole hydrochloride. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when dapiprazole hydrochloride ophthalmic solution is administered to a nursing woman.
Pediatric Use: Safety and effectiveness in pediatric patients below the age of 4 have not been established.
Adverse Reactions : In controlled studies the most frequent reaction to dapiprazole was conjunctival injection lasting 20 minutes in over 80% of patients. Burning on instillation of dapiprazole hydrochloride ophthalmic solution was reported in approximately half of all patients. Reactions occurring in 10% to 40% of patients included ptosis, lid erythema, lid edema, chemosis, itching, punctate keratitis, corneal edema, browache, photophobia and headaches. Other reactions reported less frequently included dryness of eyes, tearing and blurring of vision.
Dosage and Administration : Two drops followed 5 minutes later by an additional 2 drops applied topically to the conjunctiva of each eye should be administered after the ophthalmic examination to reverse the diagnostic mydriasis. Dapiprazole hydrochloride ophthalmic solution should not be used in the same patient more frequently than once per week.
How Supplied : REV-EYES™ Ophthalmic Eyedrops, 0.5% Sterile (NDC 24208-394-07)
Each package contains one vial of dapiprazole hydrochloride (25 mg) lyophilized powder, one vial of diluent (5 mL) and dropper for dispensing.
Storage and Stability of Eyedrops: Once the ophthalmic solution has been reconstituted it may be stored at room temperature 15°-30°C (59°-86°F) for 21 days. Discard any solution that is not clear and colorless.
Patented U.S. Patent No. 4,252,721
Revised: July, 1998
North Chicago, IL 60064
Angelini Pharmaceuticals Inc.
River Edge, NJ 07661
Bausch & Lomb Incorporated
Tampa, FL 33637
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