ATC Class: S01EA02
VA Class: OP103
Chemical Name: (±)-3,4-Dihydroxy-α-[(methylamino)methyl]benzyl alcohol 3,4-dipivalate
Molecular Formula: C19H29NO5
CAS Number: 64019-93-8
Synthetic sympathomimetic amine.78
Uses for Dipivefrin Hydrochloride
Ocular Hypertension and Glaucoma
Reduction of elevated IOP in patients with open-angle glaucoma.1 4 5 10 13 25 26 27 28 34 36 37 52 Used alone or in conjunction with other IOP-lowering drugs.1 4 5 7 10 13 25 26 27 28 31 34 36 37 38 51 52 53 56 57 59 60 62 87 88 May be used as initial therapy 1 7 10 13 25 26 27 28 34 52 or for control of IOP in those patients who have not responded adequately to other antiglaucoma agents.1 5 7 10 13 25 26 31 34 36 38 51 52 53 56 57 59 60 62 87 88
May be preferred as an alternative to topical epinephrine in some patients (e.g., those with cardiovascular disease)31 because of increased intraocular penetration (lower doses are needed) and resultant decreased adverse systemic effects (e.g., cardiovascular effects) compared with epinephrine.7 11 26 28 31 34 57 69
Has been used to reduce IOP in the treatment of other ocular conditions, including ocular hypertension† and pseudoexfoliative†, low-tension†, and secondary† (e.g., post-angle closure, pigmentary, traumatic, herpes zoster) glaucomas.34 52
Dipivefrin Hydrochloride Dosage and Administration
Adjust dosage according to individual requirements and response of patient as determined by tonometric readings before and during therapy.7
Because of diurnal variations in IOP, measure IOP at different times during the day to determine if an adequate hypotensive effect is maintained.7 Since IOP may not stabilize for a few weeks after initiating therapy, determine IOP after several weeks of therapy; thereafter, IOP should be determined as necessary.7 89 94
Avoid contamination of the solution container.6
Available as dipivefrin hydrochloride; dosage expressed in terms of the salt.1
Ocular Hypertension and Glaucoma
In patients receiving several drugs for the treatment of glaucoma, adjustments to the regimen should involve one drug at a time and should usually occur at intervals of at least 1 week.89
Initially, 1 drop of a 0.1% solution every 12 hours while therapy with other drugs is continued.1 Beginning on the following day1 and continuing at intervals of at least 1 week until optimum response is achieved, reduce dosage of one of the other drugs or discontinue one of the other drugs.89 Adjust remaining regimen according to the IOP response of the patient.89
Conversion to Dipivefrin TherapyOphthalmic
Conversion from monotherapy with epinephrine: Discontinue epinephrine and initiate dipivefrin at 1 drop of a 0.1% solution into affected eye(s) every 12 hours1 5 at the time of the next scheduled dose of epinephrine.89 94
Conversion from monotherapy with antiglaucoma agents other than epinephrine: On day 1, continue other antiglaucoma agent and add 1 drop of a 0.1% dipivefrin solution every 12 hours.1 On day 2, discontinue the other drug and continue dipivefrin.1
Cautions for Dipivefrin Hydrochloride
Blepharoconjunctivitis, requiring discontinuance of dipivefrin, reported after ≥5 months of therapy.4 36 37 54 55 59 63 Karyomegaly of conjunctival epithelial cells, 63 chemosis of the conjunctiva, 59 dry eczematoid dermatitis of the eyelids, 59 pruritus, 55 and blepharitis 25 53 55 reported.
Allergic reactions may be caused by excipients in the preparation.66
Ophthalmic use of epinephrine occasionally causes systemic sympathomimetic effects, such as tachycardia,1 7 arrhythmias,1 28 31 and hypertension;1 28 31 however, systemic sympathomimetic effects occur rarely with topical administration of dipivefrin.5
Safety and efficacy not established.1
No substantial differences in safety and efficacy relative to younger adults.1
Common Adverse Effects
Interactions for Dipivefrin Hydrochloride
Ocular hypotensive agents
Dipivefrin Hydrochloride Pharmacokinetics
Following topical application to the eye, about 7% of administered dose absorbed across the cornea into the aqueous humor mainly as epinephrine.8 Lipid solubility enhances ocular absorption of dipivefrin over that of epinephrine.7 8 13 16 38
Rarely, absorption following topical application to the eye may be sufficient to cause systemic sympathomimetic effects to occur.31
Rapidly distributed throughout ocular tissues and fluids in rabbits.7 16 30 39 44 In humans, dipivefrin and its metabolites detected in the cornea,8 aqueous humor,8 and to a lesser extent, the tissues and fluids of the contralateral untreated eye;16 32 however, distribution in human ocular tissues and fluids not fully characterized.94
Systemic distribution following administration of topical dipivefrin not determined.94
Following topical application and ocular absorption, rapidly and extensively hydrolyzed to epinephrine via esterases (e.g., acetylcholinesterase, pseudocholinesterase, carbonic anhydrase) in the cornea, conjunctiva, and aqueous humor.1 4 5 8 11 14 16 30 33 39 40 46 47 50 74
Averages 1.8, 0.9, and 3.1 hours in the cornea, aqueous humor, and iris/ciliary body, respectively.44
Lowers IOP1 4 5 10 13 25 26 27 28 34 36 37 52 in patients with glaucoma;1 4 5 10 13 25 26 27 28 34 36 37 52 lowers IOP to a lesser extent in the normal eye; causes mydriasis.27 77 Appears to lower IOP by stimulating α -and/or β2-adrenergic receptors, 7 11 23 24 67 90 93 95 96 resulting in an increase in pressure-independent (uveoscleral) and, to a lesser extent in pressure-dependent (trabecular) aqueous humor outflow.1 4
Advice to Patients
Importance of learning and adhering to proper administration techniques to avoid contamination of the product.1
Advise patients to consult a clinician immediately regarding continued use of ophthalmic preparations if an intercurrent ocular condition (e.g., trauma, infection, sensitivity, irritation) occurs.1 89 94
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as concomitant illnesses.1
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1
Importance of informing patients of other important precautionary information. (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Dipivefrin Hydrochloride Ophthalmic Solution
Bausch & Lomb, Falcon
Propine (with benzalkonium chloride)
AHFS DI Essentials. © Copyright, 2016, American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814. Review Date: September 06, 2016.
1. Allergan Pharmaceuticals. Propine (dipivefrin hydrochloride) prescribing information. Irving, CA; 2005 Aug.
2. Windholz M, ed. The Merck index. 10th ed. Rahway, NJ: Merck & Co, Inc; 1983:488.
3. The United States pharmacopeia, 23rd rev, and The national formulary, 18th ed. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1995:538-9,2084.
4. AMA Division of Drugs. AMA drug evaluations. 5th ed. Chicago: American Medical Association; 1983:454-7.
5. USP DI: 1985 drug information for the health care provider. Johnson KW, ed. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1984;I:534.
6. American Society of Health-System Pharmacists, Inc.. Medication teaching manual. 3rd ed. Bethesda, MD: American Society of Hospital Pharmacists, Inc; 1983:326.
7. Havener WH. Ocular pharmacology. 5th ed. St. Louis: The CV Mosby Company; 1983:18-43,261-417, 635-72.
8. Mandell AI, Stentz F, Kitabchi AE. Dipivalyl epinephrine: a new pro-drug in the treatment of glaucoma. Ophthalmology. 1978; 85:268-75. [PubMed 662280]
9. Wang BC, Bloxham DD, Goetz KL. Effect of dipivalyl derivatives of catecholamines on cardiovascular function in the conscious dog. J Pharmacol Exp Ther. 1977; 203:442-8. [PubMed 20498]
10. Hussar DA. New drugs of the year. Prodrug: agent for glaucoma. Am Pharm. 1981; NS21:158.
11. McClure DA. The effect of a pro-drug of epinephrine (dipivalyl epinephrine) in glaucoma—general pharmacology, toxicology, and clinical experience. In: Higuchi T, Stella V, eds. Pro-drugs as novel drug delivery systems. ACS Symposium Series 14. Washington: American Chemical Society; 1975:224-35.
12. Garzia R. The use of the epinephrine pro-drug dipivalyl epinephrine in the treatment of glaucoma. J Am Optom Assoc. 1982; 727-30.
13. Okun R. New medications—1981. Annu Rev Pharmacol Toxicol. 1981; 21:597-604. [PubMed 6786209]
14. Hussain A, Truelove JE. Prodrug approaches to the enhancement of physicochemical properties of drugs IV: novel epinephrine prodrug. J Pharm Sci. 1976; 65:1510-2. [PubMed 978412]
15. Anon. Summary of new drugs marketed in USA in 1980. J Med Soc NJ. 1981; 78:544-7.
16. Wei CP, Anderson JA, Leopold I. Ocular absorption and metabolism of topically applied epinephrine and a dipivalyl ester of epinephrine. Invest Ophthalmol Vis Sci. 1978; 17:315-21. [PubMed 640779]
17. Becker B, Pettit TH, Gay AJ. Topical epinephrine therapy of open-angle glaucoma. Arch Ophthalmol. 1961; 66:219. [PubMed 13688427]
18. Anon. Dipivefrin: an adrenaline pro-drug for glaucoma. Drug Ther Bull. 1985; 23(7):27-8. [PubMed 3987515]
19. Sears ML. The mechanism of action of adrenergic drugs in glaucoma. Invest Ophthalmol Vis Sci. 1966; 5:115-9.
20. Eakins KE. The effect of intravitreous injections of norepinephrine, epinephrine and isoproterenol on the intraocular pressure and aqueous humor dynamics of rabbit eyes. J Pharmacol Exp Ther. 1963; 140:79-84.
21. Bischoff P. Erfahrungen mit einem neuen Adrenalinpraparat in der Glaukomtherapie (Dipivalyl-Epinephrin). (German; with English abstract.) Klin Monatsbl Augenheilkd. 1978; 172:565-8.
22. Neufeld AH, Page ED. In vitro determination of the ability of drugs to bind to adrenergic receptors. Invest Ophthalmol Vis Sci. 1977; 16:1118-24. [PubMed 200584]
23. Innemee HC, van Zwieten PA. The role of β2-adrenoceptors in the IOP-lowering effect of adrenaline. Albrecht von Graefes Arch Klin Exp Ophthalmol. 1982; 218:297-300.
24. Winston M. Drug therapy of glaucoma. Iowa Pharm. 1983: 37(9):15-9. (IDIS 175621)
25. Kass MA, Mandel AI, Goldberg I et al. Dipivefrin and epinephrine treatment of elevated intraocular pressure: a comparative study. Arch Ophthalmol. 1979; 97:1865-6. [IDIS 104861] [PubMed 39539]
26. Kohn AN, Moss AP, Hargett NA et al. Clinical comparison of dipivalyl epinephrine and epinephrine in the treatment of glaucoma. Am J Ophthalmol. 1979; 87:196-201. [IDIS 108134] [PubMed 373450]
27. Kaback MB, Podos SM, Harbin TS Jr et al. The effects of dipivalyl epinephrine on the eye. Am J Ophthalmol. 1976; 81:768-72. [IDIS 74866] [PubMed 180809]
28. Kerr CR, Hass I, Drance SM et al. Cardiovascular effects of epinephrine and dipivalyl epinephrine applied topically to the eye in patients with glaucoma. Br J Ophthalmol. 1982; 66:109-14. [PubMed 7037047]
29. Mindel JS, Koenigsberg AM, Kharlamb AB et al. The effect of echothiophate on the biphasic response of rabbit ocular pressure to dipivefrin. Arch Ophthalmol. 1982; 100:147-51. [PubMed 6173032]
30. Redell MA, Yang DC, Lee VHL. The role of esterase activity in the ocular disposition of dipivalyl epinephrine in rabbits. Int J Pharm. 1983; 17:299-312.
31. Blondeau P, Coté M. Cardiovascular effects of epinephrine and dipivefrin in patients using timolol: a single-dose study. Can J Ophthalmol. 1984; 19:29-32. [PubMed 6713266]
32. Gwin RM, Gelatt KN, Gum GG et al. Effects of topical 1-epinephrine and dipivalyl epinephrine on intraocular pressure and pupil size in the normotensive and glaucomatous beagle. Am J Vet Res. 1978; 39:83-6. [PubMed 629453]
33. Krieglstein GK, Leydhecker W. The dose-response relationships of dipivalyl epinephrine in open-angle glaucoma. Albrecht von Graefes Arch Klin Exp Ophthalmol. 1978; 205:141-6. [PubMed 305728]
34. West RH, Cebon L, Gillies WE. Drop attack in glaucoma: the Melbourne experience with topical miotics, adrenergic and neuronal blocking drops. Aust J Ophthalmol. 1983; 11:149-53. [PubMed 6639505]
35. Iso T, Uda K, Yamauchi H et al. Antianaphylactic effects of dipivalyl epinephrine and related compounds in rat conjunctiva. Invest Ophthalmol Vis Sci. 1980; 19:824-6. [PubMed 7390730]
36. Frumar KD, McGuinness R. A study of the intraocular pressure lowering effect of timolol and dipivalyl epinephrine. Trans Ophthalmol Soc NZ. 1981; 33:27-9.
37. Frumar KD, McGuinness R. A study of the intraocular pressure lowering effect of timolol and dipivalyl epinephrine. Aust J Ophthalmol. 1982; 10:121-3. [PubMed 7049141]
38. Thorson JC. Concomitant glaucoma therapy with dipivefrin and timolol maleate. Trans Ophthalmol Soc NZ. 1981; 33:24-6.
39. Anderson JA, Davis WL, Wei CP. Site of ocular hydrolysis of a prodrug, dipivefrin, and a comparison of its ocular metabolism with that of the parent compound, epinephrine. Invest Ophthalmol Vis Sci. 1980; 19:817-23. [PubMed 7390729]
40. Anderson JA. Systemic absorption of topical ocularly applied epinephrine and dipivefrin. Arch Ophthalmol. 1980; 98:350-3. [PubMed 7352887]
41. Shirkey HC. Adverse reactions to drugs—their relation to growth and development. In: Shirkey HC, ed. Pediatric therapy. 5th ed. St. Louis: The CV Mosby Company; 1975:171-211.
42. Rivera-Calimlim L. Drugs in breast milk. Drug Ther. 1977; 7:4-6.
43. White GJ, White MK. Breastfeeding and drugs in human milk. Vet Hum Toxicol. 1980; 22(Suppl 1):1-43. [PubMed 6987804]
44. Tamaru RD, Davis WL, Anderson JA. Comparison of ocular disposition of free pivalic acid and pivalic acid esterified in dipivefrin. Arch Ophthalmol. 1983; 101:1127-9. [PubMed 6347153]
45. Weiner N, Taylor P. Neurohumoral transmission: the autonomic and somatic motor nervous systems. In: Gilman AG, Goodman LS, Rall TW et al, eds. Goodman and Gilman’s the pharmacological basis for therapeutics. 7th ed. New York: Macmillan Publishing Company; 1985:66-99.
46. Weiner N. Norepinephrine, epinephrine, and the sympathomimetic amines. In: Gilman AG, Goodman LS, Rall TW et al, eds. Goodman and Gilman’s the pharmacological basis for therapeutics. 7th ed. New York: The Macmillan Company; 1985:145-80.
47. Lee VHL. Esterase activities in adult rabbit eyes. J Pharm Sci. 1983; 72:239-44. [PubMed 6842375]
48. Kramer SG, Potts AM. Catecholamine metabolite formation in the iris and ciliary body in vivo. Am J Ophthalmol. 1971; 72:939-46. [PubMed 5119705]
49. Waltman S, Sears M. Catechol-O-methyl transferase and monoamine oxidase activity in the ocular tissues of albino rabbits. Invest Ophthalmol. 1964; 3:601-5. [PubMed 14238873]
50. Mindel JS, Cohen G, Barker LA et al. Enzymatic and nonenzymatic hydrolysis of D,L-dipivefrin. Arch Ophthalmol. 1984; 102:457-60. [PubMed 6703997]
51. McGuinness R, Frumar KD. Timolol and dipivalyl epinephrine combination therapy. Aust J Ophthalmol. 1982; 10:179-82. [PubMed 7181758]
52. Cebon L, West RH, Gillies WE. Experience with dipivalyl epinephrine: its effectiveness, alone or in combination, and its side effects. Aust J Ophthalmol. 1983; 11:159-61. [PubMed 6639507]
53. Keates EU, Stone RA. Safety and effectiveness of concomitant administration of dipivefrin and timolol maleate. Am J Ophthalmol. 1981; 91:243-8. [IDIS 164677] [PubMed 7468740]
54. Theodore J, Leibowitz HM. External ocular toxicity of dipivalyl epinephrine. Am J Ophthalmol. 1979; 88:1013-6. [IDIS 109379] [PubMed 517603]
55. Yablonski ME, Shin DH, Kolker AE et al. Dipivefrin use in patients with intolerance to topically applied epinephrine. Arch Ophthalmol. 1977; 95:2157-8. [IDIS 92006] [PubMed 588107]
56. Mindel JS, Yablonski ME, Tavitian HO et al. Dipivefrin and echothiophate: efficacy of combined use in human beings. Arch Ophthalmol. 1981; 99:1583-6. [IDIS 137458] [PubMed 7283808]
57. Krieglstein GK, Leydhecker W. Die augendrucksenkende Wirkung von Pilokarpin und Adrenalin-Dipivalat bei Glaucoma simplex: eine kontrollierte klinische Studie. (German; with English abstract.) Klin Monatsbl Augenheilkd. 1979; 175:86-90.
58. Newton MJ, Nesburn AB. Lack of hydrophilic lens discoloration in patients using dipivalyl epinephrine for glaucoma. Am J Ophthalmol. 1979; 87:193-5. [IDIS 108133] [PubMed 86303]
59. Liesegang TJ. Bulbar conjunctival follicles associated with dipivefrin therapy. Ophthalmology. 1985; 92:228-33. [PubMed 3982802]
60. Pilger IS, Khwarg SG. Angle recession glaucoma: review and two case reports. Ann Ophthalmol. 1985; 17:197-9. [PubMed 3994222]
61. Miranda MN, Garcia-Castineiras S. Effects of pH and some common topical ophthalmic medications on the contact lens Permalens. CLAO J. 1983; 9:43-8. [PubMed 6839434]
62. Knupp JA, Shields MB, Mandel AI et al. Combined timolol and epinephrine therapy for open angle glaucoma. Surv Ophthalmol. 1983; 28(Suppl):280-5. [PubMed 6665707]
63. Wandel T, Spinak M. Toxicity of dipivalyl epinephrine. Ophthalmology. 1981; 88:259-60. [PubMed 7231914]
64. Mehelas TJ, Kollarits CR, Martin WG. Cystoid macular edema presumably induced by dipivefrin hydrochloride (Propine). Am J Ophthalmol. 1982; 94:682. [IDIS 161132] [PubMed 7148952]
65. Polak BCP. Antiglaucomatous drugs: sympathomimetic agents, dipivefrine. In: Dukes MNG, ed. Side effects of drugs. Annual 8. New York: Elsevier/North Holland Inc; 1984:438-40.
66. Schwartz HJ, Scher TH. Bisulfite intolerance manifest as bronchospasm following topical dipivefrin hydrochloride therapy for glaucoma. Arch Ophthalmol. 1985; 103:14-5. [IDIS 195001] [PubMed 3977669]
67. Langham ME, Krieglstein GK. The biphasic intraocular pressure response of rabbits to epinephrine. Invest Ophthalmol Vis Sci. 1976; 15:119-27.
68. Ballin N, Becker B, Goldman ML. Systemic effects of epinephrine applied topically to the eye. Invest Ophthalmol. 1966; 5:125-9.
69. Stella VJ, Charman WNA, Naringrekar VH. Prodrugs: do they have advantages in clinical practice? Drugs. 1985; 29:455-73. (IDIS 199973)
70. Miller D, Brooks SM, Mobilia E. Adrenochrome staining of soft contact lenses. Ann Ophthalmol. 1976; 8:65-7. [PubMed 1247264]
71. Ferry JF. Black prosthesis: a complication of the topical use of epinephrine. Am J Ophthalmol. 1967; 64:162.
72. Sugar J. Adrenochrome pigmentation of hydrophilic lenses. Arch Ophthalmol. 1974; 91:11-2. [PubMed 4587194]
73. Abramovsky I, Mindel JS. Dipivefrin and echothiophate: contraindications to combined use. Arch Ophthalmol. 1979; 97:1937-40. [PubMed 485920]
74. Anderson JA, Richman JB, Mindel JS. Effects of echothiophate on enzymatic hydrolysis of dipivefrin. Arch Ophthalmol. 1984; 102:913-6. [PubMed 6732575]
75. Goldberg I, Ashburn FS Jr, Palmberg PF et al. Timolol and epinephrine: a clinical study of ocular interactions. Arch Ophthalmol. 1980; 98:484-6. [IDIS 109845] [PubMed 7362504]
76. Korey MS, Hodapp E, Kass MA et al. Timolol and epinephrine: long-term evaluation of concurrent administration. Arch Ophthalmol. 1982; 100:742-5. [IDIS 150870] [PubMed 7044351]
77. Azuma I, Hirano T, Utsumi T et al. [Effects of dipivalyl epinephrine (DPE) on intraocular pressure and pupil.] (Japanese; with English abstract.) Nippon Ganka Gakkai Zasshi. 1977; 81:1036-44.
78. Harvey SC. Sympathomimetic drugs. In: Gennaro AR, chairman, Chase GD, Gibson MR et al, eds. Remington’s pharmaceutical sciences. 17th ed. Easton, PA: Mack Publishing Company; 1985:876-93.
79. Anon. Sulfites in foods and drugs. FDA Drug Bull. 1983; 13:12. [PubMed 6604672]
80. Sogn D. The ubiquitous sulfites. JAMA. 1984; 251:2986-7. [IDIS 185969] [PubMed 6716628]
81. Koepke JW, Christopher KL, Chai H et al. Dose-dependent bronchospasm from sulfites in isoetharine. JAMA. 1984; 251:2982-3. [IDIS 185966] [PubMed 6716626]
82. Twarog FJ, Leung DYM. Anaphylaxis to a component of isoetharine (sodium bisulfite). JAMA. 1982; 248:2030-1. [IDIS 158261] [PubMed 7120631]
83. Baker GJ, Collett P, Allen DH. Bronchospasm induced by metabisulphite-containing foods and drugs. Med J Aust. 1981; 2:614-7. [IDIS 146240] [PubMed 7334982]
84. Koepke JW, Selner JC, Dunhill AL. Presence of sulfur dioxide in commonly used bronchodilator solutions. J Allergy Clin Immunol. 1983; 72:(5 Part 1):504-8. [IDIS 178793] [PubMed 6630799]
85. Food and Drug Administration. Sulfiting agents; labeling in drugs for human use: warning statements. [21 CFR Part 201] Fed Regist. 1986; 51:43900-5.
86. US Food and Drug Administration Center for Food Safety and Applied Nutrition. Tentative report on the reexamination of the GRAS status of sulfiting agents, October 1984. Bethesda, MD: FASEB Life Sciences Research Office. (in press)
87. Levy NS, Boone L, Ellis E. A controlled comparison of betaxolol and timolol with long-term evaluation of safety and efficacy. Glaucoma. 1985; 7:54-62.
88. Weinreb RN, Ritch R, Kushner FH. Effect of adding betaxolol to dipivefrin therapy. Am J Ophthalmol. 1986; 101:196-8. [IDIS 211580] [PubMed 3946535]
89. Reviewers’ comments (personal observations).
90. Schenker HI, Yablonski ME, Podos SM et al. Fluorophotometric study of epinephrine and timolol in human subjects. Arch Ophthalmol. 1981; 99:1212-6. [IDIS 134903] [PubMed 7259595]
91. Nagataki S, Brubaker RF. Early effect of epinephrine on aqueous formation in the normal human eye. Ophthalmology. 1981; 88:278-82. [PubMed 7231917]
92. Townsend DJ, Brubaker RF. Immediate effect of epinephrine on aqueous formation in the normal human eye as measured by fluorophotometry. Invest Ophthalmol Vis Sci. 1980; 19:256-66. [IDIS 113307] [PubMed 7358476]
93. Thomas JV, Epstein DL. Timolol and epinephrine in primary open angle glaucoma: transient additive effect. Arch Ophthalmol. 1981; 99:91-5. [IDIS 130036] [PubMed 7006581]
94. Garbe D (Allergan Pharmaceuticals, Inc, Irvine, CA): Personal communication.
95. Norton AL, Viernstein LJ. The effect of adrenergic agents on ocular dynamics as a function of administration site. Exp Eye Res. 1972; 14:154-63. [PubMed 5070228]
96. Potter DE, Rowland JM. Adrenergic drugs and intraocular pressure: effects of selective β-adrenergic agonists. Exp Eye Res. 1978; 27:615-25. [PubMed 33056]
97. Alward WLM. Medical management of glaucoma. N Engl J Med. 1998; 339:1298-307. [IDIS 414110] [PubMed 9791148]
98. Falcon Pharmaceuticals. Dipivefrin hydrochloride solution prescribing information. Fort Worth, TX; 2000.
More about dipivefrin ophthalmic
- Other brands: Propine