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Dipivefrin ophthalmic Side Effects

For the Consumer

Applies to dipivefrin ophthalmic: ophthalmic solution

In addition to its needed effects, some unwanted effects may be caused by dipivefrin ophthalmic. In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking dipivefrin ophthalmic, check with your doctor or nurse as soon as possible:

  • Fast or irregular heartbeat
  • increase in blood pressure
  • itching, pain, redness, or swelling of eye or eyelid (severe), or other irritation of the eye
  • skin rash or hives
  • watering of eyes (severe and continuing)

Minor Side Effects

Some of the side effects that can occur with dipivefrin ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common:
  • Blurred vision
  • burning or stinging of the eye
  • headache
  • increased sensitivity of eyes to light
  • large pupils

For Healthcare Professionals

Applies to dipivefrin ophthalmic: ophthalmic solution


Ocular side effects have included injection (6.5%), stinging (6%), and burning (6%). Follicular conjunctivitis and mydriasis have been reported rarely. Corneal vascularization or vesicles, eyelid ectropion, papillary conjunctivitis, blepharoconjunctivitis, macular edema, corneal toxicity (dendritic keratitis, punctate keratitis, or epitheliopathy), and blurred vision have also been reported.

Ocular side effects associated with ocular administration of epinephrine have included conjunctival and corneal adrenochrome deposits.[Ref]

Some long-term studies have reported observations of follicular conjunctivitis in almost all patients with up to 40% classified as severe reactions.[Ref]


Cardiovascular side effects have included slight increases in heart rate and diastolic blood pressure.

Cardiovascular side effects associated with ocular epinephrine have included tachycardia, arrhythmias, and hypertension.[Ref]

Most placebo-controlled studies have reported mild average increases in heart rate (3 to 4 beats/min--with or without palpitations) or diastolic blood pressure (1 to 5 mm Hg) associated with dipivefrin.[Ref]

Nervous system

Nervous system side effects have included headache and dizziness.[Ref]


Hypersensitivity reactions have included bronchospasm associated with a formulation containing bisulfite preservative.[Ref]


1. Boerner CF "Total punctate keratopathy due to dipivefrin. Case report." Arch Ophthalmol 106 (1988): 171

2. Keates EU, Stone RA "Safety and effectiveness of concomitant administration of dipivefrin and timolol maleate." Am J Ophthalmol 91 (1981): 243-8

3. Satterfield D, Mannis MJ, Glover AT "Unilateral corneal vesicles secondary to dipivefrin therapy." Am J Ophthalmol 113 (1992): 339-40

4. Liesegang TJ "Bulbar conjunctival follicles associated with dipivefrin therapy." Ophthalmology 92 (1985): 228-33

5. Mehelas TJ, Kollarits CR, Martin WG "Cystoid macular edema presumably induced by dipivefrin hydrochloride (Propine)." Am J Ophthalmol 94 (1982): 682

6. Bartley GB "Reversible lower eyelid ectropion associated with dipivefrin." Am J Ophthalmol 111 (1991): 650-1

7. Albracht DC, LeBlanc RP, Cruz AM, Lamping KA, Siegel LI, Stern KL, Kelley EP, Stoecker JF "A double-masked comparison of betaxolol and dipivefrin for the treatment of increased intraocular pressure." Am J Ophthalmol 116 (1993): 307-13

8. Yablonski ME, Shin DH, Kolker AE, Kass M, Becker B "Dipivefrin use in patients with intolerance to topically applied epinephrine." Arch Ophthalmol 95 (1977): 2157-8

9. Salminen L, Krootila K, Helin H, Hakala T "Corneal vascularization and opacification during long-term use of dipivefrin." J Ocul Pharmacol Ther 11 (1995): 37-40

10. Coleiro JA, Sigurdsson H, Lockyer JA "Follicular conjunctivitis on Dipivefrin therapy for glaucoma." Eye 2(Pt 4) (1988): 440-2

11. Morrison JC, Robin AL "Adjunctive glaucoma therapy: a comparison of apraclonidine to dipivefrin when added to timolol maleate." Ophthalmology 96 (1989): 3-7

12. Blondeau P, Cote M "Cardiovascular effects of epinephrine and dipivefrin in patients using timolol: a single-dose study." Can J Ophthalmol 19 (1984): 29-32

13. Schwartz HJ, Sher TH "Bisulfite intolerance manifest as bronchospasm following topical dipivefrin hydrochloride therapy for glaucoma." Arch Ophthalmol 103 (1985): 14-5

Not all side effects for dipivefrin ophthalmic may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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