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Epinal Side Effects

Generic name: epinephrine ophthalmic

Medically reviewed by Last updated on Dec 2, 2022.

Note: This document contains side effect information about epinephrine ophthalmic. Some dosage forms listed on this page may not apply to the brand name Epinal.

Applies to epinephrine ophthalmic: ophthalmic solution.


Chronic ophthalmic application of epinephrine to aphakic patients may cause maculopathy in up to 28% of patients (macular edema, vascular spasm, hemorrhages), which can result in distorted vision, central scotoma, and/or loss of visual acuity. This maculopathy can reverse within six months upon drug withdrawal.

A single case of madarosis (loss of eyelashes) has been associated with topical epinephrine. After the therapy was discontinued, the lashes grew back.[Ref]

Ocular side effects have included stinging and burning, lacrimation, and local discomfort upon application in up to 62% of patients. Browache, eye pain/ache, conjunctival hyperemia, allergic lid reactions, mydriasis, blurry vision, photophobia have been reported. Ocular cicatrization, pemphigoid, loss of eyelashes, and maculopathy have been reported rarely. Prolonged use can cause corneal edema, refractoriness of superficial blood vessels to constrict, and deposition of brownish oxidation products of epinephrine in the palpebral conjunctiva.[Ref]


Cardiovascular side effects associated with ocularly applied epinephrine have rarely included palpitations, tachycardia, extrasystoles, premature ventricular depolarizations, cardiac arrhythmias, and hypertension.[Ref]

Nervous system

Nervous system side effects associated with ocularly applied epinephrine have included faintness, trembling, pallor, headache, tremors, and perspiration.[Ref]


Hypersensitivity reactions after ocular application may present as diffuse vascular engorgement, follicular hypertrophy, chemosis, conjunctivitis, and/or iritis.[Ref]


In general, systemic side effects after topical application of epinephrine to the eye are more likely if the corneum is damaged or permeability is increased by tonometry, surgery, inflammation, or topical application of a local anesthetic.[Ref]

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Further information

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

Some side effects may not be reported. You may report them to the FDA.