Ophthalmic Short-term adjunctive therapy of chronic glaucoma
Adult: In patients who require additional IOP reduction to delay laser treatment or glaucoma surgery: As 0.5% solution: Instil 1-2 drops into the affected eye(s) tid. Max recommended duration: 1 month. Treatment duration may vary based on patient's response.
Ophthalmic Control or prevention of post-surgical intraocular pressure elevation
Adult: As 1% solution: Instil 1 drop into the operative eye 1 hour before and 1 drop immediately upon completion of anterior segment laser surgery.
Contraindications
Concomitant use with MAOIs, systemic sympathomimetics or TCAs. Children. History of severe or unstable and uncontrolled CV disease including uncontrolled arterial hypertension.
Special Precautions
Patient with overt cardiac failure, history of angina, coronary insufficiency, recent MI, cerebrovascular disease, Raynaud’s disease, thromboangiitis obliterans; history of vasovagal reactions. Renal impairment (e.g. chronic renal failure) and hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Hypersensitivity reactions (e.g. pruritus, discomfort, tearing, hyperaemia, foreign body sensation, lid and conjunctival oedema); CNS effects (e.g. dizziness, somnolence). Cardiac disorders: Chest pain, arrhythmia. Eye disorders: Dry eye, conjunctivitis, mydriasis, eyelid retraction, eye disorder (e.g. conjunctival blanching), eyelid margin crusting, conjunctival follicles. Gastrointestinal disorders: Dry mouth, dysgeusia. General disorders and administration site conditions: Asthenia, fatigue. Nervous system disorders: Headache. Psychiatric disorders: Depression, nervousness, insomnia. Respiratory, thoracic and mediastinal disorders: Nasal dryness, rhinitis. Skin and subcutaneous tissue disorders: Dermatitis.
This drug may cause dizziness and somnolence, if affected, do not drive or operate machinery. Remove contact lenses before instillation and reinsert them after 15 minutes.
Monitoring Parameters
Closely monitor for excessive reductions in IOP (after peri-operative use) and visual fields (periodically for glaucoma patients on maximally tolerated treatment using 0.5% solution); tachyphylaxis; CV parameters (in patients with renal and/or hepatic impairment).
Drug Interactions
Decreased therapeutic effect with TCAs. Additive hypotensive effect with clonidine. May reduce heart rate and blood pressure with cardiac glycosides, and β-blockers (ophthalmic and systemic). Potentially Fatal: Increased serum concentration and enhanced adverse effects with MAOIs.
Action
Description: Mechanism of Action: Apraclonidine, a clonidine derivative, is a potent selective α2-adrenergic agonist. It is believed to reduce aqueous humour, thereby lowering intra-ocular pressure (IOP). Onset: Within 1 hour. Peak effect: 3-5 hours. Duration: Approx 12 hours. Pharmacokinetics: Excretion: Elimination half-life: 8 hours (0.5% solution).
Chemical Structure
Apraclonidine Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 2216, Apraclonidine. https://pubchem.ncbi.nlm.nih.gov/compound/Apraclonidine. Accessed Nov. 22, 2023.
Storage
Store below 25°C. Do not freeze. Protect from light.
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