Irifrin eye drops 2.5%, 5 ml

• Iridocyclitis (to prevent the occurrence of posterior synechiae and reduce exudation in the iris);

• dilation of the pupil during ophthalmoscopy and other diagnostic procedures necessary to monitor the condition of the posterior segment of the eye;

• conducting a provocative test in patients with a narrow anterior chamber angle profile and suspected angle-closure glaucoma;

• differential diagnosis of superficial and deep injection of the eyeball;

• in ophthalmosurgery during preoperative preparation for pupil dilation (10% solution);

• carrying out laser interventions on the fundus and in vitreoretinal surgery;

• treatment of glaucomatous crises;

• treatment of red eye syndrome (2.5% solution) (to reduce hyperemia and irritation of the membranes of the eye).

Locally.

When carrying out ophthalmoscopy, single instillations of a 2.5% solution are used. As a rule, to create mydriasis, it is enough to inject 1 drop of 2.5% IrifrinЃ into the conjunctival sac. The maximum mydriasis is achieved in 15-30 minutes and remains at a sufficient level for 1-3 hours. If it is necessary to maintain mydriasis for a long time, repeated instillation is possible after 1 hour.

In adults and children over 12 years of age with insufficient dilation of the pupil, as well as in patients with a rigid iris (pronounced pigmentation), a 10% solution in the same dosage can be used for diagnostic dilation of the pupil.

When carrying out diagnostic procedures, a single instillation of a 2.5% solution is used:

- as a provocative test in patients with a narrow anterior chamber angle profile and suspected angle-closure glaucoma. If the difference between the values ??of intraocular pressure before instillation and after dilatation of the pupil is from 3 to 5 mm Hg. Art., a provocative test is considered positive;

- for differential diagnosis of the type of injection of the eyeball: if, 5 minutes after instillation, a narrowing of the vessels of the eyeball is noted, the injection is classified as superficial; if the redness of the eye persists, it is necessary to carefully examine the patient for the presence of iridocyclitis or scleritis, because this indicates the expansion of deeper vessels.

With iridocyclitis, a 2.5 or 10% solution is used to prevent the development and rupture of already formed posterior synechiae; to reduce exudation into the anterior chamber of the eye. For this purpose, one drop of the drug is instilled into the conjunctival sac of the diseased eye (s) 2-3 times a day.

In glaucoma cyclical crises, the vasoconstrictor effect of phenylephrine has a hypotensive effect, which is more pronounced when using a 10% solution. For relief of glaucomatous crises, 10% IrifrinЃ is instilled 2-3 times a day.

When preparing patients for surgical interventions, a single instillation of a 10% solution is performed 30-60 minutes before the operation to achieve mydriasis. After opening the membranes of the eyeball, re-instillation of the drug is not allowed.

10% solution is not used for irrigation, soaking of tampons during surgery and for subconjunctival administration.

• Hypersensitivity to the drug;

• narrow-angle or angle-closure glaucoma;

• old age in the presence of serious disorders of the cardiovascular or cerebrovascular system;

• additional dilation of the pupil during surgical operations in patients with violation of the integrity of the eyeball, as well as in violation of tear production;

• hyperthyroidism;

• hepatic porphyria;

• congenital deficiency of glucose-6-phosphate dehydrogenase;

• children under 12 years of age and patients with arterial aneurysm (10% solution);

• premature babies (2.5% solution).

With care: patients with type 2 diabetes mellitus (increased risk of increased blood pressure associated with impaired autonomic regulation); elderly patients (increased risk of reactive miosis); simultaneous use with MAO inhibitors and within 21 days after stopping their intake; due to what causes conjunctival hypoxia: patients with sickle cell anemia, wearing contact lenses, after surgery (decreased healing).

pharmachologic effect

Sympathomimetic.

It has a pronounced alpha-adrenergic activity and, when used in usual doses, does not have a significant stimulating effect on the central nervous system. When applied topically in ophthalmology, it causes dilatation of the pupil, improves the outflow of intraocular fluid and narrows the vessels of the conjunctiva. Phenylephrine has a pronounced stimulating effect on postsynaptic ?-adrenergic receptors, has a very weak effect on ?-adrenergic receptors of the myocardium. The drug has a vasoconstrictor effect similar to that of norepinephrine (norepinephrine), while it has virtually no chronotropic and inotropic effect on the heart. The vasopressor effect of phenylephrine is less pronounced than that of norepinephrine, but is more prolonged. Causes vasoconstriction 30-90 seconds after instillation, duration of action - 2-6 hours.After instillation, phenylephrine contracts the dilator of the pupil and the smooth muscles of the arterioles of the conjunctiva, thereby causing the pupil to dilate. Mydriasis occurs within 10-60 minutes after a single instillation. After instillation of eye drops 2.5% mydriasis persists for 2 hours, after instillation of eye drops 10% - 3-7 hours. phenylephrine has little effect on the ciliary muscle, mydriasis occurs without cycloplegia.

Side effect

From the side of the organ of vision: conjunctivitis, periorbital edema; there may be a burning sensation at the beginning of use, blurred vision, irritation, discomfort, lacrimation, increased intraocular pressure. The next day after using the drug IrifrinЃ, reactive miosis is possible. With repeated instillations of the drug during this period, mydriasis may be less pronounced than the day before. This effect is more often seen in elderly patients. Due to a significant contraction of the pupil dilator under the influence of phenylephrine, 30-45 minutes after instillation, particles of pigment from the pigment layer of the iris can be found in the moisture of the anterior chamber of the eye. The suspension in the chamber moisture must be differentiated with the appearance of anterior uveitis or with the ingress of blood cells into the moisture of the anterior chamber.From the side of the cardiovascular system: palpitations, tachycardia, arrhythmia (including ventricular), arterial hypertension, reflex bradycardia, occlusion of coronary arteries, pulmonary embolism are possible. Dermatological reactions: contact dermatitis. Rarely, when using Irifrin in the form of 10% eye drops, the development of serious disorders of the cardiovascular system, including myocardial infarction, vascular collapse and intracranial hemorrhage, is observed.Rarely, when using Irifrin in the form of 10% eye drops, the development of serious disorders of the cardiovascular system, including myocardial infarction, vascular collapse and intracranial hemorrhage, is observed.Rarely, when using Irifrin in the form of 10% eye drops, the development of serious disorders of the cardiovascular system, including myocardial infarction, vascular collapse and intracranial hemorrhage, is observed.

Application during pregnancy and lactation

Since the effect of the drug IrifrinЃ during pregnancy and lactation has not been studied enough, the use of the drug in these patients is possible only in cases where the expected benefit of therapy to the mother outweighs the potential risk to the fetus or infant.

Application for violations of liver function

The use of the drug is contraindicated in hepatic porphyria.

special instructions

IrifrinЃ should be used with caution in patients with diabetes mellitus because of the risk of developing an increase in blood pressure associated with impaired autonomic regulation, as well as in elderly patients due to an increased risk of reactive miosis. With caution, IrifrinЃ should be used simultaneously with MAO inhibitors, as well as within 21 days after stopping their intake. Exceeding the recommended dose when using eye drops 2.5% in patients with injuries, diseases of the eye or its appendages, in the postoperative period or with reduced tear production (anesthesia) can lead to an increase in the absorption of phenylephrine and the development of systemic side effects. Due to the fact that the drug causes conjunctival hypoxia, it should be used with caution in patients with sickle cell anemia, when wearing contact lenses,after surgery (decreased healing).

Overdose

Symptoms: manifestations of systemic action of phenylephrine.

Treatment: the use of alpha-blockers (for example, 5-10 mg phentolamine IV). If necessary, the introduction can be repeated.

Drug interactions

The mydriatic effect of phenylephrine is enhanced when it is used in combination with atropine. Due to increased vasopressor action, tachycardia may develop. When using Irifrin simultaneously with MAO inhibitors or within 21 days after stopping them, there is a risk of developing an uncontrolled rise in blood pressure. The vasopressor effect of adrenomimetic agents can also be potentiated when used together with tricyclic antidepressants, propranolol, reserpine, guanethidine, methyldopa and m-anticholinergics. The use of Irifrin in the form of eye drops 10% in combination with the systemic use of beta-blockers can lead to acute arterial hypertension. IrifrinЃ can potentiate the depressing effect on the activity of the cardiovascular system during inhalation anesthesia.The use in conjunction with sympathomimetics can enhance the cardiovascular effects of phenylephrine.