Phenicamide eye drops 10 ml, 10 ml

Locally. To dilate the pupil during diagnostic ophthalmic and surgical interventions, it is instilled into the conjunctival cavity 15-30 minutes before the procedure or surgery.

tropicamide 8 mg

phenylephrine hydrochloride 50 mg

• Hypersensitivity to this combination;

• angle-closure glaucoma, increased intraocular pressure;

• diseases of the cardiovascular system (including coronary sclerosis, angina pectoris, arrhythmia, hypertensive crisis);

• thyrotoxicosis;

• type 1 diabetes mellitus;

• simultaneous reception (and also within 3 weeks after their cancellation) MAO inhibitors;

• pregnancy, breastfeeding period;

• age up to 18 years.

pharmachologic effect

Combined product for use in ophthalmology. Tropicamide. M-anticholinergic agent, blocks the m-cholinergic receptors of the sphincter of the pupil and ciliary muscle, causing short-term mydriasis and accommodation paralysis. Slightly increases intraocular pressure. Mydriasis against the background of the use of tropicamide develops in 5-10 minutes and reaches a maximum by 20-45 minutes. The maximum dilation of the pupil lasts for 1 hour and returns to normal after 6 hours. Phenylephrine. Non-selective alpha adrenergic agonist. It has a pronounced stimulating effect on postsynaptic? -Adrenergic receptors, weakly affects the? 1-adrenergic receptors of the heart. It has a vasoconstrictor effect (the vasopressor effect of phenylephrine is weaker than that of norepipephrine, but longer), practically does not have a chrono- and inotropic effect on the heart.After installation, phenylephrine reduces the dilator of the pupil and smooth muscles of the arterioles of the conjunctiva, thereby causing dilation of the pupil and narrowing of the vessels of the conjunctiva, and improves the outflow of intraocular fluid. Pupil dilation occurs within 10-60 minutes after a single instillation and persists for 4-6 hours. Mydriasis caused by phenylephrine is not accompanied by cyclopegia. Phenylephrine complements the action of tropicamide because the mechanisms of action are different. The combined use of tropicamide and phenidephrine reduces or suppresses the ability of tropicamide to increase intraocular pressure.Mydriasis caused by phenylephrine is not accompanied by cyclopegia. Phenylephrine complements the action of tropicamide because the mechanisms of action are different. The combined use of tropicamide and phenidephrine reduces or suppresses the ability of tropicamide to increase intraocular pressure.Mydriasis caused by phenylephrine is not accompanied by cyclopegia. Phenylephrine complements the action of tropicamide because the mechanisms of action are different. The combined use of tropicamide and phenidephrine reduces or suppresses the ability of tropicamide to increase intraocular pressure.Pharmacokinetics

Tropicamide.

It easily penetrates into the tissues of the eye, is rapidly absorbed into the bloodstream. When a modified radioreceptor assay is used, the lower detection limit for tropicamide in plasma is less than 240 ng / ml, the detection range is 240 ng / ml - 10 ng / ml. The average Cmax in plasma at the 5th minute after administration was 2.8 ± 1.7 ng / ml. At the 60th minute, the plasma concentration of tropicamide was 0.46 ± 0.51 ng / ml, and at the 120th minute, it was below 240 ng / ml.

Phenylephrine

It easily penetrates into the tissues of the eye, Cmax in plasma is observed 10-20 minutes after topical application. Phenylephrine is excreted by the kidneys unchanged (<20%) or as inactive metabolites. Side effect

Local reactions:

increased intraocular pressure, transient pain, burning in the eye, photophobia, transient decrease in vision, release of pigment into aqueous humor with a temporary increase in intraocular pressure, blocking of the angle of the anterior chamber (with narrowing of the angle), pain in the region of the eyebrows, lacrimation, conjunctival hyperemia, keratitis ; rarely - reactive miosis the next day after application (repeated installations of the drug at this time may give less pronounced mydriasis than the day before; this effect is more often manifested in elderly patients).

Systemic side effects:

pallor of the skin, dry mouth, redness and dryness of the skin, contact dermatitis, headache, fainting, decreased blood pressure, palpitations, tachycardia, arrhythmia, bradycardia, ventricular coronary artery occlusion, pulmonary embolism; disorders of the central nervous system, muscle rigidity, frequent urge to urinate, difficulty urinating, decreased gastrointestinal tone and peristalsis, leading to constipation; sometimes - vomiting, dizziness; in elderly patients with diseases of the cardiovascular system - ventricular arrhythmias, myocardial infarction.

Application during pregnancy and lactation

Use during pregnancy and breastfeeding is contraindicated.

Application in children

Contraindicated for use in children and adolescents under 18 years of age.

special instructions

It should be used with caution in patients with type 2 diabetes mellitus, elderly patients (risk of ventricular arrhythmias and myocardial infarction in patients with diseases of the cardiovascular system), in patients with cerebrovascular diseases, conditions after surgery (decreased conjunctival healing). Drops should be instilled into the lower conjunctival sac. To reduce the risk of developing systemic side effects, light finger pressure is recommended on the projection area of ??the lacrimal sacs at the inner corner of the eye for 1-2 minutes after instillation. Due to a significant contraction of the pupil dilator 30-45 minutes after instillation, pigment particles 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 manifestations of anterior uveitis or with the ingress of blood cells into the moisture of the anterior chamber. Cycloplegics can increase intraocular pressure and provoke the development of angle-closure glaucoma in susceptible individuals, which must be taken into account and carefully evaluated before starting treatment; tropicamide can induce the onset of psychosis.

Influence on the ability to drive vehicles and use mechanisms

During the period of treatment, it is not recommended to drive vehicles and engage in other hazardous activities that require increased concentration of attention and speed of psychomotor reactions, because due to changes in accommodation and pupil width, a decrease in visual acuity is possible.

Drug interactions

Adrenomimetics enhance, m-cholinomimetics weaken the effect of tropicamide. Tricyclic antidepressants, phenothiazines, amantadine, quinidine, antihistamines increase the likelihood of developing systemic side effects of tropicamide. Atropine enhances the mydriatic effect of phenylephrine. Concomitant use with MAO inhibitors, as well as within 21 days after stopping them, increases the risk of developing systemic adrenergic effects. The vasopressor effect of alpha-adrenergic agonists can also be enhanced when used together with tricyclic antidepressants, propranolol, guanethidine, methyldopa and m-anticholinergics. Beta-blockers increase the risk of a sharp increase in blood pressure. Phenylephrine increases the risk of cardiovascular depression during inhaled general anesthesia.With the appointment of beta-blockers, it is possible to enhance the vasoconstrictor effect of phenylephrine due to their suppression of vasodilation. Due to the risk of a hypertensive crisis, the combined use of phenylephrine and guanethidine, as well as any other adrenergic blocker or monoamine reuptake inhibitor, is not recommended. Pre-instillation of local anesthetics can increase systemic absorption of active ingredients and prolong mydriasis.Pre-instillation of local anesthetics can increase systemic absorption of active ingredients and prolong mydriasis.Pre-instillation of local anesthetics can increase systemic absorption of active ingredients and prolong mydriasis.