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|Atropine Sulfate S.O.P. Ophthalmic Atropine Sulfate/Scopolamine Hydrobromide/Hyoscyamine Sulfate/Phenobarbital

ATROPINE, HOMATROPINE, AND SCOPOLAMINE (Ophthalmic)

Some commonly used brand names are:

In the U.S.—

• AK-Homatropine ²
• Atropair ¹
• Atropine Care ¹
• Atropine Sulfate S.O.P. ¹
• Atropisol ¹
• Atrosulf ¹
• I-Homatrine ²
• Isopto Atropine ¹
• Isopto Homatropine ²
• Isopto Hyoscine ³
• I-Tropine ¹
• Ocu-Tropine ¹
• Spectro-Homatropine ²

In Canada—

• Atropisol ¹
• Isopto Atropine ¹
• Isopto Homatropine ²
• Minims Atropine ¹
• Minims Homatropine ²

Another commonly used name for scopolamine is hyoscine .

Category

• Cycloplegic—Atropine; Homatropine; Scopolamine
• mydriatic—Atropine; Homatropine; Scopolamine

Description

Ophthalmic atropine, homatropine, and scopolamine are used to dilate (enlarge) the pupil of the eye. They are used before eye examinations, before and after eye surgery, and to treat certain eye conditions, such as uveitis or posterior synechiae.

These medicines are available only with your doctor"s prescription, in the following dosage forms:

• Ophthalmic
• Atropine
  • Ophthalmic ointment (U.S. and Canada)
  • Ophthalmic solution (eye drops) (U.S. and Canada)
• Homatropine
  • Ophthalmic solution (eye drops) (U.S. and Canada)
• Scopolamine
  • Ophthalmic solution (eye drops) (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ophthalmic atropine, homatropine, and scopolamine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to atropine, homatropine, or scopolamine. Also tell your health care professional if you are allergic to any other substances, such as certain preservatives.

Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals. However, these medicines may be absorbed into the body.

Breast-feeding—These medicines may be absorbed into the body. Atropine passes into the breast milk in very small amounts and may cause side effects, such as fast pulse, fever, or dry skin, in babies of nursing mothers using ophthalmic atropine. It is not known whether homatropine or scopolamine passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using one of these medicines and who wish to breast-feed should discuss this with their doctor.

Children—Infants and young children and children with blond hair or blue eyes may be especially sensitive to the effects of atropine, homatropine, or scopolamine. This may increase the chance of side effects during treatment . Children should use a lower strength of this medicine.

Older adults—Elderly people are especially sensitive to the effects of atropine, homatropine, or scopolamine. This may increase the chance of side effects during treatment.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of ophthalmic atropine, homatropine, or scopolamine. Make sure you tell your doctor if you have any other medical problems, especially:

• Brain damage (in children) or
• Down"s syndrome (mongolism) (in children and adults) or
• Glaucoma or
• Other eye diseases or problems or
• Spastic paralysis (in children)—Use of ophthalmic atropine, homatropine, or scopolamine may make the condition worse

Proper Use of This Medicine

To use the ophthalmic solution (eye drops) form of this medicine:

• First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 2 or 3 minutes to allow the medicine to be absorbed by the eye.
• Immediately after using the eye drops, wash your hands to remove any medicine that may be on them. If you are using the eye drops for an infant or child, be sure to wash his or her hands immediately afterwards also, and do not let any of the medicine get in his or her mouth. In addition, wipe off any medicine that may have accidentally gotten on the infant or child, including his or her face or eyelids.
• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.

To use the ointment form of this medicine:

• First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Squeeze a thin strip of ointment into this space. A 1/3- to 1/2-cm (approximately 1/8-inch in infants and young children and 1/4-inch in older children and adults) strip of ointment is usually enough, unless you have been told by your doctor to use a different amount. Let go of the eyelid and gently close the eyes. Keep the eyes closed for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
• Immediately after using the eye ointment, wash your hands to remove any medicine that may be on them. If you are using the eye ointment for an infant or child, be sure to wash his or her hands immediately afterwards also, and do not let any of the medicine get in his or her mouth. In addition, wipe off any medicine that may have accidentally gotten on the infant or child, including his or her face or eyelids.
• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). After using the eye ointment, wipe the tip of the ointment tube with a clean tissue and keep the tube tightly closed.

Use this medicine only as directed . Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of too much medicine being absorbed into the body and the chance of side effects. This is especially important when this medicine is used in infants and children, since overdose is very dangerous in infants and children .

Dosing—The doses of these medicines will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of doses you use each day, the time allowed between doses, and the length of time you use the medicine depend on the medical problem for which you are using atropine, homatropine, or scopolamine.

• For atropine
• For ophthalmic ointment dosage form:
  • For uveitis:
    • Adults—Use a thin strip of the ointment in the eye one or two times a day.
    • Children—Use a thin strip of the ointment in the eye one to three times a day.
  • For eye examinations:
    • Adults—Use and dose must be determined by your doctor.
    • Children—Use a thin strip of the ointment in the eye three times a day for one to three days before the examination.
• For ophthalmic solution (eye drops) dosage form:
  • For uveitis:
    • Adults—Use one drop in the eye one or two times a day.
    • Children—Use one drop in the eye one to three times a day.
  • For eye examinations:
    • Adults—Use and dose must be determined by your doctor.
    • Children—Use one drop in the eye two times a day for one to three days before the examination.

• For homatropine
• For ophthalmic solution (eye drops) dosage form:
  • For uveitis:
    • Adults and children—Use 1 or 2 drops in the eye two or three times a day.
  • For eye examinations:
    • Adults—Use 1 or 2 drops in the eye. May be repeated every five to ten minutes for two or three doses.
    • Children—Use 1 or 2 drops in the eye every ten minutes for two or three doses.

• For scopolamine
• For ophthalmic solution (eye drops) dosage form:
  • For uveitis:
    • Adults and children—Use one drop in the eye up to four times a day.
  • For eye examinations:
    • Adults—Use one drop in the eye one hour before the examination.
    • Children—Use one drop in the eye two times a day for two days before the examination.
  • For posterior synechiae:
    • Adults—Use one drop in the eye every ten minutes for three doses.
    • Children—Use and dose must be determined by your doctor.
  • For use before and after surgery:
    • Adults and children—Use one drop in the eye one to four times a day.

Missed dose—If you miss a dose of this medicine and your dosing schedule is:

• One dose a day—Apply the missed dose as soon as possible. However, if you do not remember the missed dose until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
• More than one dose a day—Apply the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children. Overdose of this medicine is very dangerous for infants and children.
• Store away from heat and direct light.
• Keep this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

After you apply this medicine to your eyes:

• Your pupils will become unusually large and you will have blurring of vision, especially for close objects. Make sure your vision is clear before you drive, use machines, or do anything else that could be dangerous if you are not able to see well .
• Your eyes will become more sensitive to light than they are normally. Wear sunglasses to protect your eyes from sunlight and other bright lights .

These effects may continue for several days after you stop using this medicine. However, check with your doctor if they continue longer than:

• 14 days if you are using atropine.
• 3 days if you are using homatropine.
• 7 days if you are using scopolamine.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Blurred vision; brief burning or stinging of the eyes; eye irritation not present before use of this medicine; increased sensitivity of eyes to light; swelling of the eyelids

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 03/03/2000

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