Apraclonidine (Ophthalmic)
   
Apraclonidine (Ophthalmic)
US Brand Names
• Iopidine
Canadian Brand Names
• Iopidine
Other commonly used names are aplonidine and p-aminoclonidine.
Description
Apraclonidine (a-pra-KLON-i-deen) 0.5% is used to treat glaucoma when the medications you have been using for glaucoma do not reduce your eye pressure enough.
Apraclonidine 1% is used just before and after certain types of eye surgery (argon laser trabeculoplasty, argon laser iridotomy, and Nd:YAG laser posterior capsulotomy). The medicine is used to control or prevent a rise in pressure within the eye (ocular hypertension) that can occur after this type of surgery.
Apraclonidine 0.5% is available only with your doctor's prescription. Apraclonidine 1% is given in the hospital at the time of the surgery. This medicine is available in the following dosage form:
Special Considerations
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 apraclonidine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to apraclonidine or clonidine. Also tell your health care professional if you are allergic to any other substances, such as preservatives.
Pregnancy
Apraclonidine has not been studied in pregnant women. However, apraclonidine has been shown to cause death of the fetus when given by mouth to pregnant rabbits in doses that are many times larger than the human dose. Before using this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.
Breast-feeding
It is not known whether apraclonidine passes into the 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 0.5% apraclonidine and who wish to breast-feed should discuss this with their doctor. For mothers who are to be treated with 1% apraclonidine during eye surgery, your doctor may want you to stop breast-feeding during the day of your surgery.
Children
Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of apraclonidine in children with use in other age groups.
Older adults
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of apraclonidine in the elderly with use in other age groups.
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 apraclonidine. Make sure you tell your doctor if you have any other medical problems, especially:
• Depression or
• Heart or blood vessel disease or
• High blood pressure-Apraclonidine may make the condition worse
• Kidney disease or
• Liver disease-Higher blood levels of apraclonidine may result, which may lead to increased side effects
• Unusual reaction to a medicine that reduces the pressure within the eye-Apraclonidine is a strong reducer of eye pressure and could also cause this reaction
• Vasovagal attack (history of)-The signs and symptoms are paleness, nausea, sweating, slow heartbeat, sudden and severe tiredness or weakness, and possibly fainting, usually brought on by emotional stress caused by fear or pain. Apraclonidine may cause this reaction to happen again
Administration
If your doctor ordered two different eye drops to be used together, wait at least 10 minutes between the times you apply the medicines. This will help to keep the second medicine from ''washing out'' the first one.
To use the eye drops :
• 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 1 or 2 minutes to allow the medicine to be absorbed by the eye.
• If you think you did not get the drop of medicine into your eye properly, use another drop.
• 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.
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.
It is important that your doctor check your progress at regular visits . This is to make sure the medicine is working properly.
Dosing
The dose of ophthalmic apraclonidine will be different for different patients. Follow the doctor's orders or the directions on the label . The following information includes only the average doses of ophthalmic apraclonidine. If your dose is different, do not change it unless your doctor tells you to do so.
• For ophthalmic solution (eye drops) dosage form:
o For glaucoma (0.5% apraclonidine):
§ Adults-Use one drop in each eye two or three times a day.
§ Children-Use and dose must be determined by your doctor.
o For preventing ocular hypertension before and after eye surgery (1% apraclonidine):
§ Adults-One drop is placed in the affected eye one hour before surgery, then one drop in the same eye immediately after surgery.
§ Children-Use and dose must be determined by your doctor.
Missed dose
If you are using this medicine regularly and you miss a dose, use it 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.
• Store away from heat and direct light.
• The 0.5% eye drops may be stored in the refrigerator. However, keep the 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
This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert .
Apraclonidine may cause your eyes to become more sensitive to light than they are normally. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort.
Side Effects
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 or nurse as soon as possible if the following side effects occur:
For 0.5% apraclonidine
More common
Allergic reaction (redness, itching, tearing of eye).
Less common or rare
Blurred vision or change in vision; chest pain; clumsiness or unsteadiness; depression; dizziness; eye discharge, irritation, or pain; irregular heartbeat; numbness or tingling in fingers or toes; raising of upper eyelid; rash around eyes; redness of eyelid, or inner lining of eyelid; swelling of eye, eyelid, or inner lining of eyelid; swelling of face, hands, or feet; wheezing or troubled breathing.
For 1% apraclonidine
Less common or rare
Allergic reaction (redness of eye or inner lining of eyelid, swelling of eyelid, watering of eye); irregular heartbeat.
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 or nurse if any of the following side effects continue or are bothersome:
For 0.5% apraclonidine
More common
Dryness of mouth; eye discomfort.
Less common or rare
Change in taste or smell; constipation; crusting or scales on eyelid or corner of eye; discoloration of white part of eye; drowsiness or sleepiness; dry nose or eyes; general feeling of discomfort or illness; headache; increased sensitivity of eyes to light; muscle aches; nausea; nervousness; paleness of eye or inner lining of eyelid; runny nose; sore throat; tiredness or weakness; trouble in sleeping.
For 1% apraclonidine
More common
Increase in size of pupil of eye; paleness of eye or inner lining of eyelid; raising of upper eyelid.
Less common or rare
Runny nose.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor or nurse.
July 03, 1995 
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