Apraclonidine (Ophthalmic)

Apraclonidine (Ophthalmic Route) is a prescription medication that is used primarily for relieving eye pressure in patients that suffer from glaucoma and as part of the pre and post-operative care in patients receiving laser eye surgery.

Overview:

The increase in eye pressure that is commonly associated with glaucoma is referred to as ocular hypertension and, in some patients, the pressure can prove difficult to relieve. The drug is available in both 0.5% and 1.0% strengths, with the latter being used primarily as part of the pre-operation regimen for certain eye surgeries.

Patients that are undergoing Nd: YAG laser posterior capsulotomy, argon laser trabeculoplasty, or argon laser iridotomy may be prescribed this medication at 1.0% strength by their eye doctor prior to undergoing the surgical procedure. These types of eye surgeries have been known to create an increase in eye pressure, and, in certain patients whose pressure is already elevated, this can become a serious issue. Comprehensive treatment will include the administration of this drug both prior to and following the laser eye surgery.

Glaucoma patients whose eye pressure levels are not contained by typical glaucoma medications are often prescribed Apraclonidine in the 0.5% strength to help to relieve the pressure affecting the eyes. This drug works by decreasing the amount of fluid that is produced in the eye area.

While there are not currently any reported interactions with major drugs, it is imperative that, as with any other medication, the patient informs their doctor of any other drugs being taken for other ailments. In addition to prescription drugs, patients must also advise their doctors of any herbal remedies that they are currently using, along with vitamin and mineral supplements. Side effects are not considered to be overly dangerous, with most dissipated on their own without further medical attention. Patients using the drug will need to monitor any side effects that do occur and seek medical advice or treatment where applicable.

Condition(s) Treated:

  • Ocular Hypertension (Eye Pressure Commonly Caused by Glaucoma)

Type of Medicine:

  • Eye Drop Solution, Alpha-2 Adrenergic Agonist

Side Effects:

The side effects for both the 0.5% and 1.0% strengths of this medication do differ while there is some known overlap. If you notice any of these side effects following the use of this drug, let your eye doctor or physician know as soon as possible.

Most Likely in Both 0.5% and 1.0%:

The most likely side effect in patients taking both the 0.5% and 1.0% drug is an allergic reaction. This reaction may manifest with symptoms such as itchiness and redness in the eye area along with excessive tearing. This reaction is common but is still one that requires the patient to inform the doctor for further guidance on treating the symptoms.

Less Likely and Unlikely Side Effects in Using 0.5% Apraclonidine:

  • Blurred vision or change in vision
  • Swelling of face, hands, or feet
  • Chest pain
  • Redness of eyelid, or inner lining of the eyelid
  • Depression
  • The raising of an upper eyelid
  • Eye discharge, irritation, or pain
  • Numbness or tingling in fingers or toes
  • Irregular heartbeat
  • Rash around eyes
  • Dizziness
  • Swelling of eye, eyelid, or inner lining of the eyelid
  • Clumsiness or unsteadiness and
  • Wheezing or troubled breathing.

While the side effects listed above require medical advice and attention, this next group of side effects will typically dissipate on their own and do not usually require further treatment. Patients who suffer any of the below ailments should continue to monitor the situation and notify their eye doctor or physician if they worsen or linger after a couple of days.

Common Side Effects of 0.5% Apraclonidine that Typically Do Not Require Further Medical Attention:

  • Discomfort in the Eye Area and of the Eye Itself and
  • Excessive Dryness of the Eyes

Less Common Side Effects of 0.5% Apraclonidine that Typically Do Not Require Further Medical Attention:

  • Change in taste or smell
  • Tiredness or weakness
  • Constipation
  • Runny nose
  • Discoloration of the white part of one or both eyes
  • Nervousness
  • Dry nose or eyes
  • Muscle aches
  • Headache
  • Increased sensitivity of eyes to light
  • Nausea
  • General feeling of discomfort or illness
  • Paleness of eye or inner lining of the eyelid
  • Drowsiness or sleepiness
  • Sore throat
  • Crusting or scales on eyelid or corner of the eye and
  • A difficulty with sleeping.

More Common Side Effects of 1.0% Apraclonidine that Typically Do Not Require Further Medical Attention:

  • The raising of the upper eyelid on one or both eyes
  • An Increase in pupil size
  • A pale appearance of one or both eyes as well as the inner lining of eyelid

Less Common Side Effects of 1.0% Apraclonidine that Typically Do Not Require Further Medical Attention:

  • In rare occasions, some patients have reported a sinus reaction to the use of this drug which typically manifests as a runny nose.

In addition to side effects, there are other concerns for patients who suffer from other medical conditions and ailments. Patients who are currently being treated for any of the following treatments will need to discuss the use of Apraclonidine with their eye doctor and general practitioner prior to beginning the use of this drug.

  • Kidney Disease
  • If you have used other eye pressure reduction medications and experienced unusual side effects it is important to inform your eye doctor and physician of any such instances.
  • Depression
  • Any Type of Heart Disease
  • Conditions Relating to the Blood Vessels
  • A History of Vasovagal Attack
  • Liver Disease

Dosage:

Due to the typical use of this drug as one to treat issues caused by glaucoma, it is not generally used in children or young adults. There are two different types of dosage levels relevant to Apraclonidine (Ophthalmic Route), one is at the strength of 0.5% which is used to relieve the pressure that glaucoma can cause, and the other is 1.0% use in both pre and post-operative treatment.

Depending on the direction of the eye doctor or physician, patients using the 0.5% strength for the treatment of eye pressure will need to administer one drop in each eye of the medication two to three times per day. Patients should always follow the instructions provided by their doctor and take care to not put too many drops into the eye.

Pre and post-surgery patients will be utilizing Apraclonidine in the 1.0% strength. This dosage is typically administered by the eye surgeon to reduce the level of eye pressure during surgery. Typically, one drop is administered to each eye both pre and post-surgery.

This medication is not typically used in children, but when it is prescribed by the eye doctor or pediatrician, it is imperative to administer the dosage exactly as directed by the eye doctor or pediatrician.

Special Care and Directions for the Safe Use of Eye Drops:

Doctors can prescribe that two different types of eye drops be used in a patient's treatment, and in such cases, it is important to wait at least 10 minutes between administering the different types of drops. The first drop must have time to be absorbed and begin working prior to the second being used. Applying the second dosage of drops too quickly can negate or diminish the effectiveness of the first round of drops.

The proper procedure to utilize when delivering the drops into the eyes should be followed as closely as possible to avoid infection and other issues. Eye drops must be kept sterile and the dosage instructions provided by the eye doctor must be followed.

Prior to administering the eye drops, be sure to fully wash your hands. Due to touching of the eye area, it is important that patients do not skip this step! Once the hands have been completely and thoroughly washed, tilt the head back and open the eyes by separating the upper and lower eyelids with one hand. With the other hand, take the bottle of eye drops and squeeze the prescribed amount directly on to the eye.

It is important to hold the eyelids open and resist the urge to blink. Once the drops have reached the eye, close the eye and keep the lid closed without blinking. Use your fingertip to apply a slight amount of pressure to the corner of the eye while keeping the eyelid closed and resisting the urge to blink. Remain in this position, with slight pressure on the closed corner of the eye, for at least one to two minutes. Keeping the eye closed allows the medicine to be absorbed into the eye and able to be effective.

Never allow the applicator from the bottle to touch the eye or any other surface outside of the bottle. If you accidentally touch the applicator with your fingers, or it touches the surface of the eye during application, be sure to talk to your doctor about how to remedy the situation. Do not put the applicator back into the eye drop bottle if it has been contaminated. Be sure to always keep the applicator bottle tightly closed when not in use and always store this medication following the proper guidelines recommended by your doctor.

Major Drug Interactions:

While there are no reported interaction concerns with other major drugs, patients who are prescribed Apraclonidine (Ophthalmic Route) are advised to inform their eye doctor or physician of any prescription drugs that they are taking, as well as any herbal medication, vitamins or mineral supplements prior to use.

Warnings:

Patients using this drug may experience a heightened sensitivity to bright lights and sun. The use of heavy sunglasses that provide protection from UV rays can offer some relief. Keeping the indoor lighting at a low level can also be helpful. This drug has also been reported to cause feelings of lightheadedness, disorientation, sleepiness, and less aware of their surroundings. As with any new medication, it is important to understand how the body will react prior to undertaking any potentially dangerous activities, such as operating heavy machinery or driving a motor vehicle.

Storage:

As Apraclonidine (Ophthalmic Route) is an eye drop, it is important to keep the drops in a completely sterile environment. It is always best to store any medication in its original container, and the same is true with this medication. It is important to keep this drug from direct sunlight, moisture, excessive heat, and freezing. It can be stored in the refrigerator if that is what is recommended by the eye doctor.

Excess, outdated, and unused drops need to be disposed of in the proper manner. It is important to check with one's eye doctor for guidance on proper methods of disposal.

Summary:

Patients that experience increased eye pressure (ocular hypertension) that does not respond to other drugs are often prescribed Apraclonidine (Ophthalmic Route) to help to relieve the pressure. This drug is administered via eye drops and comes in two separate strengths: 0.5% and 1.0% with the latter being used mainly for pre and post-operative purposes in patients undergoing laser eye surgery. Glaucoma patients who do not respond to other medications often find relief with the use of this drug as it helps to relieve eye pressure by reducing the amount of fluid that is produced by the body in the eye area.

The use of these eye drops has been reported to cause light-sensitivity and an aversion to bright indoor lights. The use of polarized sunglasses that provide UV protection will help to reduce the negative effects of this sensitivity. Keeping indoor lights at a dim level is also helpful. Any such sensitivities that begin to affect the patient's daily life should be discussed with their eye doctor or physician. This sensitivity should dissipate when the drops are no longer used.

Due to the risk of infection that is inherent when touching the eyes, it is important that patients take all recommended precautions when administering this drug. Side effects that are associated with Apraclonidine are typically mild with the most prevalent being an allergic reaction to the drops. The 1.0% strength of this drug is typically administered by the eye surgeon as part of the pre and post-operative care.

This drug has been known to cause confusion and a lack of alertness in patients, which makes it important that anyone using the drug understand how their body will react prior to undertaking any activity that requires a state of full alertness. There are no reported interactions with other major drugs, but as with any new medication, it is important to notify the eye doctor and physician of any other drugs, supplements, or herbal remedies that are currently in use by the patient.

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Last Reviewed:
December 22, 2017
Last Updated:
April 04, 2018
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