Atropine, Homatropine, and Scopolamine (Ophthalmic)

Atropine, homatropine, and scopolamine is used either as an ointment or a solution to treat eye conditions such as uveitis and posterior synechiae, and also to prepare or recover the eye during examinations and surgery.

Overview

Atropine, homatropine, and scopolamine is an ophthalmic drug designed to dilate the pupil of the eye. This could be needed due to a medical condition, such as uveitis (an inflammation of the uvea area of your eye) or posterior synechiae (unwanted adhesions between certain parts of the eye as a result of inflammation). It could also be needed in the event that a patient is about to undergo eye surgery or as part of the recovery process afterwards.

A prescription from a physician is required for this medication, and it is available as either an ointment or a solution. It is known by a wide range of alternative brand names: in the USA, these are Ak-Pentolate, Eye Cool, Mydfrin, Neofrin, Neo-Synephrine, Mydriacyl, Omidria, Homatropine, Mydral, Isopto, Homatropaire and Paremyd. Other names include Isopto Hyoscine, Altafrin, Cyclogyl, Atropine Care, Isopto Atropine and Cyclomydril.

Conditions treated

  • Uveitis
  • Posterior synechiae
  • Other eye conditions

Type of medicine

  • Ophthalmic

Side effects

As with any medication, unwanted side effects - as well as desirable relief from your symptoms - are possible when taking atropine, homatropine, and scopolamine. Unfortunately, these unwanted side effects, if they occur, are often a necessary part of achieving relief from your condition.

The first category of possible side effects from taking atropine, homatropine, and scopolamine is the most serious category. If these side effects occur, it can be indicative of too much atropine, homatropine, and scopolamine being absorbed into your body, and as a result you should consult your physician or other health professional right away.

The impairment of some serious cognitive functions are included in this category. These include symptoms of confusion, an increase in clumsiness, observing things which are not actually there or a heightened feeling of unsteadiness. Some skin problems are also serious side effects, including dry skin, a redness in the face and skin rash. Other miscellaneous but serious side effects include slurring of speech, an unusually dry mouth or a fever.

In the event that you experience any of these side effects, you should consult your physician without delay. In the event that your physician is unavailable and you are required to attend the emergency room, you or whoever is with you should inform the staff on duty that you are taking atropine, homatropine, and scopolamine.

The second category of side effects includes those which are less serious. In this category are a number of eye-related side effects, including blurring of your vision, a short sensation of burning in your eye region, a newfound feeling in your eyes of sensitivity to the light, swollen eyelids or a fresh eye irritation.

In the event that you experience side effects from this category, you do not ordinarily need to seek urgent medical attention. Often, these side effects will simply go away on their own once your body has had a short while to get used to atropine, homatropine, and scopolamine. However, if the side effects persist or are causing you pain or distress, speak to a healthcare professional.

It is important to bear in mind that it is not possible to predict what side effects a patient will or will not experience as a result of taking atropine, homatropine, and scopolamine. The health outcomes of any medication can vary from person to person, and as a result, it may not be until you begin taking the medication that you become fully aware of how it will affect you.

If you are in any way concerned about what effect taking atropine, homatropine, and scopolamine will have on you, you should speak to your physician or healthcare professional to find out more. They will be able to help you with tips and tricks to manage any side effects you do experience.

Remember, these lists are not exhaustive. You should consult a full list of possible side effects prior to taking atropine, homatropine, and scopolamine. These can usually be found in the information booklet which comes with your medication.

Dosage

While there is standard dosage information available for patients taking atropine, homatropine, and scopolamine, it is important to remember that precise doses can vary from person to person. As a result, what is prescribed to you will be designed specifically for your needs, and you should never take a dosage different to the one either prescribed by your physician or written on the label.

Furthermore, it is not only the exact dosage which is bespoke to you. Other factors, such as how often you take it and what intervals you ought to leave in between doses, will be determined by your physician, and you should not alter these without your physician's consent.

The standard atropine dosage when it is taken for the relief of uveitis in ointment format is one narrow strip of ointment into your eye once or twice per day. For children, the maximum goes up to around three times per day. In the event that atropine is being used to prepare for exams involving the eye, the standard dose for children is three times per day. For adults, the dosage is most often determined by your physician.

For those taking atropine as eye drops for the treatment of uveitis, a single drop straight into the eye once or twice per day is the standard dosage for adults. For children, the maximum number of drops is again raised up to around three occasions per day. When the drops are being used to prepare for exams involving the eye, children are often prescribed one drop into the eye twice per day for a period of between one and three days prior to the exam taking place. For adults, the dosage tends to be determined by a physician.

In addition to atropine, this medicine also contains homatropine and scopolamine, and you may need to consume each drug separately. When taking homatropine, the standard dosage for those taking it in eye drop form for the relief of uveitis - whether they are adults or children - is one or two drops inserted straight into the eye two or three times per day. For those taking it as preparation for an eye examination, adults are usually given one or two drops inserted straight into the eye which can be repeated at intervals of between five and ten minutes for a series of around two or three doses. For children, the number of drops is the same (one or two into the eye) but the intervals are split into ten-minute chunks, again for around two to three doses.

Finally, scopolamine dosages are different again. For those taking scopolamine in eye drop format to treat uveitis, one drop is required straight into the eye region for a maximum of four times per day, whether you are an adult or a child. Adults who need the drug to prepare for examinations involving the eye region are expected to insert one drop straight into the eye area around one hour prior to the exam, while children can use a single drop straight into the eye twice each day for a period of two days in the run-up to the exam.

Those taking scopolamine in eye drop format for treatment of the condition posterior synechiae will have a different standard dose. For adults, one drop will need to be added to the eye once at intervals of ten minutes for a series of three doses, while for children the dosage will differ depending on the patient and must be designated by a physician.

If scopolamine is being used for the eye surgery process, patients of all ages can usually insert one drop into the eye between one and four times per day, both before and after surgery.

You should always endeavour to stick to your regular dosing schedule and try not to miss any. However, in the event that you do forget to take a dose, you should decide what to do based on how long it is until the following dose is supposed to be taken.

Generally, you should only take your missed dose late if it is still a long time from now until the next dose. If the upcoming dose is approaching quickly, then you should wait, take the upcoming dose then return to your normal dosing schedule. You should never take a double dose.

Specific advice applies for those on dosing schedules which run by the day. In the event that your physician has prescribed a single dose per day, you should take the dose you forgot as soon as you remember. In the event that you only remember the following day, you should skip the dose you missed, return to your normal dosing schedule and ensure you only take a single dose on that day.

When using the solution or eye drop format of atropine, homatropine, and scopolamine, it's important to make sure you prepare the medication carefully and use it as directed.

To begin with, you should always wash your hands. Tilt your head back slightly, then press down on the skin underneath your lower eyelid and pull (not firmly) on the skin of the lower eyelid. This creates a space for the drops to enter. Once the medication has entered your eye, you should remove your grip on this piece of skin and close your eyes. You should then keep your eyes closed, avoiding blinking, for at least two minutes. In order to improve the absorption of medication by your eye, you can also press down on the inward corner of your eye (again, gently).

Remember to wash your hands after using these eye drops, otherwise you could spread the medication around as you go about your business that day. You can lessen the chances of infecting your medication with bacteria by ensuring the tip of the bottle does not touch any surfaces.

If you are responsible for giving this medication to a child, remember to clean up any amount which has fallen on to the child's skin in error as soon as the dosage is over.

If you are taking atropine, homatropine, and scopolamine in ointment format, the application instructions are slightly different.

You should once again begin by washing your hands and pulling the lower eyelid away, as outlined above. You can squeeze the ointment into this space. You should check with your physician how much you should squeeze in, but the standard amount is between a quarter of an inch (for adults and older children) and an eighth of an inch (for younger children). If your physician has told you to use a different amount, you should follow their advice. Again, you should close your eyes afterwards and keep them closed for a couple of minutes in order to maximize absorption by the eye.

As above, you should once again wash your hands after performing this task.

If you are applying this medication to a child, once again be sure to clean up any medicine which has dripped on to the child in error as soon as the application is over.

Interactions

Most drugs can interact with other drugs once inside the human body, and atropine, homatropine, and scopolamine is no exception.

There are a large number of other drugs which atropine, homatropine, and scopolamine interact with, and for that reason you should always ensure that you have an up to date list of all medications which you are currently taking which is shared with your physician.

Medications which can interact with atropine, homatropine, and scopolamine include common over the counter drugs such as ibuprofen and aspirin. Other drugs which can interact include piroxicam, diflunisal, nepafenac, iproniazid and bufexamac.

There are also a number of other medical conditions which can pose problems in conjunction with atropine, homatropine, and scopolamine.

These include Down's syndrome, com/health/coma/">glaucoma, spastic paralysis (in children) and more. In the event that you or your child suffers from one of these conditions, your physician may need to speak to you about your medication configuration.

This is not an exhaustive list of interactions, so again, remember to make sure your physician has an up to date list of your current medication.

Warnings

Patients who are about to take atropine, homatropine, and scopolamine are warned that there are a number of short-term consequences which may happen as a result of taking the drugs.

Your pupils will become dilated, and you may experience blurred vision - particularly when looking at items up close. For that reason, you should always wait until you are sure how the medication is affecting you before you carry out tasks such as using heavy machinery or driving.

Due to the possibility of increased sensitivity to light, it's likely you may need to wear sunglasses to ensure your eyes are protected from the sunlight.

Storage

As with any drug, it is vital that you store and dispose of atropine, homatropine, and scopolamine correctly to avoid causing danger to or problems for other people.

Firstly, you should always ensure that you keep your atropine, homatropine, and scopolamine stored in a place where children cannot reach it. Even if you don't have children living in your home, you should still keep it stored away in a high place in case you have children coming over to visit in the future. This will help cut down on the chances of dangerous accidental consumption.

Secondly, you should store your atropine, homatropine, and scopolamine in supportive environmental conditions. You should never store your atropine, homatropine, and scopolamine in a location where it is exposed to direct light or heat, and it should instead be kept at room temperature. Moisture should be prevented from entering the medication, and you should ensure that you keep your atropine, homatropine, and scopolamine stored in a closed container. Do not freeze your atropine, homatropine, and scopolamine.

You should never stop taking atropine, homatropine, and scopolamine unless advised to by your healthcare team, but in the event that you have any excess medication which you no longer need after your course has finished you should dispose of it correctly. If you are unsure of the appropriate way to dispose of atropine, homatropine, and scopolamine, you should consult your healthcare professional to find out more.

Summary

Atropine, homatropine, and scopolamine is a useful ophthalmic drug for those patients who are undergoing eye examinations, surgery or need treatment for certain eye conditions. The drug, which is only available via prescription and comes in either ointment or solution format, is designed to dilate the pupil of the eye.

Some side effects are possible when taking atropine, homatropine, and scopolamine. Serious side effects, such as an increase in clumsiness or dry skin, require you to consult your physician or healthcare professional straight away. Other less serious side effects, such as a blurring of your vision, will usually pass as your body adjusts to the medication.

Standard dosage information for atropine, homatropine, and scopolamine is available, but you should always follow the advice of your physician.

The standard dosages vary greatly based on a number of factors including the age of the patients and the specific drug being administered.

There are specific instructions to follow when it comes to applying atropine, homatropine, and scopolamine. In all cases you should wash your hands thoroughly first.

Many drugs can interact with atropine, homatropine, and scopolamine once they are inside the human body. These include common drugs such as ibuprofen and aspirin, while less common drugs such as nepafenac and iproniazid can also interact negatively. Your doctor should always receive a full and up to date list of all medications you are currently taking in order to prevent problems caused by interactions.

Always store your atropine, homatropine, and scopolamine out of the reach of children. Once you have finished with your atropine, homatropine, and scopolamine, you should dispose of it appropriately. If you are not sure how to do this, consult your healthcare professional.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
Content Source: