Version July 2025
Allergic conjunctivitis/ocular itching: Children ≥2 years and Adolescents: Ophthalmic: Instill 1 drop into affected eye(s) once daily.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely to be necessary due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely to be necessary due to low systemic absorption.
(For additional information see "Alcaftadine: Drug information")
Allergic conjunctivitis: Ophthalmic:
Rx labeling: Instill 1 drop into each eye once daily.
OTC labeling: Instill 1 drop into affected eye(s) once daily.
The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
Altered kidney function: Ophthalmic: No dosage adjustment necessary for any degree of kidney dysfunction (minimal systemic absorption (Ref)) (Ref).
Hemodialysis, intermittent (thrice weekly): Ophthalmic: Unlikely to be significantly dialyzed: No supplemental dose or dosage adjustment necessary (minimal systemic absorption) (Ref).
Peritoneal dialysis: Ophthalmic: Unlikely to be significantly dialyzed: No dosage adjustment necessary (minimal systemic absorption) (Ref).
CRRT: Ophthalmic: No dosage adjustment necessary (Ref).
PIRRT (eg, sustained, low-efficiency diafiltration): Ophthalmic: No dosage adjustment necessary (Ref).
There are no dosage adjustments provided in the manufacturer’s labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%:
Central nervous system: Headache (<3%)
Ophthalmic: Burning sensation of eyes (<4%), eye irritation (<4%), eye pruritus (<4%), eye redness (<4%), stinging of eyes (<4%)
Respiratory: Nasopharyngitis (<3%)
<1%, postmarketing, and/or case reports: Allergic dermatitis, blurred vision, drowsiness, erythema of eyelid, eye discharge, eyelid edema, facial edema, hypersensitivity, increased lacrimation, swelling of eye
Hypersensitivity to alcaftadine or any component of the formulation.
OTC labeling: When used for self-medication, do not use if you are sensitive to any ingredient of the formulation or to treat contact lens irritation.
Special populations:
• Contact lens wearers: Contains benzalkonium chloride which may be absorbed by soft contact lenses; remove lenses prior to administration and wait 10 minutes before reinserting. Not for the treatment of contact lens irritation; do not wear contact lens if eye is red.
Other warnings/precautions:
• Appropriate use: For topical ophthalmic use only. To avoid eye injury and contamination, do not touch dropper tip to eyelids or any surface.
• Self-medication (OTC use): When used for self-medication (OTC), discontinue use and notify health care provider if eye pain or changes in vision occur, redness of the eye increases, or itching worsens or lasts >72 hours.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Ophthalmic:
Lastacaft: 0.25% (3 mL [DSC], 5 mL) [contains benzalkonium chloride, edetate (edta) disodium]
No
Solution (Lastacaft Ophthalmic)
0.25% (per mL): $2.61
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Ophthalmic: For topical ophthalmic use only. Contains benzalkonium chloride; contact lenses should be removed prior to application and may be reinserted 10 minutes after administration. Separate administration of other ophthalmic agents by 5 minutes. Do not insert contacts if eyes are red. Avoid contamination; do not touch the applicator tip to eye, eyelid, or other surfaces.
For topical ophthalmic use only. Contact lenses should be removed prior to application, and may be reinserted 10 minutes after administration. Separate administration of other ophthalmic agents by 5 minutes. Do not insert contacts if eyes are red. Avoid contaminating the applicator tip with affected eye(s).
Store at 15°C to 25°C (59°F to 77°F).
Prescription products: Prevention of itching associated with allergic conjunctivitis (FDA approved in ages ≥2 years and adults).
OTC products: Temporary relief of itchy eyes due to animal dander and hair, grass, pollen, and ragweed (OTC: FDA approved in ages ≥2 years and adults).
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program
There are no known significant interactions.
Adverse events were not observed in animal reproduction studies.
If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples 1988).
Direct H1-receptor antagonist and inhibitor of histamine release from mast cells
Absorption: Minimal systemic absorption following ophthalmic administration with no systemic accumulation of acid metabolite occurs (Ref).
Protein binding: Alcaftadine: ~40%; Carboxylic acid (major acid metabolite): ~60% (Ref).
Metabolism: Primarily via aldehyde oxidation to the active major metabolite, carboxylic acid.
Half-life elimination: Carboxylic acid: ~2 hours (Ref).
Time to peak: 15 minutes (plasma) and decline rapidly by 3 hours post dose (Ref).
Excretion: Urine (55% to 60% of the dose as acid metabolite following oral administration) (Ref).
