Version May 2024
Note: Individuals with heavily pigmented eyes may require higher strength or additional doses.
Mydriasis: Ophthalmic: (0.5%): Instill 1 drop 15 to 20 minutes prior to exam
Note: Individuals with heavily pigmented eyes may require higher strength or additional doses.
Cycloplegia: Infants, Children, and Adolescents: Ophthalmic (1%): Instill 1 to 2 drops; repeat in 5 minutes. If the patient is not examined within 20 to 30 minutes, instill an additional drop to prolong effect.
Mydriasis: Infants, Children, and Adolescents: Ophthalmic (0.5%): Instill 1 to 2 drops (0.5%) 15 to 20 minutes before exam
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Tropicamide: Drug information")
Note: Individuals with heavily pigmented eyes may require higher strength or additional doses. Mydriasis will reverse spontaneously with time, typically in 4 to 8 hours. However, in some cases, complete recovery may take up to 24 hours.
Cycloplegia: Ophthalmic: Instill 1 to 2 drops (1%) in the eye(s); repeat in 5 minutes. If the patient is not examined within 20 to 30 minutes, instill an additional drop to prolong effect.
Mydriasis: Ophthalmic: Instill 1 to 2 drops (0.5%) in the eye(s) 15 to 20 minutes before exam.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions are derived from product labeling unless otherwise specified.
Postmarketing:
Cardiovascular: Tachycardia
Dermatologic: Pallor
Gastrointestinal: Nausea, vomiting, xerostomia
Hypersensitivity: Anaphylaxis (Sefi-Yurdakul 2021), hypersensitivity reaction
Nervous system: Central nervous system dysfunction, headache
Neuromuscular & skeletal: Muscle rigidity
Ophthalmic: Blurred vision, photophobia, stinging of eyes (transient), superficial punctate keratitis
Hypersensitivity to tropicamide or any component of the formulation.
Canadian labeling: Additional contraindications (not in US labeling): Known or suspected narrow angle glaucoma; small infants (<3 months of age).
Concerns related to adverse effects:
• CNS effects: May cause drowsiness and/or blurred vision, which may impair physical or mental abilities; patients must be cautioned about performing tasks that require mental alertness (eg, operating machinery, driving).
• Increased intraocular pressure: May cause a transient increase in intraocular pressure.
Special populations:
• Contact lens wearers: Contains benzalkonium chloride, which may be absorbed by soft contact lenses; remove lenses prior to administration.
• Pediatric: Use with caution in infants and children; may cause potentially dangerous CNS disturbances. Psychotic reactions, behavioral disturbances, and vasomotor or cardiorespiratory collapse in children have been reported with the use of anticholinergic drugs.
Other warnings/precautions:
• Appropriate use: For topical ophthalmic use only. Remove contact lenses prior to administration. To avoid excessive systemic absorption, apply gentle finger pressure to lacrimal sac for 2 to 3 minutes following application. Do not touch dropper tip to eyelids or any surface.
May cause increased blood pressure in premature neonates: The use of tropicamide 1% solution in combination with phenylephrine has been associated with significant increases in mean blood pressure (Chew 2005).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Mydriacyl: 1% (15 mL)
Generic: 0.5% (15 mL); 1% (2 mL, 3 mL, 15 mL)
Yes
Solution (Mydriacyl Ophthalmic)
1% (per mL): $8.01
Solution (Tropicamide Ophthalmic)
0.5% (per mL): $1.67 - $1.78
1% (per mL): $2.38 - $3.17
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.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Mydriacyl: 0.5% (15 mL); 1% (15 mL) [contains benzalkonium chloride, edetate (edta) disodium]
Generic: 1% (0.5 mL, 15 mL)
Ophthalmic: For topical ophthalmic use only. Remove contact lenses prior to instillation. Do not touch dropper tip to eyelids or any surface. Apply gentle pressure to lacrimal sac during and immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration, to decrease systemic absorption of ophthalmic drops (Ref). Wash hands following administration.
Ophthalmic: For topical ophthalmic use only. Remove contact lenses prior to instillation. To avoid excessive systemic absorption, apply gentle finger pressure to lacrimal sac for 2 to 3 minutes following application. Do not touch dropper tip to eyelids or any surface. Wash hands following administration.
Store at 8°C to 27°C (46°F to 80°F). Do not refrigerate or store at high temperatures. Avoid freezing.
For mydriasis and cycloplegia in diagnostic procedures (FDA approved in pediatric patients [age not specified] 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 Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Carbachol: Tropicamide may diminish the therapeutic effect of Carbachol. Risk C: Monitor therapy
Echothiophate Iodide: Tropicamide may diminish the therapeutic effect of Echothiophate Iodide. Risk C: Monitor therapy
Pilocarpine (Ophthalmic): Tropicamide may diminish the therapeutic effect of Pilocarpine (Ophthalmic). Risk C: Monitor therapy
Animal reproduction studies have not been conducted. 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).
Ophthalmic exam, intraocular pressure, CNS reactions (especially in pediatric patients)
Prevents the sphincter muscle of the iris and the muscle of the ciliary body from responding to cholinergic stimulation; produces dilation and prevents accommodation.
Onset of action: Cycloplegic effect: Peak: 20 to 35 minutes; Mydriatic effect: ~20 to 40 minutes
Duration: Cycloplegic effect: <6 hour; Mydriatic effect: ~6 to 7 hours
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