Interacting drugs- summary

Apraclonidine+ -

Cardiovascular

 apraclonidine may reduce pulse and blood pressure, caution in using cardiovascular drugs is adviced.

Patients using cardiovascular drugs concurrently with apraclonidine 0.5% should have pulse and blood pressures frequently checked

MAO inhibitors

 apraclonidine should not be used in patients receiving MAO inhibitors

Opthalmic- Upper lid elevation,, mydriasis, burning discomfort, foreign body sensation, dryness, itching, hypotony, blurred or diminished vision, allergic responsde, conjunctival microhemorrhage.

GI- abdominal pain, duarrhea, stomach discomfort, emesis, dry mouth, nausea.

Cardiovascular- bradycardi, vasovagal attackk, palpitations, orthostatic episode

CNS- insomnia, dream disturbances, irritability, decreased libido, headache, paresthesia.

Hypersensitivity- use can lead to allergic-like reactions.

Miscellaneous- taste abnormalities, nasal burning,dryness, head cold sensation, ckest heaviness or burning, clammy or sweaty palms, body heat sensation, shortness of breath, increased pharyngeal secretion, extremity pain or numbness, fatigue, pruritus not associated with rash.

Hypersens to any component of this medication or to clonidine, concurrent monoamine oxidase inhibitor therapy.

Special preacutions-

Concomittant therapy- the addition of apraclonidine 0.5% to patients already using two aqueous suppressing drugs (eg,. beta-blocker plus carbonic anhydrase inhibitor) as part of maximaly tolerated medical therapy may not significantly reduce IOP.

Tachyphyaxis- the IOP lowering efficacy of apraclonidine 0.5% diminishes over time in some patients. The loss of effect or tachphylaxis appaeras to be an individual occurence with avariable time of onset and should be closely monitored.

Hypersentivity- aprclonidine can lead to an allergic-like reaction characterized wholly or n part by the symptoms of hyperemia, pruritus,discomfort, taerring,foreign body sensation andedema of the lids and conjuntiva. If occular allergic-like reaction occur, discontinue therapy.

Renal/heaptic functin impairment- although the topical use of aprclonidine had not been studied in renal failure patients, structurally related clonidine undergoes a significant increase in half-lfe in patients with severe renal impairment.Close monitoring of cardiovascular parameters in patients with impaired renal function, is adviced if they are candidates for topical apraclonidine therapy.

Pregnancy- use during pregnancy only if potentail benefit justifies the potentail risk to the fetus.

Lactation- Consider discontiuning nursing for the day on which apraclonodine is used.

Children- safety and efficacy for use in children have not been established.

Indication

Treatment of chronic glaucoma

Dosage:

Instil 1 drop in scheduled operative eye 1 hour before initiating anterior segment laser surgery. Instil second drop into the same eye upon completion of surgery .

Missed dose-

1. If you miss a dose of this medicine, take it as soon as possible.

2. However, if it is almost time for next dose, skip the missed dose and go back to your regular dosing schedule.

3. Do not double doses.

Pharmacology:

Apraclonidine has the action of reducing elevated as well as normal intraocular pressure(IOP) whether accompanied by glaucoma or not.

Pharmacokinetics:

Topical use of aparclonidine 0.5% leads to to systemic absorption. The half-life of apraclonidine is estimated to be 8 hrs.

Pregnancy:

Use during pregnancy only if needed.

Lactation:

Consider discontinuing apraclonidine when administering to nursing women

Children-

Safety and efficacy for use in children have not been established.