Description
Latin name
IRIFRIN BK
Release form
Irifrin BK. Eye drops
Packaging
In a single-use tube dropper of 0.4 ml solution of eye drops. There are 5 dropper tubes in a bag of laminated paper. In a pack of cardboard 3 bags of laminated paper.
Pharmacological action
Adrenergic agonist. It has a direct stimulating effect mainly on -Adrenoreceptors.
With systemic use, it causes narrowing of arterioles, increases OPSS and blood pressure. Cardiac output does not change or decreases, which is associated with reflex bradycardia (an increase in the tone of the vagus nerve) in response to arterial hypertension. Phenylephrine does not increase blood pressure as dramatically as norepinephrine and epinephrine, but it lasts longer. This, apparently, is due to the fact that phenylephrine is more stable and does not collapse under the influence of COMT.
When applied topically, phenylephrine has a pronounced vasoconstrictive effect, causes mydriasis, and may lower intraocular pressure in open-angle glaucoma.
At moderate therapeutic doses, virtually no effect on the central nervous system.
Pharmacokinetics
After oral administration, phenylephrine is poorly absorbed from the digestive tract. It is metabolized with the participation of MAO in the intestinal wall and during the first passage through the liver. Phenylephrine bioavailability is low.
After topical application, it undergoes systemic absorption.
Indications
Iridocyclitis (to prevent the occurrence of posterior synechia and reduce exudation from the iris).
Dilation of the pupil during ophthalmoscopy and other diagnostic procedures necessary to monitor the condition of the posterior segment of the eye, during laser interventions on the fundus and vitreoretinal surgery.
Provide a provocative test in patients with a narrow anterior chamber angle profile and suspected angle-closure glaucoma.
Differential diagnosis of superficial and deep injection of the eyeball.
Red eye syndrome (to reduce hyperemia and irritation of the mucous membrane of the eye).
Prevention of asthenopia and accommodation spasm in patients with high visual stress.
Treatment of false myopia (spasm of accommodation) and prevention of progression of true myopia in patients with high visual stress.
Contraindications
Hypersensitivity to the drug.
Narrow-angle or angle-closure glaucoma.
Arterial hypertension in combination with Coronary heart disease, aortic aneurysm, atrioventricular block I – III degree, arrhythmia.
tachycardia.
History of type I diabetes.
Continuous use of monoamine oxidase inhibitors, tricyclic antidepressants, antihypertensive drugs.
Additional dilated pupil during surgical operations in patients with impaired eyeball integrity, as well as in violation of tear production.
Reduced body weight in newborns.
Hyperthyroidism.
Hepatic porphyria.
Congenital deficiency of glucose-6-phosphate dehydrogenase.
Breastfeeding period.
Precautions: In patients with type II diabetes mellitus – an increased risk of high blood pressure.
In elderly patients, there is an increased risk of reactive myosis.
Exceeding the recommended dose of 2.5% solution in patients with injuries, diseases of the eye or its appendages, in the postoperative period, or with reduced tear production may lead to increased absorption of phenylephrine and the development of systemic side effects.
Due to what causes conjunctival hypoxia – in patients with sickle cell anemia, when wearing contact lenses, after surgical interventions (decreased healing).
With cerebral atherosclerosis.
With long-term bronchial asthma.
Use during pregnancy and lactation
Pregnancy
In animals in late pregnancy, phenylephrine caused fetal growth retardation and stimulated the early onset of labor.
The effect of Irifrin BC in pregnant women is not well understood, therefore, the drug should be used in this category of patients only, if the expected benefit to the mother exceeds the risk of developing possible side effects for the fetus.
Lactation
If a drug is prescribed for lactation, breast-feeding should be discontinued.
Composition
In 1 ml of 2.5% solution of eye drops contains:
Active ingredient
Phenylephrine hydrochloride – 25 mg.
Excipients
Disodium edetate 1.0 mg, sodium metabisulfite 2.0 mg, citric acid 1.16 mg, sodium citrate dihydrate.e., hyperrmellose 3.0 mg, water for injection qs
Dosage and administration of
Ophthalmoscopy uses a single instillation of a 2.5% solution of Irifrin BK. As a rule, to create mydriasis, it is enough to introduce 1 drop of a 2.5% solution of Irifrin BK into the conjunctival sac.
Maximum mydriasis is reached after 15-30 minutes and remains at a sufficient level for 1-3 hours. If it is necessary to maintain mydriasis for a long time, after 1 hour, repeated instillation of Irifrin BK is possible.
For diagnostic procedures:
As a provocative test in patients with a narrow anterior chamber angle profile and suspected angle-closure glaucoma, 1 drop of the drug is instilled once. If the difference between the values of intraocular pressure before instillation of IrifrinavBK and after the expansion of the pupil is from 3 to 5 mm RT. Art., the provocative test is considered positive.
For differential diagnosis of an eyeball injection type, 1 drop of the drug is instilled once: if, after 5 minutes after instillation, a narrowing of the vessels of the eyeball is noted, then the injection is classified as superficial, while maintaining redness of the eye, it is necessary to carefully examine the patient for the presence of iridocyclitis or scleritis, as this indicates the expansion of more deeply lying vessels.
With iridocyclitis
To prevent the development and rupture of already formed posterior synechiae and to reduce exudation in the anterior chamber of the eye, 1 drop of the drug is instilled into the conjunctival sac of the sick eye 2-3 times a day for 5-10 days, depending on the severity of the disease.
In schoolchildren
With mild myopia
To prevent accommodation spasm during periods of high visual load, 1 drop of Irifrin BK is buried in the evening before bedtime.
With progressive moderate myopia
3 times a week in the evening before bedtime.
With emmetropia
In the daytime, depending on the load.
In case of hyperopia with a tendency to accommodation spasm at high visual load
Buried in the evening Irifrin BK in combination with a 1% solution of cyclopentolate. With normal visual load, Irifrin BK is instilled 3 times a week in the evening before bedtime.
In the treatment of false and true myopia
, one drop of Irifrin BK is instilled in the evening before bedtime 2-3 times a week for a month.
Side effects
Local
Conjunctivitis, keratitis, periorbital edema, eye pain, burning sensation during instillation, lacrimation, blurred vision, irritation, discomfort, increased intraocular pressure, blocking the anterior chamber angle (with narrowing of the angle), allergic reactions, reactive hyperemia. Phenylephrine can cause reactive myosis the day after application. Repeated instillations of the drug at this time may produce less pronounced mydriasis than the day before. This effect is more often seen in elderly patients. Due to a significant reduction in the pupil dilator under the influence of phenylephrine 30-45 minutes after instillation in the moisture of the anterior chamber of the eye, particles of pigment from the pigment leaf of the iris can be detected. Suspension in chamber moisture must be differentiated with manifestations of anterior uveitis or with the formation of blood cells in the moisture of the anterior chamber .
Systemic
Contact dermatitis.
From the cardiovascular system
Heart palpitations, tachycardia, arrhythmia, increased blood pressure, ventricular arrhythmia, reflex bradycardia, coronary artery occlusion, pulmonary embolism.
Drug Interactions
The mydriatic effect of phenylephrine is enhanced when used in combination with topical use of atropine. Due to increased vasopressor action, the development of tachycardia is possible.
The use of Irifrin BK within 21 days after the patient stops taking monoamine oxidase inhibitors and tricyclic antidepressants should be carried out with caution, since in this case there is the possibility of an uncontrolled rise in blood pressure.
The vasopressor action of adrenergic agents can also be potentiated when used together with tricyclic antidepressants, beta-blockers, reserpine, guanethidine, methyldopa and m-anticholinergics.
Irifrin BK can potentiate the inhibition of cardiovascular activity during inhalation anesthesia as a result of increased myocardial sensitivity to sympathomimetics and the occurrence of ventricular fibrillation.
Use in conjunction with other sympathomimetics may increase the cardiovascular effects of phenylephrine.
The use of phenylephrine can weaken concomitant antihypertensive therapy and lead to an increase in blood pressure and tachycardia.
Pre-instillation of local anesthetics may increase systemic absorption and prolong mydriasis
overdose
Symptoms: overdoses are anxiety, nervousness, dizziness sweating, vomiting, palpitations, weak or shallow breathing.
Treatment: If systemic action of phenylephrine occurs, it is possible to stop undesirable effects by using alpha-blockers, for example, from 5 to 10 mg of phenolamine intravenously. If necessary, the injection can be repeated.
Storage Conditions
At room temperature (up to 25 ° C) in a dark place and out of the reach of children. Do not freeze.
Shelf life
2 years.
Possible product names
IRIFRIN BK 2.5% 0.4ML N15 TUBE / CAP GL DROPS
IRIFRIN BK 2.5% 0.4ML. No. 15 GL.DROPS
Irifrin BK 2.5% Eye Drops 0.4ml tube-drop. X15 M
Irifrin BK 2.5% eye drops 0.4ml Tube-cap. X15
Irifrin BK eye drops 2.5%, 0.4 ml, 15 pcs.
