Description
Dosage form
Eye drops
Packaging
Bottle 5 ml
Pharmacological action
sympathomimetic. It has a pronounced alpha-adrenergic activity and when used in usual doses does not have a significant stimulating effect on the central nervous system.
When applied topically in ophthalmology, it causes the expansion of the pupil, improves the outflow of intraocular fluid and narrows the vessels of the conjunctiva.
Phenylephrine has a pronounced stimulating effect on postsynaptic -adrenoreceptors, has a very weak effect on myocardial -adrenoreceptors. The drug has a vasoconstrictor effect, similar to the action of norepinephrine (norepinephrine), while it has virtually no chronotropic and inotropic effect on the heart. The vasopressor effect of phenylephrine is less pronounced than that of norepinephrine, but is longer. It causes vasoconstriction 30-90 seconds after instillation, duration of action is 2-6 hours.
After instillation, phenylephrine shortens the pupil dilator and the smooth muscles of the conjunctival arterioles, thereby causing pupil expansion. Mydriasis occurs within 10-60 minutes after a single instillation. After instillation of eye drops, 2.5% mydriasis persists for 2 hours, after instillation of eye drops 10% – 3-7 hours. Since phenylephrine has little effect on the ciliary muscle, mydriasis occurs without cycloplegia.
Pharmacokinetics
Pharmacokinetics of the drug Irifrin ® not available.
Indications
Iridocyclitis (to prevent the occurrence of posterior synechia and reduce exudation from the iris).
For diagnostic dilatation of the pupil with ophthalmoscopy and other diagnostic procedures necessary to monitor the condition of the posterior segment of the eye.
Providing a provocative test in patients with a narrow angle of the anterior chamber of the eye and suspected angle-closure glaucoma.
Differential diagnosis of superficial and deep injection of the eyeball.
For dilating the pupil during laser interventions in the fundus and in vitreoretinal surgery.
Treatment of glaucoma-cyclical crises.
Treatment of red eye syndrome to reduce hyperemia and irritation of the membranes of the eye.
Contraindications
Angle-angle or narrow-angle glaucoma.
Elderly patients with serious disorders of the cardiovascular system and cerebral circulation.
For additional dilatation of the pupil during surgery in patients with impaired eyeball integrity, as well as in violation of tear production.
Hyperthyroidism.
Hepatic porphyria.
Congenital deficiency of glucose-6-phosphate dehydrogenase.
Premature.
Hypersensitivity to the drug.
Use during pregnancy and lactation
Since the effect of Irifrin during pregnancy and lactation has not been sufficiently studied, the use of the drug in these patients is only possible if the expected benefit of therapy for the mother outweighs the potential risk to the fetus or infant.
Special instructions
Use caution with Irifrin in patients with diabetes mellitus because of the risk of developing an increase in blood pressure associated with impaired autonomic regulation, as well as in elderly patients due to an increased risk of reactive myosis.
Composition
1 ml drops contains:
Active ingredient: Phenylephrine hydrochloride 25 mg.
Excipients: Benzalkonium chloride, disodium edetate, sodium hydroxide, sodium metabisulfide, citric acid, sodium citrate dihydrate, water d / i.
Dosage and administration
For ophthalmoscopy, eye drops of 2.5% are used once in the form of instillations. As a rule, to create mydriasis, it is enough to introduce 1 drop into the conjunctival sac. Maximum mydriasis is achieved 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 is possible.
In adults and children over 12 years old with insufficient dilatation of the pupil, as well as in patients with rigid iris (pronounced pigmentation), 10% eye drops can be used in the same dose for diagnostic dilatation of the pupil.
To relieve the spasm of accommodation, adults and children over 6 years of age are prescribed eye drops of 2.5%, 1 drop in each eye at night every day for 4 weeks.
In the case of persistent accommodation spasm, eye drops of 10% are possible in adults and children over 12 years of age – 1 drop in each eye at night every day for 2 weeks.
When conducting diagnostic procedures, a single instillation of eye drops 2.5% is used in the following cases:
– as a provocative test in patients with a narrow profile of the anterior chamber angle and suspected angle-closure glaucoma – if the difference between the intraocular pressure before instillation of Irifrin and after pupil expansion is 3 to 5 mmHg, then the provocative test is considered positive
– for differential diagnosis such as an eyeball injection – 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 eyes should be carefully examined by the patient for the presence of iridocyclitis or scleritis, because this indicates the expansion of deeper vessels.
With iridocyclitis, Irifrin ® is used as eye drops 2. 5% or 10% to prevent the development and rupture of the already formed posterior synechiae and to reduce exudation into the anterior chamber of the eye. For this purpose, 1 drop 2-3 times a day is instilled into the conjunctival sac of a sick eye (eye).
In glaucoma-cyclical crises, due to the vasoconstrictor action of phenylephrine, intraocular pressure decreases, this effect is more pronounced when Irifrin is used in the form of eye drops of 10%. To stop glaucoma-cyclical crises, the drug is instilled 2-3 times / day.
In preparation for surgery 30-60 minutes before surgery, in order to achieve mydriasis, a single instillation of Irifrin in the form of eye drops of 10% is performed. After opening the membranes of the eyeball, repeated instillation of the drug is not allowed.
Eye drops 10% are not used for irrigation, impregnation of tampons during surgical interventions and for subconjunctival administration.
Side effects
From the side of the organ of vision: conjunctivitis, periorbital edema, a burning sensation at the beginning of use, blurred vision, irritation, discomfort, lacrimation, increased intraocular pressure.
The day after the use of Irifrin ®, reactive myosis is possible. With repeated instillations of the drug during this period, mydriasis may be less pronounced than the day before. This effect is more often seen in elderly patients.
Due to a significant reduction in the dilator of the pupil under the influence of phenylephrine 30-45 min after instillation in the moisture of the anterior chamber of the eye, particles of pigment from the pigment sheet of the iris can be detected. Suspension in chamber moisture must be differentiated with the appearance of anterior uveitis or with the formation of blood cells in the moisture of the anterior chamber.
From the cardiovascular system: possible sensation of palpitations, tachycardia, arrhythmia (including ventricular), arterial hypertension, reflex bradycardia, coronary artery occlusion, pulmonary embolism.
Dermatological reactions: contact dermatitis.
Rarely, when Irifrin is used in the form of eye drops of 10%, serious disorders of the cardiovascular system are observed, including myocardial infarction, vascular collapse, and intracranial hemorrhage.
Drug Interactions
The mydriatic effect of phenylephrine is enhanced when used in combination with atropine. Due to increased vasopressor action, the development of tachycardia is possible.
When using Irifrin simultaneously with MAO inhibitors or within 21 days after stopping their intake, there is a risk of developing an uncontrolled rise in blood pressure.
The vasopressor action of adrenergic agonists can also be potentiated when used together with tricyclic antidepressants, propranolol, reserpine, guanethidine, methyldopa and m-anticholinergics.
Irifrin may potentiate a depressing effect on cardiovascular activity during inhalation anesthesia.
Use in conjunction with sympathomimetics may enhance the cardiovascular effects of phenylephrine.
Overdose
Symptoms: Phenylephrine systemic action may occur.
Treatment: The administration of alpha-blockers, such as 5 to 10 mg of phentolamine I / O, can be repeated if necessary.
Storage conditions
In a dark place, at a temperature not exceeding 25 ° C
Shelf life
2 years, after opening the bottle shelf life – 1 month.
drugstore
drugstore
dosage form
eye drops
Possible product names
Irifrin eye drops 2.5%, 5 ml
Sentiss Farm Pvt.Ltd, India
