AK-Pentolate Ophthalmic

Name: AK-Pentolate Ophthalmic

Proper Use of atropine, homatropine, and scopolamine

This section provides information on the proper use of a number of products that contain atropine, homatropine, and scopolamine. It may not be specific to AK-Pentolate. Please read with care.

To use the ophthalmic solution (eye drops) form of this medicine:

  • First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 2 or 3 minutes to allow the medicine to be absorbed by the eye.
  • Immediately after using the eye drops, wash your hands to remove any medicine that may be on them. If you are using the eye drops for an infant or child, be sure to wash his or her hands immediately afterwards also, and do not let any of the medicine get in his or her mouth. In addition, wipe off any medicine that may have accidentally gotten on the infant or child, including his or her face or eyelids.
  • To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.

To use the ointment form of this medicine:

  • First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Squeeze a thin strip of ointment into this space. A 1/3- to ½;-cm (approximately ⅛-inch in infants and young children and ¼-inch in older children and adults) strip of ointment is usually enough, unless you have been told by your doctor to use a different amount. Let go of the eyelid and gently close the eyes. Keep the eyes closed for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
  • Immediately after using the eye ointment, wash your hands to remove any medicine that may be on them. If you are using the eye ointment for an infant or child, be sure to wash his or her hands immediately afterwards also, and do not let any of the medicine get in his or her mouth. In addition, wipe off any medicine that may have accidentally gotten on the infant or child, including his or her face or eyelids.
  • To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). After using the eye ointment, wipe the tip of the ointment tube with a clean tissue and keep the tube tightly closed.

Use this medicine only as directed. Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of too much medicine being absorbed into the body and the chance of side effects. This is especially important when this medicine is used in infants and children, since overdose is very dangerous in infants and children.

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    For atropine
  • For ophthalmic ointment dosage form:
    • For uveitis:
      • Adults—Use a thin strip of the ointment in the eye one or two times a day.
      • Children—Use a thin strip of the ointment in the eye one to three times a day.
    • For eye examinations:
      • Adults—Use and dose must be determined by your doctor.
      • Children—Use a thin strip of the ointment in the eye three times a day for one to three days before the examination.
  • For ophthalmic solution (eye drops) dosage form:
    • For uveitis:
      • Adults—Use one drop in the eye one or two times a day.
      • Children—Use one drop in the eye one to three times a day.
    • For eye examinations:
      • Adults—Use and dose must be determined by your doctor.
      • Children—Use one drop in the eye two times a day for one to three days before the examination.
    For homatropine
  • For ophthalmic solution (eye drops) dosage form:
    • For uveitis:
      • Adults and children—Use 1 or 2 drops in the eye two or three times a day.
    • For eye examinations:
      • Adults—Use 1 or 2 drops in the eye. May be repeated every five to ten minutes for two or three doses.
      • Children—Use 1 or 2 drops in the eye every ten minutes for two or three doses.
    For scopolamine
  • For ophthalmic solution (eye drops) dosage form:
    • For uveitis:
      • Adults and children—Use one drop in the eye up to four times a day.
    • For eye examinations:
      • Adults—Use one drop in the eye one hour before the examination.
      • Children—Use one drop in the eye two times a day for two days before the examination.
    • For posterior synechiae:
      • Adults—Use one drop in the eye every ten minutes for three doses.
      • Children—Use and dose must be determined by your doctor.
    • For use before and after surgery:
      • Adults and children—Use one drop in the eye one to four times a day.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of this medicine and your dosing schedule is:

  • One dose a day—Apply the missed dose as soon as possible. However, if you do not remember the missed dose until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
  • More than one dose a day—Apply the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Side Effects

Burning/stinging/redness of the eye, eye irritation, or temporary blurred vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: dizziness, fainting, mental/mood changes (e.g., confusion, hallucinations, restlessness, strange behavior).

Get medical help right away if you have any very serious side effects, including: eye pain/swelling, vision changes (such as seeing rainbows around lights at night), slow/shallow breathing, fast/irregular heartbeat, seizures.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

List AK-Pentolate Drops side effects by likelihood and severity.

Interactions

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: eye medications for glaucoma/increased pressure in the eye (e.g., dorzolamide, pilocarpine), certain antiarrhythmic drugs (e.g., quinidine), antihistamines (e.g., diphenhydramine, meclizine), antispasmodics (e.g., dicyclomine), certain drugs for Parkinson's disease (e.g., anticholinergics such as benztropine, trihexyphenidyl), MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine), tricyclic antidepressants (e.g., amitriptyline).

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Cyclopentolate ophthalmic Pregnancy Warnings

Cyclopentolate ophthalmic has been assigned to pregnancy category C by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancy. Cyclopentolate ophthalmic is only recommended for use during pregnancy when benefit outweighs risk.

Cyclopentolate Levels and Effects while Breastfeeding

Summary of Use during Lactation

No information is available on the use of cyclopentolate during breastfeeding. Anticholinergic drugs might interfere with breastfeeding. A single dose of ophthalmic cyclopentolate is not likely to interfere with breastfeeding; however, during long-term use, observe the infant for signs of decreased lactation (e.g., insatiety, poor weight gain). To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information in nursing mothers was not found as of the revision date. Anticholinergics can inhibit lactation in animals, apparently by inhibiting growth hormone and oxytocin secretion.[1][2][3][4][5] Anticholinergic drugs can also reduce serum prolactin in nonnursing women.[6] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

References

1. Aaron DK, Ely DG, Deweese WP et al. Reducing milk production in ewes at weaning using restricted feeding and methscopolamine bromide. J Anim Sci. 1997;75:1434-42. PMID: 9250502

2. Powell MR, Keisler DH. A potential strategy for decreasing milk production in the ewe at weaning using a growth hormone release blocker. J Anim Sci. 1995;73:1901-5. PMID: 7592071

3. Daniel JA, Thomas MG, Powell MR, Keisler DH. Methscopolamine bromide blocks hypothalmic-stimulated release of growth hormone in ewes. J Anim Sci. 1997;75:1359-62. PMID: 9159285

4. Bizzarro A, Iannucci F, Tolino A et al. Inhibiting effect of atropine on prolactin blood levels after stimulation with TRH. Clin Exp Obstet Gynecol. 1980;7:108-11. PMID: 6788407

5. Svennersten K, Nelson L, Juvnas-Moberg K. Atropinization decreases oxytocin secretion in dairy cows. Acta Physiol Scand. 1992;145:193-4. PMID: 1636447

6. Masala A, Alagna S, Devilla L et al. Muscarinic receptor blockade by pirenzepine: effect on prolactin secretion in man. J Endocrinol Invest. 1982;5:53-5. PMID: 6808052

Administrative Information

LactMed Record Number

762

Last Revision Date

20150310

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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