Atropine Sulfate

Drug overview for ATROPINE SULFATE (atropine sulfate/pf):

Generic name: ATROPINE SULFATE/PF (AT-roe-peen SUL-fate)
Drug class: Ophthalmic Cycloplegics/Mydriatics
Therapeutic class: Ophthalmic Agents

Atropine (dl-hyoscyamine), a naturally occurring tertiary amine antimuscarinic, is a mydriatic and cycloplegic.

Atropine sulfate ophthalmic preparations are used to produce mydriasis and cycloplegia for examination of the retina and optic disk and accurate measurement of refractive errors. However, because of the long duration of action of the drug, it is seldom, if ever, used for cycloplegic refraction in adults. In rare cases, topical ophthalmic atropine use may be necessary to achieve maximal cycloplegia in pediatric patients, but cyclopentolate is more frequently used.

Atropine sulfate also is used in the management of acute inflammatory conditions (i.e., iridocyclitis) of the iris and uveal tract (e.g., uveitis). Atropine sulfate also is used for its cycloplegic effects in the treatment of suppression amblyopia to reduce the visual acuity of the unaffected eye below that of the amblyopic one and thus force fixation with the amblyopic eye. The drug also has been used to treat patients with a functional excess of accommodation and convergence.

For other uses of atropine, see 12:08.08.

DRUG IMAGES

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The following indications for ATROPINE SULFATE (atropine sulfate/pf) have been approved by the FDA:

Indications:
Cycloplegia
Mydriasis
Penalization therapy for unilateral amblyopia

Professional Synonyms:
None.

The following dosing information is available for ATROPINE SULFATE (atropine sulfate/pf):

Dosing
Administration
Dosing Information
Generic

To produce mydriasis and cycloplegia for refraction in adults, 1 drop of a 1% solution may be instilled onto the eye(s) 1 hour before the procedure. In children, the usual dosage for cycloplegic refraction is 1-2 drops of a 0.5% solution instilled onto the eye(s) twice daily for 1-3 days before the procedure (the 0.5% solution is no longer commercially available in the US).

Alternatively, to produce mydriasis and cycloplegia for refraction in adults, 0.3-0.5 cm of a 1% ointment may be placed into the conjunctival sac 1-3 times daily.

In children, the usual dosage for cycloplegic refraction is 0.3 cm of a 1% ointment placed into the conjunctival sac 3 times daily for 1-3 days before the procedure. If the ointment is used for refraction, the drug should be applied several hours before the procedure, since it may impair corneal transparency and prevent accurate measurement of refractive errors.

For pupillary dilation in the treatment of acute inflammatory conditions of the iris and uveal tract in adults (i.e., iridocyclitis, uveitis), 1 or 2 drops of a 0.5 or 1% solution may be instilled onto the eye(s) up to 4 times daily. In children, the usual dosage for the treatment of uveitis is 1 or 2 drops of a 0.5%

solution up to 3 times daily. Alternatively, for pupillary dilation in the treatment of acute inflammatory conditions of the iris and uveal tract in adults and children, 0.3-0.5 cm of a 1% ointment may be placed into the conjunctival sac up to 3 times daily.

Atropine sulfate is applied topically to the eye in the form of an ophthalmic ointment or solution. To avoid excessive systemic absorption, finger pressure should be applied on the lacrimal sac during and for 1-2 minutes following topical administration of the solution or ointment. Care should be taken to avoid contamination of the ointment tube and solution container.

No dosing information available.

No generic dosing information available.

Moderate List
Hypertension

The following adverse reaction information is available for ATROPINE SULFATE (atropine sulfate/pf):

Overview
Severe
Less Severe

Adverse reaction overview.

No enhanced Common Adverse Effects information available for this drug.

There are 16 severe adverse reactions.

More Frequent	Less Frequent
None.	None.

Rare/Very Rare
Acute cognitive impairment Anticholinergic toxicity Ataxia Behavioral disorders Dizziness Drowsy Dry skin Fatigue Fever Flushing Hallucinations Skin rash Slurred speech Tachycardia Unsteady gait Xerostomia

There are 4 less severe adverse reactions.

More Frequent	Less Frequent
None.	Blurred vision Eyelid edema Ocular irritation Photophobia

Rare/Very Rare
None.

The following precautions are available for ATROPINE SULFATE (atropine sulfate/pf):

Pediatric
Pregnant
Lactation
Geriatric

No enhanced Pediatric Use information available for this drug.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

No enhanced Pregnancy information available for this drug.

No enhanced Lactation information available for this drug.

No enhanced Geriatric Use information available for this drug.

The following icd codes are available for ATROPINE SULFATE (atropine sulfate/pf)'s list of indications:

Mydriasis
Z01.0	Encounter for examination of eyes and vision
Z01.00	Encounter for examination of eyes and vision without abnormal findings
Z01.01	Encounter for examination of eyes and vision with abnormal findings
Penalization therapy for unilateral amblyopia
H53.0	Amblyopia ex anopsia
H53.00	Unspecified amblyopia
H53.001	Unspecified amblyopia, right eye
H53.002	Unspecified amblyopia, left eye
H53.009	Unspecified amblyopia, unspecified eye
H53.01	Deprivation amblyopia
H53.011	Deprivation amblyopia, right eye
H53.012	Deprivation amblyopia, left eye
H53.019	Deprivation amblyopia, unspecified eye
H53.02	Refractive amblyopia
H53.021	Refractive amblyopia, right eye
H53.022	Refractive amblyopia, left eye
H53.029	Refractive amblyopia, unspecified eye
H53.03	Strabismic amblyopia
H53.031	Strabismic amblyopia, right eye
H53.032	Strabismic amblyopia, left eye
H53.039	Strabismic amblyopia, unspecified eye