Irifrin, eye drops 2.5% 5 ml

It has a pronounced stimulatory effect on postsynaptic alpha-adrenoreceptors, has little effect on the beta-adrenoreceptors of the heart. It has a vasoconstrictor effect (vasopressor effect of phenylephrine is weaker than that of norepinephrine, but longer), has almost no chrono- and inotropic action.

After instillation phenylephrine contracts the dilator of the pupil and smooth muscles of conjunctival arterioles, thus causing pupil dilation and constriction of conjunctival vessels, improves outflow of intraocular fluid (as phenylephrine has little effect on the ciliary muscle, mydriasis occurs without cycloplegia).Phenylephrine easily penetrates into the tissues of the eye, pupil dilation occurs within 10-60 minutes after a single injection and persists for 4-6 hours.

Due to significant contraction of the dilator of the pupil 30-45 minutes after phenylephrine instillation, pigment particles from the iris pigment sheet may be detected in the moisture of the anterior chamber of the eye.

Phenylephrine suspended in the chamber humor must be differentiated from manifestations of anterior uveitis or from blood cell infiltration into the anterior chamber humor.When used topically in normal doses, phenylephrine has no significant stimulating effect on the CNS.

Indications

Active ingredient

Composition

Eye drops

Active ingredient:

Phenylephrine hydrochloride 25 mg.

Associates:

Benzalkonium chloride,

dynate edetate,

sodium hydroxide,

How to take, the dosage

In ophthalmoscopy Ophthalmoscopy, 2.5% eye drops are used once in the form of instillation. As a rule, to create mydriasis it is enough to inject 1 drop into the conjunctival sac. Maximal mydriasis is achieved after 15-30 minutes and maintained at a sufficient level for 1-3 hours. If it is necessary to maintain mydriasis for a long time after 1 h, repeated instillation of Irifrin is possible.

In adults and children over 12 years with insufficient pupil dilation, as well as in patients with rigid iris (marked pigmentation) for diagnostic pupil dilation the use of 10% eye drops at the same dose is possible.

For relieving accommodation spasm adults and children over 6 years are prescribed 2.5% eye drops 1 drop in each eye at night daily for 4 weeks.

In cases of persistent accommodation spasm, 10% eye drops adults and children over 12 years may be used – 1 drop in each eye at night daily for 2 weeks.

In diagnostic procedures, a single instillation of 2.5% eye drops is used in the following cases:

– as a provocation test in patients with a narrow anterior chamber angle profile and suspected closed angle glaucoma – if the difference between the intraocular pressure values before Irifrin injection and after pupil dilation is 3 to 5 mm Hg, the provocation test is considered positive;

– for differential diagnosis of ocular injection type – If a narrowing of the eyeball vessels is noted 5 min after injection, the injection is classified as superficial, if redness of the eye persists, the patient should be carefully examined for iridocyclitis or scleritis, asThis suggests dilatation of the deeper vessels.

In cases of iridocyclitis Irifrin® is used as 2.5% or 10% eye drops to prevent the development and rupture of posterior synechiae that have already formed and to reduce exudation in the anterior chamber of the eye. For this purpose, 1 drop 2-3 times per day is put into the conjunctival sac of the affected eye (eye).

In glaucoma-cyclic crises due to the vasoconstrictor effect of phenylephrine the intraocular pressure decreases, this effect is more pronounced when using Irifrin in the form of 10% eye drops. For relief of glaucoma-cyclic crises the drug is injected 2-3 times a day.

In preparing for surgical interventions 30-60 minutes before surgery to achieve mydriasis a single instillation of Iriphrin in the form of eye drops 10%. After opening of the eyeball membranes repeated instillation of the drug is not allowed.

The 10% Eye Drops are not used for irrigation, impregnation of tampons during surgical interventions and for subconjunctival administration.

Interaction

The mydriatic effect of phenylephrine is enhanced when used in combination with atropine. Due to the increased vasopressor effect, tachycardia may develop.

Irifrin is used concomitantly with MAO inhibitors or within 21 days after stopping their administration there is a risk of uncontrolled BP elevation.

The vasomotor effect of adrenomimetic agents may also be potentiated when combined with tricyclic antidepressants, propranolol, reserpine, guanethidine, methyldopa, and m-cholinoblockers.

Irifine may potentiate suppressive effects on cardiovascular activity during inhalation anesthesia.

The use together with sympathomimetics may increase the cardiovascular effects of phenylephrine.

Special Instructions

Irifrin should be used with caution in patients with diabetes mellitus because of the risk of increased BP associated with autonomic dysregulation, as well as in elderly patients because of increased risk of reactive miosis.

Contraindications

Hypersensitivity, narrow-angle or closed-angle glaucoma, advanced age, marked cardiovascular or cerebrovascular disorders; for additional pupil dilation during surgical operations in patients with compromised eyeball integrity, as well as in cases of tear production disorders; hyperthyroidism, hepatic porphyria, congenital glucose-6-phosphate dehydrogenase deficiency; 10 % solution – children (under 12 years), arterial aneurysm; 2.5% solution – children with reduced body weight.

Cautiousness.

Pregnancy, lactation, simultaneous use with MAO inhibitors (including within 21 days after stopping their use).

Side effects

Overlooking organs:conjunctivitis, periorbital edema; possible burning sensation at the beginning of use, blurred vision, irritation, discomfort, lacrimation, increased intraocular pressure.

The next day after use of Irifrin® reactive miosis may occur. If 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.

Within 30-45 min after instillation due to significant contraction of the pupil dilator under the influence of phenylephrine, pigment particles from the iris pigment sheet may be detected in the moisture of the anterior chamber. Suspension in the chamber humor should be differentiated with the occurrence of anterior uveitis or with the penetration of blood cells into the moisture of the anterior chamber.

Cardiovascular system disorders:possible palpitations, tachycardia, arrhythmias (including ventricular), arterial hypertension, reflex bradycardia, coronary artery occlusion, pulmonary embolism.

Dermatological reactions: contact dermatitis.

Rarely, the development of serious cardiovascular disorders including myocardial infarction, vascular collapse and intracranial hemorrhage has been observed when using Irifrin in the form of 10% eye drops.

Overdose

Symptoms:possible systemic effects of phenylephrine.

Treatment:prescription of alpha-adrenoblocking agents, e.g. 5 to 10 mg of phentolamine by IV, if necessary, the injection can be repeated.

Similarities