Altafrin

1 What is Altafrin?

Brand: Altafrin, Atropine Care, Cyclogyl, Cyclomydril, Eye Cool, Homatropaire, Isopto Atropine, Isopto Homatropine, Isopto Hyoscine, Mydfrin, Mydral, Mydriacyl, Neofrin, Neo-Synephrine, Omidria, Paremyd

Generic: Ophthalmic atropine, homatropine and scopolamine

Altafrin are used to dilate (enlarge) the pupil. They are used before eye examinations and after eye surgery and to treat certain eye conditions such as uveitis or posterior synechiae.

The medications are available only with a doctor’s prescription.

This product is available in the following forms:

  • Ointment
  • Solution

2 What To Know Before Using

As with all medicines, the risks must be compared to how much Altafrin will help you. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

Allergies

Inform your doctor if you have ever had an allergic reaction to Doxorubicin or to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.

Pediatric Usage

Infants and young children and children with blond hair or blue eyes may be particularly sensitive to the effects of these medications. Children should use a lower strength of this medication.

Geriatric

Elderly patients are particularly sensitive to these medications. The may increase their chance of side effects.

Pregnancy

Studies on the effects of this medication during pregnancy have not been done. These medications may be absorbed into the body.

Breastfeeding

These medications may be absorbed into the body. Atropine passes into breast milk in very small amounts and may cause side effects in nursing babies (fast pulse, fever, dry skin).

It is not known whether Homatropine or Scopolamine passes into breast milk. Although most medications pass into breast milk in small amounts, many of them can be used safely while breastfeeding.

Breastfeeding mothers who use one of these medications should discuss this with their doctor.

Drug Interactions

Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur.

In these cases, your doctor may want to change your dose or take other precautions. When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below.

The following interactions were selected on the basis of potential significance and are not all-inclusive. Using this medication with any of the following is not recommended.

Your doctor may decide not to treat you with this medication, or change some of the other medications you take:

  • Aceclofenac
  • Acemetacin
  • Amtolmetin Guacil
  • Aspirin
  • Bromfenac
  • Bufexamac
  • Celecoxib
  • Choline Salicylate
  • Clonixin
  • Clorgyline
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Droxicam
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Ibuprofen
  • Ibuprofen Lysine
  • Indomethacin
  • Iproniazid
  • Isocarboxazid
  • Ketoprofen
  • Linezolid
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Nialamide
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Pentoxifylline
  • Phenelzine
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Probenecid
  • Procarbazine
  • Proglumetacin
  • Propionic Acid
  • Propyphenazone
  • Proquazone
  • Rasagiline
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Selegiline
  • Sodium Salicylate
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Tranylcypromine
  • Valdecoxib

Using this medication with any of the following medication is not recommended, but may be unavoidable in some cases.

Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:

  • Abciximab
  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Anagrelide
  • Apixaban
  • Ardeparin
  • Argatroban
  • Beta Glucan
  • Bivalirudin
  • Bupropion
  • Certoparin
  • Cilostazol
  • Citalopram
  • Clomipramine
  • Clopidogrel
  • Cyclosporine
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desipramine
  • Desirudin
  • Desvenlafaxine
  • Dibenzepin
  • Dipyridamole
  • Donepezil
  • Dothiepin
  • Doxepin
  • Duloxetine
  • Edoxaban
  • Enoxaparin
  • Eptifibatide
  • Erlotinib
  • Escitalopram
  • Feverfew
  • Fluoxetine
  • Fluvoxamine
  • Fondaparinux
  • Furazolidone
  • Ginkgo
  • Gossypol
  • Heparin
  • Imipramine
  • Iobenguane I 123
  • Lepirudin
  • Levomilnacipran
  • Lofepramine
  • Meadowsweet
  • Melitracen
  • Methotrexate
  • Midodrine
  • Milnacipran
  • Nadroparin
  • Nefazodone
  • Nortriptyline
  • Opipramol
  • Oxymorphone
  • Pargyline
  • Parnaparin
  • Paroxetine
  • Pemetrexed
  • Pentosan Polysulfate Sodium
  • Pralatrexate
  • Prasugrel
  • Protein C
  • Protriptyline
  • Reboxetine
  • Reviparin
  • Rivaroxaban
  • Sertraline
  • Sibutramine
  • Tacrolimus
  • Tianeptine
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Trimipramine
  • Venlafaxine
  • Vilazodone
  • Vortioxetine

Other Interactions

Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions.

Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.

Other Medical Problems

Pre-existing medical problems may affect the use of this medication.

Be sure to tell your doctor if you have any other medical problems, especially:

  • Brain damage (in children)
  • Down’s Syndrome
  • Glaucoma
  • Other eye diseases or problems
  • Spastic paralysis (in children) - Use of these medications may make these conditions worse.

3 Proper Usage

Only take  as directed by your doctor. Do not take more, less or for a longer or shorter period of time than your doctor tells you.

Solution:

  • Wash your hands. 
  • Tilt your head back and press your lower finger gently just beneath the lower eyelid.
  • Pull the lower eyelid away from the eye to make a space. Drop the medication into this space.
  • Let go of the eyelid and close your eyes.
  • Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye for 2-3 minutes to allow your eye to absorb the medication.
  • Wash your hands immediately after use to remove any medication that may be on them.

Do not touch the applicator tip to any surface. Keep the container tightly closed. This will help prevent infection of the eye.

Ointment:

  • Wash your hands.
  • Tilt your head back and press your lower finger gently 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-in amount is enough unless your doctor tells you to use a different amount.
  • Let go of the eyelid and close your eyes.
  • Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye for 1-2 minutes to allow your eye to absorb the medication.

To keep the medication as germ-free as possible, do not touch the applicator tip to any surface. Keep the container tightly shut.

Dosing

Different patients will be given a different dose of this medication based on the strength of the medication.

The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.

The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.

For atropine:

Ointment:

  • For uveitis:
    • Adults - Use a thin strip of ointment 1-2 times a day.
    • Children - Use a thin strip of ointment 1-3 times a day.
  • For eye examinations:
    • Adults - Use and dose must be determined by your doctor.
    • Children - Use a thin strip of ointment 3 times a day for 1-3 days before the examination.

Solution:

  • For uveitis:
    • Adults - Use 1 drop 1-2 times a day.
    • Children - Use 1 drop in the eye 1-3 times a day.
  • For eye examinations:
    • Adults - Use and dose must be determined by your doctor. Use 1 drop twice a day for 1-3 days before the examination.

For homatropine (solution):

  • For uveitis:
    • Adults and children - Use 1-2 drops 2-3 times a day.
  • For eye examinations:
    • Adults - Use 1-2 drops. May be repeated every 5-10 minutes for 2-3 doses.
    • Children - Use 1-2 drops every 10 minutes for 2-3 doses.

For scopolamine (solution):

  • For uveitis:
    • Adults and children - Use 1 drop up to 4 times a day.
  • For eye examinations:
    • Adults - Use 1 drop in the eye 1 hour before the examination.
    • Children - Use 1 drop twice a day for 2 days before the examination.
  • For posterior synechiae:
    • Adults - Use 1 drop every 10 minutes for 3 doses.
    • For children - Use and dose must be determined by your doctor.

For use before and after surgery: Adults and children - Use 1 drop 1-4 times a day.

Missed Dose

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

  • 1 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 resume your normal dosing schedule. Do not double dose.
  • More than 1 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 resume your normal dosing schedule. Do not double dose.

Storage

Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze.

Keep out of the reach of children. Do not keep expired medication or medication you no longer need. Ask your doctor how to dispose of any medication you do not use.

4 Precautions To Take

If you use Altafrin, your doctor should perform routine checkups and advise you in taking precautions.

After you apply this medication:

  • Your pupils will enlarge and you will have blurred vision, especially for close objects.
  • Make sure your vision is clear before you drive, use machinery or do anything else that may be dangerous while you cannot see well.
  • You eyes will become more sensitive to light than normal. Wear sunglasses to protect your eyes from sunlight and other bright lights.

These effects may continue for several days after you stop using this medication.

Inform your doctor if the effects last longer than:

  • 14 days for Atropine
  • 3 days for Homatropine
  • 7 days for Scopolamine

5 Potential Side Effects

Altafrin may produce unwanted effects along with the intended effects. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

Symptoms of too much medication being absorbed into the body:

  • Clumsiness or unsteadiness
  • Confusion or unusual behavior
  • Dryness of skin
  • Fast or irregular heartbeat (tachycardia, palpitations)
  • Fever
  • Flushing or redness of face
  • Seeing, hearing, or feeling things that are not there (hallucinations)
  • Skin rash
  • Slurred speech
  • Swollen stomach in infants
  • Thirst or unusual dryness of mouth
  • Unusual fatigue or weakness

Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Talk to your doctor if any of the following side effects continue or are bothersome, or if you have questions:

Common: Pupil dilation (enlargement) causing light sensitivity.

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects.

Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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