1 What is Iopidine?

Brand: Iopidine

Generic: Apraclonidine

Iopidine is a polar clonidine congener which is used topically (0.5-1%) along with other medications to treat serious high pressure inside the eye (glaucoma). This medicine is usually applied to control or prevent a rise in pressure within the eye (ocular hypertension) that can occur after this type of surgery.

Also, when the medications you have been using for glaucoma do not reduce your eye pressure enough, this topical drug lowers intraocular tension by decreasing aqueous production. However, its use is restricted to short-term control of spikes of intraocular tension after laser trabeculoplasty or iridotomy.

Iopidine is available only with your doctor's prescription. This product is available in the following dosage forms:

  • Solution

2 What to Know Before Using

Before using Iopidine, you must know all about the risks and complications associated with it. The suitable drug therapy is usually chosen by a doctor with the active participation of the patient.

There are some important factors such as drug interactions, the presence of any metabolic impairment, history of hypersensitivity reaction, pregnancy, lactation etc. which may alter the desired therapeutic effects of a medicine.

Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects. If you have had any allergic reactions to any medicine then you must tell your doctor about that.

The use of apraclonidine is contraindicated in children, in patients with a history of severe or unstable and uncontrolled cardiovascular disease including severe uncontrolled arterial hypertension.

Make sure you inform your doctor if you have any other medical problems, especially:

  • Depression
  • Heart or blood vessel disease or
  • High blood pressure— Apraclonidine may make the condition worse
  • History of vasovagal attack— signs and symptoms are paleness, nausea, sweating, slow heartbeat, sudden and severe tiredness or weakness, and possibly fainting, usually brought on by emotional stress caused by fear or pain. Apraclonidine may cause this reaction to happen again
  • Kidney disease 
  • Liver disease— these conditions may cause higher blood levels of apraclonidine, which may lead to increased side effects

Because of drug-drug interactions, certain medicines should not be used along with this medicine. It is always recommended to consult with your doctor if you are in need of some other medications or even any over-the-counter medicine for another health problem in order to avoid unwanted toxic effects.

Apraclonidine is Contraindicated in those who are hypersensitive to this drug or any of the ingredients of the formulation or to systemic clonidine and in patients receiving monoamine oxidase inhibitors, systemic sympathomimetics or tricyclic antidepressants.

The following guidelines should be kept in mind:

  • Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your health care professional when to start or stop taking this medication.
  • Before receiving this medication, tell your doctor of all prescription and nonprescription/herbal products you may use, especially of: beta-blockers (e.g., atenolol, metoprolol), high blood pressure medications, tricyclic antidepressants (e.g., amitriptyline, nortriptyline).

Animal reproduction studies have shown an adverse effect, and there are no adequate and well-controlled studies in pregnant women. Thus, this drug should be used during pregnancy only if clearly needed.

Besides, caution should be exercised when used in lactating women because there are no adequate studies in women for determining infant risk when using this medication during breastfeeding.

3 Proper Usage

To use Iopidine properly, you must follow all instructions given by your doctor.The dosage schedule and the duration of drug therapy should be individualized and determined based on the physician’s advice.

The therapeutic dose may also vary with the patient’s condition or requirement and the strength of the medicine as well; however, different doses for different indications are listed below:

For glaucoma (0.5% apraclonidine):

  • Adults—Use one drop in each eye two or three times a day.
  • Children—Use and dose must be determined by your doctor.

For preventing ocular hypertension before and after eye surgery (1% apraclonidine):

  • Adults—One drop is placed in the affected eye one hour before surgery, then one drop in the same eye immediately after surgery.
  • Children—Use and dose must be determined by your doctor.

This medicine comes with patient information. You should read and follow the instructions carefully before using this medicine. You should use any kind of medicines following the directions were given by your doctor.

To use Iopidine eye drop, you can follow some guidelines:

  • This medication is given as an eye drop, usually 3 times daily or as directed by your doctor.
  • If you are wearing contact lenses, remove them before using eye drops. Wait at least 15 minutes before replacing your contact lenses.
  • To apply eye drops, wash your hands first. To avoid contamination, be careful not to touch the dropper tip or let it touch your eye or any other surface.
  • Tilt your head back, look up, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place 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 1 or 2 minutes to allow the medicine to be absorbed by the eye.
  • If you think you did not get the drop of medicine into your eye properly, use another drop.
  • If you are using another kind of eye medication (e.g., drops or ointments), wait at least 5 minutes before using the other medication. Use eye drops before ointments to allow the eye drops to enter the eye.
  • If your doctor ordered two different eye drops to be used together, wait at least 10 minutes between the times you apply for the medicines. This will help to keep the second medicine from ''washing out'' the first one.

If you miss a dose of this medicine, take it as soon as possible. But, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use this drug in larger amounts, more often, or for a longer time than your doctor ordered.

Further, it is advised to store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. However, outdated medicines should be disposed of by an appropriate way.

4 Precautions to Take

Before using Iopidine, there are some precautions you must take. Firstly, regular visits to your doctor are recommended to check that this medicine is working properly or not.

Additionally, the following guidelines should be followed to prevent unwanted complications as well as for the better prognosis of the patients:

Apraclonidine may cause your eyes to become more sensitive to light than they are normal. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort.

After you apply this drug, your vision may become temporarily blurred or unstable. It may also rarely make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.

Your doctor 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.

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

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Iopidine. These side effects usually go away during the treatment episode as your body adjusts to the medicine.

Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted side effects.

Sometimes you may need to consult with the doctor if you notice any of the following toxic effects:

  • Eye discomfort/redness/burning
  • Eye itching/watering
  • Eyelid swelling
  • Blurred vision
  • Dry mouth/nose
  • Dizziness
  • Drowsiness
  • Mental/mood changes (e.g., depression, irritability)
  • Rash, itching/swelling (especially of the face/tongue/throat)
  • Slow/irregular heartbeat
  • Troubled breathing
  • Unusual tiredness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.