Irifrin, eye drops 2.5%, 5ml

Composition

Eye drops

Active ingredient:

Phenylephrine hydrochloride 25 mg.

Auxiliary substances:

 Benzalkonium chloride,

disodium edetate,

sodium hydroxide,

sodium metabisulfide,

citric acid,

sodium citrate dihydrate,

d/i water.

Pharmacological action

It has a pronounced stimulating effect on postsynaptic alpha-adrenergic receptors, weakly affects the beta-adrenergic receptors of the heart. It has a vasoconstrictor effect (the vasopressor effect of phenylephrine is weaker than that of norepinephrine, but more prolonged), practically does not have a chrono – and inotropic effect.

After instillation, phenylephrine reduces the dilator of the pupil and the smooth muscles of the conjunctival arterioles, thereby causing dilation of the pupil and narrowing of the conjunctival vessels, improves the outflow of intraocular fluid (since phenylephrine has a slight effect on the ciliary muscle, mydriasis occurs without cycloplegia). Phenylephrine easily penetrates the eye tissue, pupil dilation occurs within 10-60 minutes after a single instillation and persists for 4-6 hours.

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

Suspension in the chamber moisture must be differentiated with the manifestations of anterior uveitis or with the ingress of shaped blood elements into the moisture of the anterior chamber. When applied topically in normal doses, phenylephrine does not have a significant stimulating effect on the central nervous system.

Indications

• Iridocyclitis (to prevent the occurrence of posterior synechiae and reduce exudation from the iris);
• to dilate the pupil during ophthalmoscopy and other diagnostic procedures necessary to monitor the condition of the posterior segment of the eye;
• to conduct a provocative test in patients with a narrow profile of the anterior chamber angle and suspected angle-closure glaucoma;

Contraindications

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

With caution.

Pregnancy, lactation, concomitant use with MAO inhibitors (including for 21 days after discontinuation of their use).

Side effects

From the side of the visual organ: conjunctivitis, periorbital edema; possible burning sensation at the beginning of application, blurred vision, irritation, discomfort, lacrimation, increased intraocular pressure.

Reactive miosis may occur on the day following use of Irifrin. With 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.

Due to a significant reduction of the pupil dilator under the influence of phenylephrine, pigment particles from the iris pigment sheet can be detected in the moisture of the anterior chamber of the eye 30-45 minutes after instillation. Suspension in the chamber moisture must be differentiated with the appearance of anterior uveitis or with the ingress of shaped blood elements into the moisture of the anterior chamber.

From the cardiovascular system: palpitations, tachycardia, arrhythmia (including ventricular), arterial hypertension, reflex bradycardia, coronary artery occlusion, and pulmonary embolism are possible.

Dermatological reactions:  contact dermatitis.

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

Interaction

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

When using Irifrin simultaneously with MAO inhibitors or within 21 days after discontinuation of their use, there is a risk of developing an uncontrolled rise in blood pressure.

The vasopressor effect of adrenomimetic agents can also be potentiated when combined with tricyclic antidepressants, propranolol, reserpine, guanethidine, methyldopa and m-holinoblockers.

Irifrin can potentiate the depressing effect on the activity of the cardiovascular system during inhalation anesthesia.

Concomitant use with sympathomimetics may increase the cardiovascular effects of phenylephrine.

How to take, course of use and dosage

During ophthalmoscopy, 2.5% eye drops are used once in the form of instillations. As a rule, the introduction of 1 drop into the conjunctival sac is sufficient to create mydriasis. Maximum mydriasis is reached in 15-30 minutes and remains at a sufficient level for 1-3 hours. If it is necessary to maintain mydriasis for a long time, repeated instillation of Irifrin is possible after 1 h.

In adults and children over 12 years of age with insufficient pupil dilation, as well as in patients with a rigid iris (pronounced pigmentation),10% eye drops in the same dose can be used for diagnostic pupil dilation.

To relieve the spasm of accommodation, adults and children over 6 years of age are prescribed 2.5% eye drops,1 drop in each eye at night every day for 4 weeks.

In case of persistent spasm of accommodation, it is possible to use 10% eye drops in adults and children over 12 years of age – 1 drop in each eye at night every day for 2 weeks.

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

— as a provocative test in patients with a narrow profile of the anterior chamber angle and suspected angle closure glaucoma – if the difference between the values of intraocular pressure prior to instillation of Erythrina and after pupil dilation is 3 to 5 mm Hg. St., the provocation test is considered positive;

— for differential diagnosis of the type of injection of the eyeball – if after 5 minutes after instillation of marked narrowing of the vessels of the eyeball, the injection is classified as superficial, while maintaining the redness of the eyes, one should carefully examine the patient for the presence of iridocyclitis or scleritis, because it indicates the extension to the more deep-lying vessels.

For iridocyclitesIrifrin® is used in the form of 2.5% or 10% eye drops to prevent the development and rupture of already formed posterior synechiae and to reduce exudation into the anterior chamber of the eye. For this purpose,1 drop is instilled into the conjunctival sac of the patient’s eye (s) 2-3 times a day.

In glaucoma-cyclical crises, due to the vasoconstrictive effect of phenylephrine, intraocular pressure decreases, this effect is more pronounced when using Irifrin in the form of eye drops of 10%. To stop glaucoma-cyclical crises, the drug is instilled 2-3 times a day.

When preparing for surgical interventions, a single instillation of Irifrin in the form of 10% eye drops is performed 30-60 minutes before the operation in order to achieve mydriasis. After opening the membranes of the eyeball, repeated instillation of the drug is not allowed.

Eye drops 10% are not used for irrigation, impregnation of tampons during surgical procedures and for subconjunctival use.

Overdose

Symptoms: systemic effects of phenylephrine may occur.

Treatment: use of alpha-blocking agents, for example, from 5 to 10 mg of phentolamine IV, if necessary, you can repeat the injection.

Special instructions

Caution should be exercised when using Irifrin in patients with diabetes mellitus due to the risk of increased blood pressure associated with impaired autonomic regulation, as well as in elderly patients due to an increased risk of reactive miosis.

Storage conditions

 In a dark place, at a temperature not exceeding 25 °C.

Shelf life

2 years

Active ingredient

Phenylephrine

Conditions of release from pharmacies

By prescription

Dosage form

eye drops