Irifrin bk eye drops 2.5% 0.4ml N15
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Active ingredients
Phenylephrine
Release form
Drops
Composition
Active ingredient: Phenylephrine. Auxiliary substances: Disodium edetate, sodium metabisulphite, citric acid, sodium citrate dihydrate, hypromellose, water for injection. Concentration of active ingredient (mg): 25 mg
Pharmacological effect
Adrenomimetic. It has a direct stimulating effect mainly on α-adrenergic receptors. In case of systemic use, it causes narrowing of arterioles, increases OPSS and HELL. Cardiac output does not change or decreases, which is associated with reflex bradycardia (increased vagus nerve tone) in response to arterial hypertension. Phenylephrine does not increase blood pressure as sharply as norepinephrine and epinephrine, but it lasts longer. This is apparently due to the fact that phenylephrine is more stable and does not collapse under the influence of COMT. When used topically, phenylephrine has a pronounced vasoconstrictor effect, causes mydriasis, and can lower intraocular pressure with open-angle glaucoma.
Pharmacokinetics
After oral administration, phenylephrine is poorly absorbed from the gastrointestinal tract. Metabolized with the participation of MAO in the intestinal wall and during the first passage through the liver. The bioavailability of phenylephrine is low. After topical administration, systemic absorption is observed.
Indications
Iridocyclitis (to prevent the occurrence of posterior synechiae and reduce exudation from the iris). Expansion of the pupil during ophthalmoscopy and other diagnostic procedures necessary for monitoring the condition of the posterior segment of the eye, during the laser interventions on the fundus and vitreoretinal surgery. Conducting a provocative test in patients with a narrow profile of the anterior chamber angle and suspicion of angle-closure glaucoma. Differential diagnosis of superficial and deep injection of the eyeball. Red eye syndrome (to reduce hyperemia and irritability of the mucous membrane of the eye). Prevention of asthenopia and spasm of accommodation in patients with high visual load. Treatment of false myopia (spasm of accommodation) and prevention of progression of true myopia in patients with high visual load.
Contraindications
Hypersensitivity to the drug.Narrow-angle or angle-closure glaucoma. Arterial hypertension in combination with coronary artery disease, aortic aneurysm, atrioventricular block I - III, arrhythmia. Tachycardia. Diabetes mellitus type I in history. Constant intake of monoamine oxidase inhibitors, tricyclic antidepressants, antihypertensive drugs. Additional expansion of the pupil during surgical operations in patients with impaired integrity of the eyeball, as well as in violation of the tear production. Reduced body weight in newborns. Hyperthyroidism. Hepatic porphyria. Congenital deficiency of glucose-6-phosphate dehydrogenase. Lactation period. With care In patients with type 2 diabetes mellitus - an increased risk of high blood pressure. In elderly patients, an increase in the risk of reactive miosis. Exceeding the recommended dose of a 2.5% solution in patients with injuries, diseases of the eye or its appendages, in the postoperative period, or with reduced tear production can lead to an increase in the absorption of phenylephrine and the development of systemic side effects. Due to the fact that causes conjunctival hypoxia - in patients with sickle cell anemia, when wearing contact lenses, after surgical interventions (reduced healing). With cerebral atherosclerosis, long-existing bronchial asthma. Pregnancy and lactation In animals in late pregnancy, phenylephrine caused a delay in fetal growth and stimulated early onset of labor. The effect of Irifrin in pregnant women is not well understood, therefore, it is necessary to use the drug in this category of patients only if the expected benefit to the mother exceeds the risk of possible side effects for the fetus. In the case of the appointment of the drug during lactation, breastfeeding should be stopped.
Precautionary measures
Do not exceed recommended doses.
Use during pregnancy and lactation
Adequate and strictly controlled clinical studies of the safety of phenylephrine during pregnancy and lactation have not been conducted.
Dosage and administration
When performing ophthalmoscopy, single installations of a 2.5% Irifrin solution are used. As a rule, to create mydriasis, it is enough to introduce 1 drop of a 2.5% Irifrin solution into the conjunctival sac.The 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, after 1 hour Irifrin can be re-installed. For diagnostic procedures: as a provocative test in patients with a narrow profile of the anterior chamber angle and suspected angle-closure glaucoma, 1 drop of the drug is administered once. If the difference between the values of intraocular pressure before instillation of Irifrin and after the expansion of the pupil is from 3 to 5 mm Hg. Art., the provocative test is considered positive; For the differential diagnosis of the type of eyeball injection, 1 drop of the drug is administered once: if the eyeball vessels are narrowed 5 minutes after instillation, the injection is classified as superficial, while preserving redness of the eye, the patient should be carefully examined for iridocyclitis or sclerite, since this indicates expansion of more deeply lying vessels. With iridocyclitis, to prevent the development and rupture of already formed posterior synechiae and to reduce exudation into the anterior chamber of the eye, 1 drop of the drug is buried in the conjunctival sac of the sore eye 2-3 times a day for 5-10 days depending on the severity of the disease. Schoolchildren with mild myopia for the prevention of accommodation spasm during the period of high visual load 1 drop of Irifrin is buried in the evening before bedtime, with progressive myopia of an average degree 3 times a week in the evening before bedtime, with emmetropia - during the day depending on the load. In case of hyperopia with a tendency to accommodation spasm under high visual load, Irifrin combined with a 1% solution of cyclopentolate is instilled in the evening. Under normal visual load, Irifrin is instilled 3 times a week in the evening before bedtime. In the treatment of false and true myopia, 1 drop of Irifrin is buried in the evening before going to bed 2-3 times a week for a month.
Side effects
Local Conjunctivitis, keratitis, periorbital edema, eye pain, burning during installation, tearing, blurred vision, irritation, discomfort, increased intraocular pressure, blocking the anterior chamber angle (with a narrowing angle), allergic reactions, reactive hyperemia. Phenylephrine may cause reactive miosis the next day after application. Repeated installations of the drug at this time may give less pronounced mydriasis than the day before.This effect is more common in older patients. Due to a significant reduction in the dilator of the pupil under the influence of phenylephrine, 30-45 minutes after installation, particles of pigment from the pigment sheet of the iris can be found in the moisture of the anterior chamber. Suspended in chamber moisture must be differentiated with manifestations of anterior uveitis or with the entry of blood corpuscles into moisture of the anterior chamber. SystemicContact dermatitis From the side of the cardiovascular system: Rapid heartbeat, tachycardia, arrhythmia, high blood pressure, ventricular arrhythmia, reflex bradycardia, occlusion of the coronary arteries, pulmonary embolism.
Overdose
Overdose of the drug is not described.
Interaction with other drugs
With the use of phenylephrine against the background of general anesthesia caused by halothane or cyclopropane, ventricular fibrillation may develop. Simultaneous use with MAO inhibitors, potentiation of the effects of phenylephrine is observed (including topical administration). other diuretics reduce the vasoconstrictor effect of phenylephrine. Guanethidine enhances the mydriatic effect of phenylephrine (with systemic absorption). Oxytocin, ergot alkaloids, tricyclic antidepressants, furas olidone, procarbazine, selegilin, sympathomimetics enhance the pressor effect, and the latter - and arrhythmogenicity. With the simultaneous use of beta-blockers reduce cardiac stimulating activity; against reserpine, arterial hypertension is possible (due to depletion of catecholamine reserves in adrenergic neurons, sensitivity to sympathomimetics is increased).
special instructions
The use of phenylephrine in patients with severe hyperthyroidism should be avoided. Use with caution in IBS. When applied topically after absorption through the mucous membrane, phenylephrine can cause systemic effects. Therefore, the use of phenylephrine in the form of 10% eye drops in infants and elderly patients should be avoided.