Cyclopentolate and Phenylephrine

• If you have an allergy to cyclopentolate, phenylephrine, or any other part of cyclopentolate and phenylephrine.
• If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• If you have narrow-angle glaucoma.

This is not a list of all drugs or health problems that interact with this medicine.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take cyclopentolate and phenylephrine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

For all patients taking this medicine:

• Tell all of your health care providers that you take cyclopentolate and phenylephrine. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for clear eyesight while your pupils are dilated.
• Bright lights may bother you. Wear sunglasses.
• Use this medicine with care in children. They may have more side effects. Talk with the doctor.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using cyclopentolate and phenylephrine while you are pregnant.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Infants:

• Watch infants closely for at least 30 minutes after giving this medicine.
• If cyclopentolate and phenylephrine is used on an infant, do not feed the infant until 4 hours after the exam is over.

(sye kloe PEN toe late & fen il EF rin)

The anticholinergic effects of cyclopentolate and the adrenergic effects of phenylephrine cause a greater mydriasis than produced by either agent alone, and cause little cycloplegia.

4-12 hours

Diagnostic aid (mydriasis): Ophthalmic: Instill 1 drop into the eye every 5 to 10 minutes.

Refer to adult dosing.

Concerns related to adverse effects:

• CNS effects: May cause CNS disturbances. Patients must be cautioned about performing hazardous activities (eg, operating machinery or driving) while pupils are dilated.

• Intraocular pressure: May cause a transient elevation in intraocular pressure.

Disease-related concerns:

• Cardiovascular effects: Use caution in patients with cardiovascular disease or hypertension.

• Down syndrome: Use caution in patients with Down syndrome.

• Glaucoma: Use caution in patients predisposed to angle-closure glaucoma.

• Hyperthyroidism: Use caution in patients with hyperthyroidism.

Special populations:

• Contact lens wearers: Contains benzalkonium chloride, which may be adsorbed by contact lenses; remove contacts prior to administration and wait 15 minutes before reinserting.

• Pediatric: May result in psychotic reactions and behavioral disturbances in children; risk may be increased with brain damage or spastic paralysis. Observe infants for at least 30 minutes following instillation. Feeding intolerance may occur in infants; withhold feeding for 4 hours after examination.

Other warnings/precautions:

• Appropriate use: For topical ophthalmic use and short term administration only. To minimize systemic absorption, apply pressure over the lacrimal sac for 2 to 3 minutes after application.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience ocular burning sensation, blurred vision, or sensitivity to lights. Have patient report immediately to prescriber vision changes, eye pain, severe eye irritation, tachycardia, severe headache, flushing, difficult urination, confusion, hallucinations, seizures, change in balance, abnormal gait, slurred speech, or agitation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.