apraclonidine hydrochloride: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
apraclonidine hydrochloride: clinical details
Prescribing considerations
- Reserve for its licensed add-on role in chronic glaucoma when maximally tolerated therapy is insufficient.
- Clinical benefit commonly diminishes through tachyphylaxis; reassess continued effectiveness.
- Consider nasolacrimal occlusion to limit systemic exposure.
- Use caution with angina, coronary insufficiency, recent myocardial infarction, heart failure, hypertension, cerebrovascular disease, Parkinsonism, Raynaud’s disease, chronic renal impairment or depression.
- The selected product contains benzalkonium chloride, which may irritate dry or compromised corneas and discolour soft contact lenses.
Contraindications and cautions
- Severe, unstable or uncontrolled cardiovascular disease, including severe uncontrolled hypertension
- Children
- Hypersensitivity to apraclonidine, any excipient or systemic clonidine
- Concurrent monoamine oxidase inhibitor, systemic sympathomimetic or tricyclic antidepressant treatment
Monitoring
- Intraocular pressure and ongoing clinical benefit
- Visual fields where clinically appropriate
- Ocular allergy or intolerance, including redness, itching, lid or conjunctival swelling
- Pulse and blood pressure when cardiovascular medicines are used concurrently
- Renal or hepatic impairment; include cardiovascular parameters in hepatic impairment
- Mood in people with current or previous depression
Clinical pharmacology
A relatively selective alpha-2 adrenergic agonist that lowers intraocular pressure mainly by reducing aqueous humour formation. Systemic exposure after topical ocular administration is low but not absent.
Formulation and product differences
- The selected multidose solution contains benzalkonium chloride and is not preservative-free.
- UK NHS supply information reports that the multidose formulation has been discontinued by the manufacturer; availability and alternatives should be confirmed through ophthalmology or pharmacy services.
apraclonidine hydrochloride preparations and strengths
Eye drops
Route: Ophthalmic
Strengths: 5 mg/mL, 0.5% w/v, 1% w/v
apraclonidine hydrochloride interactions
Tell the prescriber about eye drops, prescription medicines, non-prescription products and alcohol. Important interactions include:
Monoamine oxidase inhibitors
Concurrent use is contraindicated because of potentially significant adrenergic effects.
Tricyclic antidepressants
Concurrent use is contraindicated because these medicines can alter the handling of circulating amines.
Systemic sympathomimetics
Concurrent use is contraindicated because blood-pressure effects may be increased.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.