Homatropine

What is Homatropine?

• Homatropine (Equipin, Isopto Homatropine) is an anticholinergic used in eye drops as a cycloplegic (to temporarily paralyze accommodation), and as a mydriatic (to dilate the pupil).
• HomAtropine (hoe mat' roe peen) is a synthetic derivative of atropine and is less potent and has a shorter half-life, which makes it appropriate as a cycloplegic eye drops to dilate the pupils.
• It is also used in combination with opiate drugs for its aversive side effects to prevent abuse of high doses.
• It is available as the hydrobromide salt.

Homatropine structure

Homatropine

What are the uses of this medicine?

• Homatropine (Equipin, Isopto Homatropine) is used in the treatment of inflammatory conditions of the uveal tract.
• It is used in pre and postoperative states when mydriasis is required.
• It is also used as an optical aid in some cases of axial lens opacities.

How does this medicine work?

• The hydrobromide salt form of homatropine, a synthetic tertiary amine alkaloid with antimuscarinic properties.
• Homatropine, a competitive inhibitor of acetylcholine at the muscarinic receptor, blocks parasympathetic nerve stimulation.
• When applied topically to the eye, dilation of the pupil (mydriasis) and paralysis of accommodation (cycloplegia) result from the local anticholinergic effects on the ciliary muscle and iris.

Who Should Not Use this medicine ?

This medicine cannot be used in patients:

• with primary glaucoma or a tendency toward glaucoma, e.g. narrow anterior chamber angle.
• showing hypersensitivity to any component of this preparation.

What drug interactions can this medicine cause?

• Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Is this medicine FDA approved?

• yes, it was FDA approved.

How should this medicine be used?

Recommended dosage:

• For refraction, instill one or two drops topically in the eye(s).
• May be repeated in five or ten minutes if necessary.
• For uveitis, instill one or two drops topically up to every three to four hours.
• Individuals with heavily pigmented irides may require larger doses.

Administration:

• For topical use only – not for injection.
• Do not touch dropper tip to any surface, as this may contaminate the solution.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As a sterile topical ophthalmic solution.

This medicine is available in fallowing brand namesː

• Equipin, Isopto Homatropine

What side effects can this medication cause?

The most common side effects of this medicine include:

• stinging and burning
• local irritation characterized by follicular conjunctivitis, vascular congestion, edema, exudates, and an eczematoid dermatitis
• Thirst or dryness of mouth
• eye irritation not present before therapy
• increased sensitivity of eyes to light

What special precautions should I follow?

• Use with caution in patients with the following medical problems: keratoconus (Homatropine may produce fixed dilated pupil); Down’s syndrome, children with brain damage and the elderly (increased susceptibility).
• In infants and small children, use with extreme caution.
• Excessive use in pediatric patients or certain individuals with a history of susceptibility to belladonna alkaloids may produce systemic symptoms of homatropine poisoning.
• To avoid excessive systemic absorption, the lacrimal sac should be compressed by digital pressure for two to three minutes after installation.
• To avoid inducing angle closure glaucoma, an estimation of the depth of the angle of the anterior chamber should be made.
• Patient should be advised not to drive or engage in other hazardous activities while pupils are dilated.
• Patient may experience sensitivity to light and should protect eyes in bright illumination during dilation.
• Parents should be warned not to get this preparation in their child’s mouth and to wash their own hands and the child’s hands following administration.
• It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when homatropine hydrobromide is administered to a nursing woman.

What to do in case of emergency/overdose?

Symptoms of overdose may include:

• Excessive topical use of this drug can potentially lead to a confusional state characterized by delirium, agitation, and rarely coma. This state is more apt to occur in the pediatric and geriatric age groups.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• The specific antidote for this systemic anticholinergic syndrome is injectable physostigmine salicylate.
• In infants and pediatric patients, the body surface must be kept moist.

Can this medicine be used in pregnancy?

• Pregnancy Category C.
• It is also not known whether homatropine hydrobromide can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.
• Homatropine Hydrobromide should be given to a pregnant woman only if clearly needed.

Can this medicine be used in children?

• Homatropine should not be used during the first three months of life due to a possible association between the cycloplegia produced and the development of amblyopia.
• Safety and effectiveness in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• HOMATROPINE HYDROBROMIDE

Inactive ingredients:

• BENZALKONIUM CHLORIDE
• BORIC ACID
• EDETATE DISODIUM
• POTASSIUM CHLORIDE
• WATER
• SODIUM CARBONATE

Who manufactures and distributes this medicine?

Mfd. by:

• Altaire Pharmaceuticals, Inc
• Aquebogue, NY

What should I know about storage and disposal of this medication?

• Store at 15° - 30°C (59°- 86°F).

anticholinergic agents

• Aclidinium
• Atropine
• Homatropine
• Darifenacin
• Dicyclomine
• Fesoterodine
• Flavoxate
• Glycopyrrolate
• Hyoscyamine
• Ipratropium
• Mepenzolate
• Methscopolamine
• Oxybutynin
• Propantheline
• Scopolamine
• Solifenacin
• Tiotropium
• Tolterodine
• Trospium

• Dailymed label info on Homatropine
• FDA Homatropine

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