Irifrin bc eye drops tube dropper 2.5% 0.4ml №15

Release form

Irifrin BK. Eye drops

Packaging

In a disposable tube-dropper 0.4 ml solution of eye drops. In a package of laminated paper 5 tubes, droppers. In a pack of cardboard 3 bags of laminated paper.

Pharmacology

Adrenomimetic. It has a direct stimulating effect mainly on α-adrenoreceptors.

With systemic use causes a narrowing of the arterioles, increases the OPSS and HELL. Cardiac output does not change or decreases, which is associated with reflex bradycardia (increased vagal nerve tone) in response to arterial hypertension. Phenylephrine does not increase blood pressure as sharply as norepinephrine and epinephrine, but it lasts longer. This, apparently, is due to the fact that phenylephrine is more stable and does not collapse under the influence of COMT.

When applied topically, phenylephrine has a pronounced vasoconstrictor effect, causes mydriasis, can reduce intraocular pressure in open-angle glaucoma.

In moderate therapeutic doses, virtually no effect on the central nervous system.

Pharmacokinetics

After oral administration, phenylephrine is poorly absorbed from the gastrointestinal tract. Metabolized with the participation of MAO in the intestinal wall and the "first pass" through the liver. The bioavailability of phenylephrine is low.

After topical application, undergoes systemic absorption.

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 laser eye surgery 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.
• The syndrome of "red eye" (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 of aortic aneurysm, atrioventricular block I - III degree, 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 tears.
• Reduced body weight in newborns.
• Hyperthyroidism.
• Hepatic porphyria.
• Congenital deficiency of glucose-6-phosphate dehydrogenase.
• Lactation period.

• 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 increased 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.
• With long-existing bronchial asthma.

Pregnanacy and breastfeeding

Pregnancy

In animals in late pregnancy, phenylephrine caused fetal growth retardation and stimulated early onset of labor.

The effect of Irifrin BK 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 the development of possible side effects for the fetus.

Lactation

In the case of the appointment of the drug during lactation, breastfeeding should be discontinued.

Active ingredient

Active substance

• Phenylephrine hydrochloride - 25 mg.

Excipients

Disodium edetate 1.0 mg, sodium metabisulphite 2.0 mg, citric acid 1.16 mg, sodium citrate dihydrate.e., hypermmellose 3.0 mg, water for injection q.s.

Dosage and administration

When carrying out an ophthalmoscopy, single instillations of a 2.5% solution of Irifrin BK are used. As a rule, to create mydriasis, it is enough to inject 1 drop of a 2.5% Irifrin BK solution into the conjunctival sac.

The maximum Midriaz 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, repeated instillation of Irifrin BK is possible.

For diagnostic procedures:

• As a provocative test in patients with a narrow profile of the angle of the anterior chamber 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 IrifrinavBK and after pupil dilation 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.

When 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 in the period of high visual load, 1 drop of Irifrin BK is buried in the evening before bedtime.

• With progressive myopia moderate

3 times a week in the evening before bedtime.

• With emmetropia

During the day, depending on the load.

With hyperopia with a tendency to accommodation spasm under high visual load

• Buried in the evening Irifrin BK in combination with a 1% solution of cyclopentolate. Under normal visual load, Irifrin Bq is instilled 3 times a week in the evening before bedtime.

In the treatment of false and true myopia

• One drop of Irifrin BK is buried in the evening before bedtime 2-3 times a week for a month.

Adverse effects

Local

Conjunctivitis, keratitis, periorbital edema, eye pain, burning during instillation, 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 instillations of the drug at this time may produce a less pronounced mydriasis than the day before. This effect is more common in older patients.Due to a significant reduction of the dilator of the pupil under the influence of phenylephrine 30-45 minutes after instillation in the anterior chamber moisture, pigment particles from the iris pigment sheet can be detected. .

Systemic

Contact dermatitis.

Since the cardiovascular system

Heart palpitations, tachycardia, arrhythmia, high blood pressure, ventricular arrhythmia, reflex bradycardia, occlusion of the coronary arteries, pulmonary embolism.

Drug interaction

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

The use of Irifrin BK for 21 days after discontinuation of patient intake of monoamine oxidase inhibitors and tricyclic antidepressants should be carried out with caution, as in this case there is the possibility of an uncontrolled rise in blood pressure.

The vasopressor effect of adrenergic agents can also be potentiated when used together with tricyclic antidepressants, beta-blockers, reserpine, guanethidine, methyldopa and m-anticholinergics.

Irifrin BK can potentiate the inhibition of cardiovascular activity during inhalation anesthesia as a result of increased sensitivity of the myocardium to sympathomimetics and the onset of ventricular fibrillation.

Concurrent use with other sympathomimetics may increase the cardiovascular effects of phenylephrine.

The use of phenylephrine may cause a weakening of concomitant antihypertensive therapy and lead to an increase in blood pressure, tachycardia.

Symptoms: overdose are anxiety, nervousness, Dizziness sweating, vomiting, rapid heartbeat, weak or shallow breathing.

Treatment: in case of the occurrence of the systemic action of phenylephrine, the undesirable effects can be stopped by using alpha-adreno-blocking agents, for example, from 5 to 10 mg of phentolamine intravenously. If necessary, the injection can be repeated.

At room temperature (up to 25 ° С) protected from light and inaccessible to children. Do not freeze.