Homatropine
Drug class: Antineoplastic Agents
Usage of Homatropine
Ophthalmologic Examination
Used to produce mydriasis and cycloplegia for refraction. However, because homatropine has prolonged mydriatic and relatively weak cycloplegic effects, other antimuscarinics may be preferred.
Ophthalmic Inflammation
Management of acute inflammatory conditions (e.g., iridocyclitis) of the uveal tract.
Perioperative Mydriasis
Used for pre- and postoperative states when mydriasis is required.
Axial Lens Opacities
Used as an optical aid in some cases of axial lens opacities.
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How to use Homatropine
General
Administration
Ophthalmic Administration
Apply topically to eye(s) as an ophthalmic solution.
For topical ophthalmic use only. Not for injection.
Following topical application, apply finger pressure on lacrimal sac for 2–3 minutes to avoid excessive systemic absorption.
Avoid contamination of solution container.
Dosage
Available as homatropine hydrobromide; dosage expressed in terms of the salt.
In patients with heavily pigmented irides, higher dosages may be required.
Pediatric Patients
Use only the 2% solution in pediatric patients.
Ophthalmologic Examination Ophthalmic1 drop of a 2% solution in the eye(s) immediately before the procedure; may repeat at 10-minute intervals as necessary.
Ophthalmic Inflammation Ophthalmic1 drop of a 2% solution in the eye(s) 2 or 3 times daily.
Adults
Ophthalmologic Examination Ophthalmic1 or 2 drops of a 2 or 5% solution in the eye(s) immediately before the procedure; may repeat in 5–10 minutes if necessary.
Ophthalmic Inflammation Ophthalmic1 or 2 drops of a 2 or 5% solution in the eye(s) 2 or 3 times daily or, if necessary, up to every 3–4 hours.
Special Populations
No special population dosage recommendations at this time.
Warnings
Contraindications
Warnings/Precautions
Warnings
Concomitant ConditionsConsider risks and benefits in patients with keratoconus (homatropine may produce fixed dilated pupil), Down’s syndrome, and children with brain damage.
Sensitivity Reactions
Discontinue if signs or symptoms of sensitivity occur during treatment.
General Precautions
Systemic EffectsExcessive use, especially in children, geriatric patients, or other susceptible individuals, may produce adverse systemic antimuscarinic effects, including delirium, agitation, and coma. Parenteral physostigmine is the recommended antidote for systemic anticholinergic symptoms.
Specific Populations
PregnancyCategory C.
LactationNot known whether homatropine is distributed into milk. Caution when used in nursing women.
Pediatric UseSafety and efficacy not established in pediatric patients.
Use with extreme caution in infants and young children because of increased susceptibility to the systemic effects of the drug in these patients. Consider risks and benefits of use in children with brain damage.
Geriatric UseNo substantial differences in safety or efficacy relative to younger adults.
Use cautiously due to increased susceptibility to the systemic effects of the drug in geriatric patients.
Common Adverse Effects
Elevated IOP, transient stinging, burning. With prolonged administration, local irritation (characterized by follicular conjunctivitis, vascular congestion, edema, exudate, and eczematoid dermatitis ), thirst, dry mouth, increased light sensitivity of eyes.
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