From the Guidelines
Apraclonidine eye drops are contraindicated in patients with hypersensitivity to apraclonidine, clonidine, or any component of the formulation, as well as those taking monoamine oxidase inhibitors (MAOIs) due to potential drug interactions. According to the primary open-angle glaucoma suspect preferred practice pattern guidelines 1, alpha2 adrenergic agonists, such as apraclonidine, are used to lower intraocular pressure (IOP). However, caution is advised in patients with severe cardiovascular disease, cerebrovascular disease, chronic renal failure, Raynaud's disease, thromboangiitis obliterans, or depression.
Some key points to consider when using apraclonidine eye drops include:
- Contraindications: hypersensitivity to apraclonidine, clonidine, or any component of the formulation, and use of monoamine oxidase inhibitors (MAOIs)
- Caution advised in patients with severe cardiovascular disease, cerebrovascular disease, chronic renal failure, Raynaud's disease, thromboangiitis obliterans, or depression
- Side effects may include dry mouth, ocular allergic reactions, lid retraction, conjunctival blanching, and mydriasis
- Approximately 15-20% of patients develop follicular conjunctivitis with long-term use, limiting its usefulness for chronic therapy
- Apraclonidine works as an alpha-2 adrenergic agonist that reduces aqueous humor production and may slightly increase outflow facility, making it effective for short-term intraocular pressure control, particularly before and after laser procedures, but less suitable for long-term glaucoma management due to tachyphylaxis and allergic reactions 1.
It is essential to assess the patient for local ocular and systemic side effects and toxicity, including interactions with other medications and potential life-threatening adverse reactions, as recommended by the guidelines 1. Patient education and informed participation in treatment decisions may improve adherence and overall effectiveness of management.
From the FDA Drug Label
Apraclonidine ophthalmic solution is contraindicated in patients with hypersensitivity to apraclonidine or any other component of this medication, as well as systemic clonidine. It is also contraindicated in patients receiving monoamine oxidase inhibitors (MAO inhibitors). Apraclonidine should not be used in patients receiving MAO inhibitors (see CONTRAINDICATIONS)
The contraindications to using apraclonidine eye drops are:
- Hypersensitivity to apraclonidine or any other component of the medication
- Systemic clonidine use
- Monoamine oxidase inhibitors (MAO inhibitors) use 2 2
From the Research
Contraindications to Using Apraclonidine Eye Drops
There are no direct contraindications mentioned in the provided studies. However, the following points can be considered:
- The most common ocular side effect is anterior segment intolerance in between 8-36% of patients, which can cause symptoms such as itching, burning, and signs of conjunctival inflammation 3.
- Apraclonidine can cause eyelid retraction, conjunctival blanching, and mydriasis 4.
- Apraclonidine can increase pupil diameter and interpalpebral fissure width 4, 5.
- While apraclonidine does not affect blood pressure or heart rate significantly, it is still important to monitor these parameters, especially in patients with pre-existing cardiovascular conditions 4, 5, 6.
Precautions
When using apraclonidine eye drops, the following precautions should be taken:
- Monitor intraocular pressure regularly to ensure the desired effect is achieved 3, 4, 5, 6.
- Monitor for ocular side effects such as anterior segment intolerance, eyelid retraction, conjunctival blanching, and mydriasis 3, 4.
- Monitor blood pressure and heart rate, especially in patients with pre-existing cardiovascular conditions 4, 5, 6.