Cyclopentolate Hydrochloride Ophthalmic Solution USP, 1% (Sterile)

Rx only

Cyclopentolate Hydrochloride Ophthalmic Solution USP, 1% is an anticholinergic prepared as a sterile, borate buffered, solution for topical ocular use. The active ingredient is represented by the following structural formula:

C₁₇H₂₅NO₃ • HCl
Mol. Wt. 327.85

Chemical name: 2-(Dimethylamino) ethyl 1-hydroxy-α-phenylcyclopentaneacetate hydrochloride.

Each mL Contains:

ACTIVE: Cyclopentolate Hydrochloride, 10 mg (1%)

INACTIVES: Boric Acid, Potassium Chloride, Edetate Disodium, Purified Water. Sodium Carbonate and/or Hydrochloric Acid may be added to adjust pH (3.0-5.5).

PRESERVATIVE ADDED: Benzalkonium Chloride 0.01%.

This anticholinergic preparation blocks the responses of the sphincter muscle of the iris and the accommodative muscle of the ciliary body to cholinergic stimulation, producing pupillary dilation (mydriasis) and paralysis of accommodation (cycloplegia). It acts rapidly, but has a shorter duration than atropine. Maximal cycloplegia occurs within 25 to 75 minutes after instillation. Complete recovery of accommodation usually takes 6 to 24 hours. Complete recovery from mydriasis in some individuals may require several days.

Cyclopentolate Hydrochloride Ophthalmic Solution is used to produce mydriasis and cycloplegia in diagnostic procedures.

Should not be used when narrow-angle glaucoma or anatomical narrow angles are present, or where there is hypersensitivity to any component of this preparation.

For Topical Use Only - Not For Injection. This preparation may cause CNS disturbances. This is especially true in younger age groups, but may occur at any age, especially with the stronger cyclopentolate hydrochloride solution. Premature and small infants are especially prone to CNS and cardiopulmonary side effects from systemic absorption of cyclopentolate. To minimize absorption, use only 1 drop of a 0.5% solution per eye followed by pressure applied over the nasolacrimal sac for two to three minutes. Observe infants closely for at least 30 minutes following instillation.

Ocular: Increased intraocular pressure, burning, photophobia, blurred vision, irritation, hyperemia, conjunctivitis, blepharoconjunctivitis, punctate keratitis, synechiae.

Systemic: Use of cyclopentolate has been associated with psychotic reactions and behavioral disturbances, usually in pediatric patients, especially with a 2% concentration. These disturbances include ataxia, incoherent speech, restlessness, hallucinations, hyperactivity, seizures, disorientation as to time and place, and failure to recognize people. This drug produces reactions similar to those of other anticholinergic drugs, but the central nervous system manifestations as noted above are more common. Other toxic manifestations of anticholinergic drugs are skin rash, abdominal distention in infants, unusual drowsiness, tachycardia, hyperpyrexia, vasodilation, urinary retention, diminished gastrointestinal motility and decreased secretion in salivary and sweat glands, pharynx, bronchi and nasal passages. Severe manifestations of toxicity include coma, medullary paralysis and death.

Excessive dosage may produce exaggerated symptoms as noted in ADVERSE REACTIONS. When administration of the drug product is discontinued, the patient usually recovers spontaneously. In case of severe manifestations of toxicity the antidote of choice is physostigmine salicylate.

Pediatric Dose: As an antidote, slowly inject intravenously 0.5 mg physostigmine salicylate. If toxic symptoms persist and no cholinergic symptoms are produced repeat at five minute intervals to a maximum cumulative dose of 2 mg.

Adolescent and Adult: As an antidote, slowly inject 2 mg physostigmine salicylate intravenously. A second dose of 1 to 2 mg may be given after 20 minutes if no reversal of toxic manifestations has occurred. ^{1, 2, 3}

Adults: One or two drops of 0.5%, 1% or 2% solution in the eye, which may be repeated in five to ten minutes if necessary. Complete recovery usually occurs in 24 hours.

Pediatric Patients: One or two drops of 0.5%, 1% or 2% solution in the eye, which may be repeated five to ten minutes later by a second application of 0.5% or 1% solution if necessary.

Small Infants: A single instillation of one drop of 0.5% solution in the eye. To minimize absorption, apply pressure over the nasolacrimal sac for two to three minutes. Observe infant closely for at least 30 minutes following instillation.

Individuals with heavily pigmented irises may require higher strengths.

Cyclopentolate Hydrochloride Ophthalmic Solution USP, 1% is available in multidose plastic squeeze bottles with a controlled drop tip and red cap in the following sizes:

15 mL bottle - NDC 42254-013-15

1. Rumack, B.H.: Anticholinergic Poisoning: Treatment with Physostigmine. Pediatrics 52(6): 449-51, 1973.

2. Duvoisin, R.C. and Katz, R.: Reversal of Central Anticholinergic Syndromes in Man by Physostigmine, J. Am. Med. Assn. 206(9): 1963-65,1968.

3. Grant, W.M.: Toxicology of the Eye. Second Edition, Volume 1. Springfield, Illinois, Charles C. Thomas: 1974.

Revised November 2007

Bausch & Lomb Incorporated

Tampa, FL 33637

©Bausch & Lomb Incorporated

Relabeled by:

Rebel Distributors Corp

Thousand Oaks, CA 91320

NDC 42254-013-15

Rebel Distributors Corp

Cyclopentolate Hydrochloride Ophthalmic Solution USP, 1% (Sterile)

Rx only

[icon- eye] [icon- 1%] [icon- solution] [icon- 15 mL]