What is it used for?

• Dilating the pupil to allow easier examination inside the eyeball.
• Relaxing the muscles in the eye when vision is being tested.
• Dilating the pupil in inflammatory conditions of the iris and uveal tract, such as iritis and uveitis.

How does it work?

• Mydrilate eye drops contain the active ingredient cyclopentolate, which is a type of medicine called an anticholinergic (or antimuscarinic). It is used to aid eye examinations.
• Cyclopentolate blocks muscarinic receptors in the muscles of the eye. These receptors are involved controlling the size of the pupil and the shape of the lens. By blocking these receptors, cyclopentolate causes the pupil to dilate (mydriasis), which it makes it easier to examine structures inside the eyeball, such as the retina, optic disc, macula and fovea. This is called fundoscopy.
• Cyclopentolate also temporarily paralyses the muscles that help the eye focus (cycloplegia), which is used to aid tests on vision (cycloplegic refraction), particularly in children.
• One drop will be put into the eyes 40 minutes before the eye exam, and if necessary a second drop 15 minutes later.
• Cyclopentolate is also used in the treatment of inflammatory eye conditions such as iritis and uveitis. When treating inflammatory eye conditions one or two drops are put into the eye up to four times a day, or as directed by your doctor.

Warning!

• This medicine is for use in the eyes only and must not be taken by mouth. If the eye drop solution is accidentally swallowed you should seek urgent medical advice.
• Wash your hands after using the eye drops.
• These eye drops can cause blurred vision, difficulty focusing and sensitivity to light. The effects can last for up to 24 hours. You must not drive or take part in hazardous activities unless you can see clearly.
• You should not wear soft contact lenses during treatment with these eye drops. This is because they contain a preservative called benzalkonium chloride, which can be absorbed by soft contact lenses and cause eye irritation.

Use with caution in

• Children.
• Elderly people.
• People at risk of increased pressure within the eye ball (raised intraocular pressure).
• People with inflamed eyes.
• Heart failure.
• Men with an enlarged prostate gland.
• People with shaky movements or an unsteady walk (ataxia).

Not to be used in

• Babies under three months of age.
• Glaucoma, or people with a tendency to glaucoma because of a shallow anterior chamber.
• Conditions where the gut is not functioning properly, resulting in an obstruction in the bowel (paralytic ileus).
• Children with organic brain syndromes, including congenital or neuro-developmental abnormalities such as epilepsy.
• This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

• The safety of this medicine during pregnancy has not been established. Seek medical advice from your doctor.
• The safety of this medicine during breastfeeding has not been established. Seek medical advice from your doctor.

Side effects

• Temporary stinging in the eye.
• Temporary sensitivity of the eyes to light due to the dilated pupil.
• Blurred vision.
• Raised pressure inside the eyeball.
• If the drops are used for a prolonged time this can cause eye irritation, redness, swelling or conjunctivitis.
• Dry mouth.
• Dry skin.
• Flushing.
• Difficulty passing urine.
• Constipation.
• Irregular heartbeat and awareness of your heartbeat.
• Vomiting.
• Dizziness.
• Rash in children.
• Enlarged abdomen in infants.
• Behaviour changes and severe effects on the heart and/or breathing that require urgent medical attention may also occur in children.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

• You should always tell your doctor, optometrist or pharmacist what medicines you are already using, including those bought without a prescription and herbal medicines, before these eye drops are used, so they can make sure that the combination is safe.
• Eye drops can be absorbed into the bloodstream from the eye and once in the bloodstream they have the potential to interact with other medicines. You should minimise the absorption of these drops into the bloodstream by pressing on the tear duct (the corner of the eye closest to the nose) for about two minutes after the drops are put in.

Many groups of medicines have anticholinergic effects. If this medicine is used in people taking any of these, there may be an increased likelihood of anticholinergic side effects, such as blurred vision, dry mouth, constipation and difficulty passing urine. Other medicines with anticholinergic effects include the following:

• amantadine
• antihistamines, eg brompheniramine, chlorphenamine
• antispasmodics, eg hyoscine
• antipsychotics, eg chlorpromazine, clozapine
• certain antisickness medicines, eg promethazine, prochlorperazine, meclozine, cyclizine
• certain medicines for abnormal heartbeats (antiarrhythmics), eg disopyramide, propafenone
• MAOI antidepressants, eg phenelzine
• medicines for urinary incontinence, eg oxybutynin, flavoxate, tolterodine, propiverine, trospium
• memantine
• muscle relaxants, eg baclofen
• nefopam
• other anticholinergics, eg trihexyphenidyl, orphenadrine
• tricyclic or related antidepressants, eg amitriptyline, maprotiline.

References:

https://www.medicines.org.uk/emc/product/1724/smpc

https://www.hpra.ie/img/uploaded/swedocuments/7c1f827d-899a-469a-a59f-8a568f21f7ec.pdf

https://www.moorfields.nhs.uk/content/pupil-dilating-eye-drops-ointments-mydriatics

https://www.medicines.ie/medicines/mydrilate-1-0-w-v-eye-drops-32963/patient-info

https://www.netdoctor.co.uk/medicines/eye-care/a7174/mydrilate-eye-drops-cyclopentolate/

https://www.drugs.com/uk/mydrilate-1-0-eye-drops-leaflet.html

https://patient.info/medicine/cyclopentolate-eye-drops-mydrilate-minims-cyclopentolate-hydrochloride