Irifrin is a sympathomimetic with pronounced alpha-adrenergic activity for topical use in ophthalmology.
Release form and composition
Irifrin dosage form - 2.5% and 10% eye drops, which are a clear, colorless or light yellow solution. Available in 5 ml plastic dropper bottles or dark glass bottles complete with dropper.
The active ingredient of the drug is phenylephrine hydrochloride (in 1 ml - 25 or 100 mg).
- 2.5% drops - disodium edetate, benzalkonium chloride, hypromellose, sodium citrate dihydrate, sodium metabisulfite, citric acid, sterile water;
- 10% drops are disodium edetate, benzalkonium chloride, sodium hydroxide, sodium dihydrogen phosphate anhydrous, sodium hydrogen phosphate dihydrate, sodium citrate dihydrate, sodium metabisulphite, citric acid, and injectable water.
Indications for use
Indications for use Irifrin are the following diseases / conditions:
- Accommodation spasm;
- Glauco-cyclic crises;
- Red eye syndrome (2.5% drops are used to reduce the severity of eye irritation and hyperemia);
- Iridocyclitis (in order to reduce exudation from the iris and prevent the occurrence of posterior synechia).
In addition, Irifrin is used in such cases:
- Differential diagnosis of superficial and deep injection of the eyeball;
- Diagnostic dilation of the pupil during ophthalmoscopy and other diagnostic procedures, the purpose of which is to monitor the state of the posterior segment of the eye;
- Conducting laser intervention in the fundus (in order to expand the pupil);
- In vitreotinal surgery (for mydriasis);
- Conducting a provocative test in case of suspected closed-angle glaucoma, as well as in patients with a narrow angle of the anterior chamber of the eye;
- When preoperative preparation in ophthalmosurgery (10% drops are used to expand the pupil).
- Narrow-angle and angle-closure glaucoma;
- Congenital deficiency of glucose-6-phosphate dehydrogenase;
- Hepatic porphyria;
- Aneurysm of arteries (for 10% drops);
- Serious disorders of cerebral circulation or functions of the cardiovascular system in elderly patients;
- Hypersensitivity to the drug.
In addition, Irifrin is contraindicated for additional dilation of the pupil in violation of tears, as well as during surgery in patients with a violation of the integrity of the eyeball.
As for the use of Irifrin in pediatrics, 10% of the drops are not indicated for children under 12 years old, 2.5% of the drops are for premature newborns.
Elderly people (due to the risk of reactive miosis), patients with diabetes mellitus (due to the likelihood of increased blood pressure), as well as people who take MAO inhibitors or have finished taking them less than 21 days ago should be under constant observation during the treatment period.
Due to the fact that Irifrin causes conjunctival hypoxia, the drug is also used with caution after surgery, when wearing contact lenses, in the presence of sickle cell anemia.
The effects of phenylephrine during pregnancy and lactation have not been studied enough, so during these periods the drug is prescribed only if the expected benefit to the woman outweighs the potential risks to the fetus / child.
Dosing and Administration
When ophthalmoscopy apply 2.5% drops. To create mydriasis, as a rule, a single instillation of 1 drop in the conjunctival sac is sufficient. The maximum expansion of the pupil is noted after 15-30 minutes and lasts for 1-3 hours. If necessary, prolonged mydriasis after 1 hour, repeated administration of the drug is possible. With insufficient dilation of the pupil, as well as patients with rigid iris, adults and children over 12 years old can be prescribed 10% drops in the same dose when performing ophthalmoscopy.
To relieve spasm of accommodation, Irifrin is prescribed to children over 6 years old and adults. In this case, apply a 2.5% solution - 1 drop daily (overnight) for 4 weeks. In case of persistent spasm of accommodation, adults and children over 12 years old can be given a 10% solution - 1 drop daily, but for 2 weeks.
When conducting diagnostic procedures, a single instillation of 2.5% drops is shown. In particular:
- As a provocative test in case of suspected closed-angle glaucoma and in patients with a narrow profile of the anterior chamber angle: if the difference between intraocular pressure before insrification of Irifrin and after mydriasis is 3-5 mm Hg, the test is considered positive;
- For differential diagnosis of the type of eyeball injection: if after 5 minutes after instillation, the narrowing of the vessels of the eyeball is noted, then the injection is classified as superficial, if the eye redness persists, it indicates the expansion of more deeply located vessels, therefore careful examination of the patient for scleritis or iridocyclitis.
With iridocyclitis, both 2.5% and 10% drops can be prescribed - 1 drop to the conjunctival sac of the sore eye 2-3 times a day.
In case of glauco-cyclic crises, Irifrin is used in the form of a 10% solution, instilled 2-3 times a day.
10% drops are also used in preparing patients for surgery. They are buried once for 30-60 minutes before the upcoming operation.
Possible side effects of Irifrin:
- Organ vision: periorbital edema, conjunctivitis, discomfort, tearing, blurred vision, irritation, increased intraocular pressure. At the beginning of application, a burning sensation is possible. The next day after instillation of the drug may develop reactive miosis, with repeated administration of droplets during this period, mydriasis may be more pronounced than the day before (most often this phenomenon is observed in the elderly);
- Cardiovascular system: arrhythmia (including ventricular), tachycardia, palpitations, arterial hypertension, pulmonary embolism, coronary artery occlusion, reflex bradycardia;
- Dermatological reactions: contact dermatitis.
Within 30-45 minutes after Irifrin is instilled in the moisture of the anterior chamber, pigment particles from the iris pigment sheet can be detected. In this case, it is necessary to differentiate the suspension in the chamber moisture with the entry of blood corpuscles and with the development of anterior uveitis.
With the use of 10% drops in rare cases, serious violations of the cardiovascular system, such as intracranial hemorrhage, vascular collapse, myocardial infarction, are possible.
In case of overdose, systemic effects of phenylephrine appear. In this case, the appointment of alpha-blockers, for example, in / in the introduction of 5-10 mg of phentolamine. If necessary, repeat the introduction.
An increase in the absorption of phenylephrine and the development of systemic side effects typical of it is also possible if the recommended dose is exceeded when using Irifrin in the form of 2.5% drops in patients with eye diseases or appendages, with reduced tear production, with injuries, in the postoperative period.
10% drops are not intended for subconjunctival administration, soaking tampons during surgical procedures and for irrigation. It is unacceptable to re-instillation of Irifrin after opening the membranes of the eyeball during the operation.
The mydriatic effect of phenylephrine enhances atropine, as a result of which vasopressor action is enhanced, tachycardia develops. The vasopressor property of Irifrin can also be potentiated with the simultaneous use of tricyclic antidepressants, m-anticholinergics, methyldopa, guanethidine, reserpine and propranolol.
When combining Irifrin with MAO inhibitors, as well as for 21 days after the end of their use, there is a risk of an uncontrolled rise in blood pressure.
When combined with 10% of drops with systemic use of beta-blockers, it is possible to develop acute arterial hypertension.
Sympathomimetics can enhance the cardiovascular effects of phenylephrine.
Irifrin may enhance the inhibitory effect of inhalation anesthesia on the activity of the cardiovascular system.
Terms and conditions of storage
Store at temperatures up to 25 ºС in a dark, out of reach of children. Do not allow freezing.
Expiration date - 2 years, after opening the bottle - 1 month.