Iopidine

Iopidine (INN: Apraclonidine) is a medication primarily used in the management of glaucoma, specifically to lower intraocular pressure (IOP). It belongs to a class of drugs known as alpha-2 adrenergic agonists. Iopidine works by decreasing the amount of fluid produced in the eye, which helps in reducing the pressure inside the eye. It is often used in patients who have not responded adequately to other treatments for glaucoma.

Medical Uses

Iopidine is indicated for the short-term adjunctive therapy in patients with open-angle glaucoma or ocular hypertension who are on maximally tolerated medical therapy and require additional IOP reduction. It may also be used pre- and post-ophthalmic surgery to prevent or reduce increases in intraocular pressure.

Mechanism of Action

Iopidine's primary mechanism of action involves stimulation of the alpha-2 adrenergic receptors in the ciliary body of the eye. This leads to a decrease in aqueous humor production and an increase in uveoscleral outflow, which together result in a reduction of intraocular pressure.

Side Effects

Common side effects of Iopidine include:

• Dry mouth
• Fatigue
• Dizziness
• Headache
• Red eye (hyperemia)
• Allergic reactions in the form of eyelid swelling and conjunctivitis

Contraindications

Iopidine is contraindicated in patients with:

• Hypersensitivity to apraclonidine or any component of the formulation
• Patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of hypertensive crisis

Pharmacokinetics

Iopidine is well absorbed through the cornea and reaches peak plasma concentrations within 1 to 2 hours after topical ocular administration. It undergoes minimal systemic metabolism and is primarily excreted unchanged in the urine.

Administration

Iopidine is administered as an ophthalmic solution. The recommended dosage is one drop in the affected eye(s) three times per day. It is important to follow the prescribed dosage and frequency to achieve optimal results and minimize side effects.

Precautions

Patients should be advised not to touch the dropper tip to any surface, including the eye, to avoid contamination. Contact lens wearers should be instructed to remove their lenses prior to the application of Iopidine and wait at least 15 minutes before reinsertion.

Interactions

Iopidine may interact with other centrally acting alpha-2 agonists and systemic absorption can lead to additive systemic effects. Caution should be exercised when it is co-administered with other systemic medications that can affect blood pressure and heart rate.