Irifrin

Irifrin – drug about the alpha adrenomimeticheskim action used in ophthalmology.

Form of release and structure

Irifrin produce eye 2,5% and 10% in the form of drops: transparent solution from light yellow color to colourless (on 5 ml in dark glass bottles complete with a dropper or plastic bottles droppers, on 1 bottle dropper or a bottle in a cardboard pack).

Is a part of 1 ml of drops:

• Active agent: Phenylephrinum – 25 or 100 mg (in the form of a hydrochloride);
• Auxiliary components: chloride a benzalkoniya, эдетат dinatrium, sodium hydroxide, sodium metabisulphite, citric acid, a sodium citrate dihydrate, water for injections; in addition for 10% of drops: hydrosodium phosphate dihydrate, anhydrous dihydrosodium phosphate.

Indications to use

• Glaukomo-tsiklitichesky crises (treatment);
• Iridocyclitis (prevention of emergence of back synechias (commissures of an iris) and for reduction of exudation from an iris of the eye);
• Syndrome of "a red eye" (treatment for the purpose of reduction of irritation and a hyperemia of covers of an eye, is applied by 2,5% Irifrin);
• Accommodation spasm;
• Diagnostic mydriasis at survey of an eyeground (oftalmoskopiya) and holding other diagnostic procedures for control of a condition of a back piece of an eye;
• Differential diagnosis of an injection (deep and superficial) eyeglobe;
• The provocative test at patients with a narrow corner of an anterior chamber of an eye and at suspicion of closed-angle glaucoma;
• Laser interventions on an eyeground, vitreoretinalny surgery (for a mydriasis);
• Preoperative preparation for a mydriasis in an ophthalmosurgery (10% Irifrin are applied).

Contraindications

• Glaucoma (uzkougolny or closed-angle);
• Aneurism of arteries (for 10% of drops eye);
• Hepatic porphyria;
• Hyperthyroidism;
• Inborn deficit glyukozo-6-fosfatdegidrogenazy;
• Age up to 12 years (for 10% of drops eye);
• Hypersensitivity to drug components.

Also Irifrin it is contraindicated to the elderly patients having serious violations of cerebral circulation and cardiovascular system, to premature children to apply (to 2,5% of drops eye) and as means for an additional mydriasis during surgeries at disturbance of a slezoproduktion, and also patients with disturbance have an integrity of an eyeglobe.

Irifrin's use by the feeding and pregnant women perhaps only when the expected advantage for health of mother is higher than the existing risk for the child or a fruit (because of insufficiency of clinical data on safety and efficiency of performing therapy at this category of patients).

Route of administration and dosage

When carrying out an oftalmoskopiya in the form of instillations 2,5% of a drop eye are once applied. Usually for creation of a mydriasis there is enough introduction of 1 drop to a conjunctival sac. The maximum mydriasis is reached in 15-30 minutes, within 1-3 hours the mydriasis remains at the sufficient level. In need of maintenance of a mydriasis for an appreciable length of time, in 1 hour carrying out repeated instillation of Irifrin is possible.

At an insufficient mydriasis at adults and children of 12 years, and also at patients with the rigid iris (expressed by pigmentation) it is possible to apply 10% of a drop to a diagnostic mydriasis eye in the same dose.

To remove a spasm of accommodation by the adult and to children of 6 years appoint 2,5% of a drop eye – daily on 1 drop in each eye to night for 4 weeks.

At a resistant spasm of accommodation at adults and children of 12 years use of 10% of drops eye – daily on 1 drop in each eye for the night for 2 weeks is possible.

When holding diagnostic procedures single instillation of 2,5% of drops eye is applied in the following cases:

• The provocative test at patients with a narrow profile of a corner of an anterior chamber and at suspicion of closed-angle glaucoma. Test results are considered positive in cases when the difference between values of intraocular pressure before Irifrin's use and after a mydriasis fluctuates within 3-5 mm hg;
• Differential diagnosis like eyeglobe injection. At eyeglobe vasoconstriction in 5 minutes after an instillation the injection is classified as superficial, at preservation of reddening of eyes it is necessary to inspect carefully the patient on existence of a sclerite or iridocyclitis as it demonstrates expansion of the vessels lying more deeply.

At iridocyclites 2,5% or 10% Irifrin – on 1 drop in a conjunctival sac of a sore eye (eyes) 2-3 times a day apply to decrease in exudation (release of liquid from small blood vessels at an inflammation) in an anterior chamber of an eye and to prevention of education and a rupture of already existing back synechias.

Thanks to vasopressor action of Phenylephrinum at glaukomo-tsiklitichesky crises there is a decrease in intraocular pressure. This action is more expressed at use of 10% of Irifrin. For stopping of glaukomo-tsiklitichesky crises it is necessary to dig in drug 2-3 times a day.

By preparation for carrying out surgical intervention in 30-60 minutes prior to it single instillation of 10% of Irifrin is made for a mydriasis. After the eyeglobe cover will be opened, repeated use of drug is not allowed.

10% of a drop do not apply to an irrigation, subconjunctival introduction and treatment of tampons when performing surgeries.

Side effects

At Irifrin's use development of disturbances from some systems of an organism is possible:

• Cardiovascular system: tachycardia, a heart consciousness, arrhythmia (including ventricular), reflex bradycardia, arterial hypertension, an embolism of a pulmonary artery and occlusion of coronary arteries are possible; seldom (at use of 10% of drops) there are serious violations including a myocardial infarction, intracraneal hemorrhage and a vascular collapse;
• Organ of sight: periorbital hypostasis, conjunctivitis; at the beginning of use dacryagogue, a burning sensation, increase in intraocular pressure, irritation, a sight zatumanennost, feeling of discomfort is possible. Next day after Irifrin's use the reactive miosis can develop. The mydriasis at repeated instillations of drug during this period can be a little less expressed, than on the eve of (is more often at patients of advanced age). In 30-45 minutes after instillation because of considerable reduction of the dilator of a pupil under the influence of active agent (Phenylephrinum) in moisture of an anterior chamber of an eye parts of a pigment from a pigmental leaf of an iris of the eye can be found. The suspension in chamber moisture needs to be differentiated with hit of uniform elements of blood in moisture of an anterior chamber or with development of a front uveitis;
• Dermatological reactions: contact dermatitis.

Special instructions

Irifrin it is necessary to apply with care at elderly patients (because of increase in risk of emergence of a reactive miosis) and at patients with a diabetes mellitus (because of risk of increase in the arterial pressure connected with disturbances of vegetative regulation).

Also drug is appointed with care along with monoamine oxidase inhibitors and for 21 days after the termination of their use.

Exceeding of the recommended doses at use of 2,5% of drops for patients with injuries, diseases of eyes or their appendages, during the postoperative period or at a reduced slezoproduktion (because of anesthesia) can lead to increase in absorption of Phenylephrinum and, therefore, to development of systemic side effects.

Because Irifrin causes a conjunctiva hypoxia, it needs to be applied with care when carrying contact lenses, at patients with a sickemia, and also after operative measures (because of decrease in healing).

Medicinal interaction

At simultaneous use of Irifrin with some medicines there can be undesirable effects:

• Atropine: strengthening of mydriatic effect of Phenylephrinum; development of tachycardia because of strengthening of angiotonic action is also possible;
• Monoamine oxidase inhibitors (at the same time and within 3 weeks after the end of their use): existence of risk of development of uncontrollable rise in arterial pressure;
• Tricyclic antidepressants, propranolol, Reserpinum, гуанетидин, Methyldopum and m-holinoblokatory: potentiation of angiotonic action;
• Beta adrenoblockers (system use): development of acute arterial hypertension (at use of 10% of drops);
• Inhalation anesthesia: potentiation of the oppressing influence on cardiovascular system;
• Sympathomimetics: strengthening of cardiovascular effects of Phenylephrinum.

Terms and storage conditions

To store in protected from light, the place, unavailable to children, at a temperature up to 25 °C, not to freeze.

Period of validity – 2 years.

After opening of a bottle of a drop it is possible to use within 1 month.