Tropicamide, sold under the brand nameMydriacyl among others, is a medication used todilate the pupil and help with theexamination of the eye.[3] Specifically it is used to help examine theback of the eye.[4] It is applied aseye drops.[3] Effects occur within 40 minutes and last for up to a day.[3]
Anisocoria caused by tropicamide instilled into the subject's right eye only.
Tropicamide is anantimuscarinic drug that produces short actingmydriasis (dilation of thepupil) andcycloplegia[7] when applied aseye drops. It is used to allow better examination of thelens,vitreous humor, andretina. Due to its relatively short duration of effect (4–8 hours), it is typically used duringeye examinations such as thedilated fundus examination, but it may also be used before or aftereye surgery. Cycloplegic drops are often also used to treat anterioruveitis, decreasing the risk of posteriorsynechiae and decreasing inflammation in the anterior chamber of the eye.
Tropicamide is occasionally administered in combination withp-hydroxyamphetamine (brand nameParemyd), which is asympathomimetic. The use of the sympathomimetic drug causes the iris dilator muscle to be directly stimulated, causing increased dilation. In the United States, the sympathomimetic drop most commonly used along with tropicamide, is 2.5%phenylephrine hydrochloride (brand name AK-Dilate).
Tropicamide induces transient stinging and a slight and transient rise inintraocular pressure in the majority of patients. It may cause redness orconjunctivitis (inflammation) and alsoblurs near vision for a short while after instillation (care must be taken, and the patient must only drive when vision returns to normal). Tropicamide may, in very rare cases,[8] cause an attack ofacute angle-closure glaucoma. This tends to be in patients with narrowanterior chamberangles, and closure risk must be assessed by the practitioner prior to instillation.
Tropicamide is often preferred toatropine because atropine has a longerhalf-life, causing prolonged dilation and blurry vision for up to a week. Atropine has lesssting effect, but can be toxic or fatal if ingested in large quantities by children or adults.
Tropicamide is sometimes abused (injected intravenously e.g. byinsulin syringe) as an inexpensive recreationaldeliriant drug (along withnaphazoline). This was initially reported in Russia, but has subsequently spread to various other countries in the former Soviet Union and around Europe, and later in the United States.[12][13][14]
Tropicamide severely destroys internal organs when injected.[15][16]
^World Health Organization (2019).World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization.hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^Vuori ML, Kaila T, Iisalo E, Saari KM (1994-01-01). "Systemic absorption and anticholinergic activity of topically applied tropicamide".Journal of Ocular Pharmacology.10 (2):431–437.doi:10.1089/jop.1994.10.431.PMID8083562.
^abcLakstygal AM, Kolesnikova TO, Khatsko SL, Zabegalov KN, Volgin AD, Demin KA, Shevyrin VA, Wappler-Guzzetta EA, Kalueff AV (May 2019). "DARK Classics in Chemical Neuroscience: Atropine, Scopolamine, and Other Anticholinergic Deliriant Hallucinogens".ACS Chem Neurosci.10 (5):2144–2159.doi:10.1021/acschemneuro.8b00615.PMID30566832.
^Bersani FS, Imperatori C, Prilutskaya M, Kuliev R, Corazza O (July 2015). "Injecting eye-drops: a mini-review on the non-clinical use of tropicamide".Hum Psychopharmacol.30 (4):262–4.doi:10.1002/hup.2481.PMID26216560.S2CID190289.
^"Bellman, V., Ukolova, A., Erovichenkova, E., Lam, S., Srivastava, H. K., Bruce, J., & Burgess, D. M. (2022). Abuse of tropicamide eye drops: review of clinical data. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)".Braz J Psychiatry.44. 2 Nov 2022.
^Rote Liste (in German). Vol. 57. Frankfurt/Main: Rote Liste Service GmbH. 2017. p. 224.ISBN978-3-946057-10-9.Arzneimittelverzeichnis für Deutschland (einschließlich EU-Zulassungen und bestimmter Medizinprodukte)
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