Highly selective alpha-2 adrenergic receptor agonist producing conjunctival vasoconstriction and blanching. Alpha-2 selectivity is the point of difference from the alpha-1 and mixed alpha-1/alpha-2 decongestants (phenylephrine, tetrahydrozoline, naphazoline, oxymetazoline), which are associated with tachyphylaxis and rebound redness.
Warnings & Precautions
Persistent redness: Eye pain, vision change, or redness or irritation that worsens or lasts more than 3 days warrants examination rather than continued use.
Scotopic miosis: Uncontrolled before-after study in 28 healthy adults found mean scotopic pupil diameter fell from 7.28 mm to 6.36 mm 60 minutes after instillation, with a larger effect in light irides than dark (1.55 mm vs 0.67 mm).
Common Side Effects
Ocular: In pooled trial safety data (426 treated, 209 vehicle), reduced visual acuity 4.0% and conjunctival hyperemia 2.6%, both at vehicle rates (4.3% and 2.9%).
Systemic: Not characterized; this OTC label has no adverse reactions section and the pooled analysis reported ocular events.
Pregnancy & Lactation
Pregnancy: No data in this OTC label.
Lactation: No data in this OTC label.
Pediatric Use
Labeled for age 5 years and over; under 5, the label directs consultation.