dapiprazole and Mydriasis

Since dapiprazole on alpha-adrenergic agent, produces miosis by paralyzing the dilator muscle, and pilocarpine, a parasympathetic drug, causes miosis by affecting the sphincter, we speculated that the two drugs might have additive effects.. The additive miotic actions of pilocarpine 2% and dapiprazole 0.5% were evaluated by comparing the effects of two drugs given together and alone on the reversal of mydriasis induced by tropicamide (0.5%) and phenylephrine (10%) in one eye each of 60 healthy volunteers.. Dapiprazole and pilocarpine together induced miosis significantly faster than each drug alone, showing additive effects.. Co-administration of dapiprazole and pilocarpine at the end of the eye examination will induce fast pupillary constriction, which might be useful in preventing the development of an acute attack of angle-closure glaucoma in patients with anatomically narrow angles.

Topics: Adolescent; Adrenergic alpha-Antagonists; Adult; Aged; Aged, 80 and over; Double-Blind Method; Drug Synergism; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Miosis; Mydriasis; Ophthalmic Solutions; Parasympathomimetics; Phenylephrine; Pilocarpine; Piperazines; Pupil; Triazoles; Tropicamide

Dapiprazole eye drops were applied 1 h after topical tropicamide or phenylephrine instillation in 30 elderly subjects. Pupil diameter normalized much earlier than in controls receiving placebo. Dapiprazole constricted the tropicamide-dilated pupil by 1 mm after 1 h and normalized the pupil diameter of the phenylephrine-dilated pupil within 1 h, whereas the pupils of the patients receiving placebo remained dilated. Intraocular pressure did not change; no major side effects were seen.

Topics: Adrenergic alpha-Antagonists; Aged; Aged, 80 and over; Female; Humans; Intraocular Pressure; Male; Middle Aged; Mydriasis; Ophthalmic Solutions; Phenylephrine; Piperazines; Prospective Studies; Reflex, Pupillary; Triazoles; Tropicamide

Particularly outpatients want to reach the ability for driving a car as soon as possible after pupillary dilatation. Dapiprazole is an alpha-1 adrenergic inhibitor that antagonizes the mydriatic effect of phenylephrine in a direct competitive way. The aim of this study was to determine restoration of traffic related functions after dapiprazole application in accordance with the guidelines of the German Society of Ophthalmology (DOG).. 65 eyes of 33 subjects were tested (17 females, 16 males). All had driving licenses without restrictions. Before mydriasis and after reversal with dapiprazole traffic-related functions were evaluated (photopic visual acuity, mesopic vision, sensitivity to glare, colour vision, accommodation, visual field).. No relevant changes of the parameter responsible for the ability to drive a motor vehicle could be shown after reaching premydriatic pupil diameters.. There is evidence that reaching normal pupil diameters after reversal of mydriasis by dapiprazole is a valid sign of restoration of traffic related functions.

Topics: Adolescent; Adrenergic alpha-Antagonists; Adult; Automobile Driving; Cross-Over Studies; Female; Germany; Humans; Male; Middle Aged; Mydriasis; Mydriatics; Phenylephrine; Piperazines; Prospective Studies; Pupil; Treatment Outcome; Triazoles; Vision, Ocular

Pupillary dilation to perform binocular indirect ophthalmoscopy has become a routine part of optometric practice. Many patients find the resulting photophobia and incapacity of near vision to be an inconvenience. Rev-Eyes (0.5% dapiprazole HCl) is a new alpha-antagonist reported to reverse the effects of pupillary dilation in approximately one hour. This study was designed to evaluate the usefulness of Rev-Eyes in a routine clinical setting.. Seventy-nine subjects free of eye disease that ranged in age from 21 to 40 years received 0.5% proparacaine, 2.5% phenylephrine, and 1.0% tropicamide in each eye. Rev-Eyes was administered to 61 subjects. Eighteen control subjects received 5% NaCl. Effects on pupil diameter, accommodation, and distance and near visual acuity were measured. Conjunctival vasodilation, corneal stippling, patient comfort, and intraocular pressure (IOP) were also evaluated.. Our results confirm that a statistically significant reduction in pupil diameter is achieved 60 minutes after installation of Rev-Eyes. However, no significant improvement was obtained in any of the other functional aspects measured. Our data suggest limited utility for Rev-Eyes with a young population. The recovery rate of near visual acuity and amplitude of accommodation is identical with or without Rev-Eyes.

Topics: Accommodation, Ocular; Adrenergic alpha-Antagonists; Adult; Female; Humans; Male; Mydriasis; Ophthalmic Solutions; Piperazines; Pupil; Triazoles; Visual Acuity