A sterile, topical ophthalmic solution combining a short-acting antimuscarinic cycloplegic agent (Cyclopentolate) with a potent corticosteroid (Dexamethasone). It is primarily used for diagnostic and therapeutic purposes in ophthalmic inflammatory conditions requiring mydriasis and cycloplegia. The combination provides rapid pupil dilation and paralysis of accommodation while simultaneously suppressing inflammation, preventing synechiae formation, and reducing pain and photophobia.
Adult: 1 drop instilled into the conjunctival sac of the affected eye(s). For inflammation: Usually 1 drop every 4 to 6 hours. For mydriasis/cycloplegia: 1 drop, may repeat after 5-10 minutes if needed. Duration should not exceed 10-14 days without re-evaluation.
Note: Wash hands. Tilt head back. Gently pull lower eyelid to form a pouch. Instill prescribed number of drops. Close eyes gently for 1-2 minutes. Apply gentle pressure on the nasolacrimal duct (inner corner of eye) for 1-2 minutes to minimize systemic absorption. Do not touch dropper tip to any surface. Wait at least 5-10 minutes before instilling any other eye drops.
Cyclopentolate competitively blocks acetylcholine at the muscarinic receptors of the sphincter pupillae and ciliary muscles, causing pupillary dilation (mydriasis) and paralysis of accommodation (cycloplegia). Dexamethasone binds to cytoplasmic glucocorticoid receptors, modulating gene expression to inhibit phospholipase A2, thereby reducing the synthesis of prostaglandins, leukotrienes, and other inflammatory mediators. It also stabilizes lysosomal membranes and inhibits migration of inflammatory cells.
Pregnancy: Category C (US FDA). Dexamethasone crosses the placenta. Topical use should be avoided unless potential benefit justifies potential risk to fetus. Animal studies show teratogenicity with corticosteroids. No adequate studies in pregnant women.
Driving: DO NOT drive or operate machinery until vision clears (blurring and photophobia may last 6-12 hours). Cycloplegia affects accommodation and depth perception.
| Other Anticholinergic Drugs (e.g., Atropine, Homatropine, Tropicamide) | Additive cycloplegic and mydriatic effects; increased systemic anticholinergic side effects. | Major |
| Systemic Corticosteroids (e.g., Prednisolone) | Increased risk of systemic corticosteroid side effects and HPA axis suppression. | Moderate |
| Phenylephrine or other Sympathomimetics | Additive mydriatic effect. | Moderate |
| Cholinergic Agonists (e.g., Pilocarpine, Carbachol) | Antagonizes the miotic effect; may reduce efficacy in glaucoma. | Moderate |
| CYP3A4 Inhibitors (e.g., Ketoconazole, Clarithromycin) | May increase systemic levels of dexamethasone, increasing side effect risk. | Moderate |
Same composition (Cyclopentolate (1% w/v) + Dexamethasone (0.1% w/v)), different brands: