Hydrocodone Bitartrate/Homatropine Methylbromide Associates

Uses

Homatropine Hydrobromide sterile Eye Drops is used for use as a mydriatic and cycloplegic agent.

Hydrocodone Bitartrate/Homatropine Methylbromide Associates is also used to associated treatment for these conditions: Strabismus

How Hydrocodone Bitartrate/Homatropine Methylbromide Associates works

Homatropine is a competitive muscarinic receptor antagonist with a bulky aromatic group in place of the acetyl group of acetylcholine. It is expected to act in similar manner as atropine, producing similar parasympatholytic effects. By blocking muscarinic receptors and cholinergic signalling pathways, homatropine blocks the response of the iris sphincter muscle and cause the pupil to become unresponsive to light upon dilation or mydriasis. It also blocks the accommodative muscle of the ciliary body to cholinergic stimulation .

Dosage

Hydrocodone Bitartrate/Homatropine Methylbromide Associates dosage

Mydriasis and cycloplegia for refraction:

• Adult: Instill 1 or 2 drops of 2% solution, or 1 drop of 5% solution immediately before the procedure, repeat at 5-10 minute intervals if necessary.
• Child: Instill 1 drop of 2% soln immediately before the procedure, repeat at 10-min intervals if necessary.

Uveitis:

• Adult: Instill 1-2 drops of 2% or 5% solution bid-tid up to every 3-4 hr as needed.
• Child: 3 mth- 2 yr: instill 1 drop of 0.5% soln once daily or on alternate days. >2 yr: instill 1 drop of 1% or 2% soln bid.

Side Effects

Hypersensitivity may occur as conjunctivitis.

Toxicity

Acute oral LD50 is 1200 mg/kg in rat, 1400 mg/kg in mouse, and 1000 mg/kg in guinea pig . Systemic toxicity may occur following topical overdose of structurally-related ophthalmic atropine, particularly in children. It is characterized by flushing and dryness of the skin, blurred vision, a rapid and irregular pulse, fever, convulsions and hallucinations, and the loss of neuromuscular coordination. Abdominal distension may be observed with infants. Severe intoxication is manifested by central nervous system depression, coma, circulatory and respiratory failure, and death . Symptomatic and supportive treatment should be initiated. In case of accidental use or overdose in infants and small children, the body surface should be kept moist .

Precaution

Should be used with caution in patients with prostatic enlargement and in patients suffering from paralytic ileus or pyloric stenosis.

Interaction

Effects may be increased by drugs with antimuscarinic effect such as; some antihistamines; phenothiazines; antipsychotics; TCAs; MAOIs or parasympathomimetics.

Volume of Distribution

No pharmacokinetic data available.

Elimination Route

No pharmacokinetic data available.

Half Life

No pharmacokinetic data available.

Clearance

No pharmacokinetic data available.

Elimination Route

No pharmacokinetic data available.

Pregnancy & Breastfeeding use

Use in pregnancy: There are no adequate and well-controlled studies in pregnant women. Matropin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Use in lactation: It is not known whether Homatropine is excreted in human milk. Caution should be exercised when Matropin is administered to a nursing mother.

Contraindication

Contraindicated in patients with closed-angle glaucoma or with a narrow angle between the iris and the cornea.

Special Warning

Use in children: Should not be used in children below the age of 3 months

Acute Overdose

Ataxia, incoherent speech, restlessness, hallucinations, disorientation, failure to recognize people and tachycardia. Psychotic reactions and behavioural disturbances (in children). SC/IM/IV Physostigmine salicylate 1-2 mg to control central and peripheral effects. Small doses of short-acting barbiturate eg. thiopentone sodium 100 mg to control excitement.

Innovators Monograph

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