cyclopentolate-phenylephrine - CYCLOMYDRIL® (Special Access Medication) *

Disclaimer to the Online Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

cyclopentolate-phenylephrine - CYCLOMYDRIL® (Special Access Medication) *

  • Combination product containing cyclopentolate 0.2% and phenylephrine 1% 

Indication

  • To dilate the pupils of infants for retinal examination

Dosage Guidelines

  • 1 drop to each eye; REPEAT in 10 minutes (approximately 60 minutes before eye examination)

Administration

  • Ophthalmic

Adverse Effects

  • Transient stinging of the eye
  • Administration may result in adverse systemic effects (e.g. inhibition of GI tract motility, urinary retention, tachycardia, relaxation of smooth muscle in bronchi and bronchioles, CNS stimulation)

Comments

  • Small infants are especially prone to the CNS and cardiopulmonary side effects from systemic absorption of Cyclomydril®
  • To minimize systemic absorption, apply pressure over the nasolacrimal sac for 2 to 3 minutes following instillation
  • Infants should be watched closely for at least 60 minutes for signs of vasoconstriction (pallor, blanching, mottling), tachycardia, increased blood pressure and apneic spells
  • The infant's pupil size should be monitored for 24 hours after instillation of the drops and exposure to bright light should be avoided
  • Post a “Protect My Eyes” sign at the bedside for 24 hours post dose
  • Feeding progression/tolerance may be affected for 24 hours post dose
  • Ophthalmologists will administer topical analgesia prior to eye exam

Supplied As

  • CYCLOMYDRIL® ophthalmic solution, 2 mL 
  • Patient specific bottles expire 30 days after opening
  • Pharmacy maintains a future use supply of Cyclomydril® -approval through the Special Access Program is not required prior to initiation * to connect to the SAP information

References

Lexi Sick Kids, Lexi Peds