Apraclonidine

How it works

By stimulating alpha-2 adrenergic receptors it reduces aqueous humour production, lowering intraocular pressure.

Prescribing in practice

• Tachyphylaxis (loss of pressure-lowering effect over time) limits its use to short-term or adjunctive therapy rather than long-term glaucoma control.
• Ocular allergic reactions, including lid oedema and conjunctival hyperaemia, are common and may necessitate stopping treatment.
• Use with caution in cardiovascular disease and avoid concurrent use with monoamine oxidase inhibitors.

Monitoring

Monitor intraocular pressure and watch for local allergic responses and any reduction in efficacy with continued use.

Counselling the patient

• Report eye redness, swelling or itching, which may indicate an allergic reaction.
• Drowsiness or dry mouth can occur; take care if affected.
• Use only for the short period directed by your ophthalmologist.

Evidence & guidelines

Apraclonidine is established for preventing post-laser intraocular pressure spikes and as short-term adjunctive therapy in current prescribing references.