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Alpha-2 Adrenergic Agonist (Ophthalmic)

Apraclonidine

Brand names: Iopidine

Apraclonidine is a topical alpha-2 adrenergic agonist eye drop used to control or prevent short-term rises in intraocular pressure, particularly after anterior segment laser procedures.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

By stimulating ocular alpha-2 adrenoceptors it reduces aqueous humour production and so lowers intraocular pressure.

Prescribing in practice

  • Loss of effect with continued use (tachyphylaxis) limits it to short-term rather than long-term pressure control.
  • It is structurally related to clonidine, so caution applies in cardiovascular disease, and concurrent monoamine oxidase inhibitors or other agents affecting sympathetic tone warrant care.
  • Ocular allergy, conjunctival blanching and lid retraction are recognised local effects, and it can cause dry mouth and drowsiness.

Monitoring

Monitor intraocular pressure around laser procedures and watch for local allergic reactions and any systemic cardiovascular or sedative effects.

Counselling the patient

  • It is mainly used for a short time around laser eye treatment to control eye pressure.
  • Tell your clinician if your eye becomes red, itchy or swollen, as an allergy can develop.
  • It may cause a dry mouth or mild drowsiness.

Evidence & guidelines

Apraclonidine is established for preventing and controlling post-laser intraocular pressure spikes in line with its SPC and ophthalmic practice.

Reference: RCOphth Glaucoma Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways