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Antimuscarinic mydriatic / cycloplegic Pregnancy: Pregnancy Category C (US labelling). Animal reproduction studies not conducted; give to a pregnant woman only if clearly needed.

Homatropine hydrobromide

Brand names: Minims homatropine

Homatropine is a topical antimuscarinic (cycloplegic and mydriatic) agent used to dilate the pupil and paralyse accommodation, including in the management of uveitis and for examination.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One or two drops topically in the eye(s)
Route: Topical (ophthalmic)
Frequency: For refraction: may be repeated in 5 or 10 minutes if necessary. For uveitis: one or two drops up to every 3 to 4 hours.
US labelling (Homatropine Hydrobromide Ophthalmic solution). For refraction: instill one or two drops topically in the eye(s), may be repeated in five or ten minutes if necessary. For uveitis: instill one or two drops topically up to every three to four hours. Individuals with heavily pigmented irides may require larger doses. Should not be used during the first three months of life (possible association between the cycloplegia produced and development of amblyopia); safety and effectiveness in paediatric patients not established.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Primary glaucoma or a tendency toward glaucoma (e.g. narrow anterior chamber angle)
  • Hypersensitivity to any component of the preparation

Side effects

  • Transient stinging and burning
  • Prolonged use: local irritation — follicular conjunctivitis, vascular congestion, oedema, exudates, eczematoid dermatitis
  • Thirst or dryness of mouth
  • Eye irritation not present before therapy
  • Increased sensitivity of eyes to light

Clinical monograph

How it works

It competitively blocks muscarinic receptors on the iris sphincter and ciliary muscle, producing pupil dilatation and temporary paralysis of accommodation, which also helps relieve ciliary spasm and prevent posterior synechiae in uveitis.

Prescribing in practice

  • It may precipitate an acute rise in intraocular pressure in eyes with a narrow anterior chamber angle, so caution is needed in those predisposed to angle-closure glaucoma.
  • Systemic antimuscarinic effects can occur, particularly in children and older patients, so apply nasolacrimal occlusion and use with care.
  • Blurred vision and light sensitivity persist while the effect lasts and impair vision and driving.

Monitoring

Assess for any rise in intraocular pressure in predisposed eyes and observe for systemic antimuscarinic effects in susceptible patients.

Counselling the patient

  • Your vision will be blurred and you may be sensitive to light, so do not drive until it wears off.
  • Wear sunglasses and press gently on the inner corner of the eye after the drops.
  • Report any eye pain, severe redness or visual disturbance.

Evidence & guidelines

Homatropine is a long-established cycloplegic and mydriatic used in uveitis and ocular examination, with use guided by the SPC.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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