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Antimuscarinic (Mydriatic)

Tropicamide

Brand names: Mydriacyl

Tropicamide is a short-acting antimuscarinic used topically in the eye to produce mydriasis and cycloplegia, mainly to facilitate fundoscopy and refraction.

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

It competitively blocks muscarinic acetylcholine receptors on the iris sphincter and ciliary muscle, paralysing accommodation and dilating the pupil.

Prescribing in practice

  • Avoid or use with caution in patients at risk of angle-closure glaucoma, as pupil dilation can precipitate an acute attack.
  • Effects are relatively short-lived compared with other mydriatics, making it convenient for routine diagnostic examination.
  • Punctal occlusion or eyelid closure after instillation reduces systemic absorption, which is relevant in young children and the frail elderly.

Monitoring

No routine laboratory monitoring is required, but watch for signs of acute angle-closure glaucoma after dilation, particularly in predisposed eyes.

Counselling the patient

  • Your vision will be blurred and you may be sensitive to light for several hours, so do not drive until it has worn off.
  • Wear sunglasses and arrange alternative transport home after the examination.
  • Seek urgent advice if you develop a painful red eye with reduced vision.

Evidence & guidelines

Tropicamide is a long-established diagnostic mydriatic with use supported by ophthalmic practice guidance and the SPC.

Reference: RCOphth Examination 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