Antimuscarinic (Mydriatic) Pregnancy: No evidence of safety in human pregnancy, nor animal evidence that it is free from hazard; use in pregnancy only if considered essential by the physician.

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.

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: 1 drop (0.5% w/v eye drops), then a second drop after 5 minutes

Route: Ocular (topical, eye drops)

Frequency: Second drop 5 minutes after the first; a further 1 drop may be instilled after 30 minutes if required

Adults (including the elderly). Children: at the discretion of the physician (no numeric paediatric dose stated). Care in an inflamed eye (increased systemic absorption); compress the lacrimal sac at the medial canthus for a minute during and after instillation to reduce systemic absorption, especially in children.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; 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

Known hypersensitivity to tropicamide
Narrow angle glaucoma or eyes with a narrow filtration angle (may precipitate an acute attack of angle closure glaucoma)

Side effects

Transient stinging
Dry mouth
Blurred vision

Interactions

None known (per §4.5)

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. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways