Cyclopentolate
CYCLOGYL
Pronunciation: sye-kloe-PEN-toe-layt
What it isAntimuscarinic cycloplegic eye drop; refraction and uveitis.
Why this oneFaster onset and shorter duration than atropine, which suits office cycloplegic refraction.
What limits itSystemic anticholinergic effects in children, including hallucinations and seizures. It precipitates angle closure.
FDA-approved for
- cycloplegia and mydriasis for eye examination
Principal riskSystemic anticholinergic effects in children
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Mydriasis/cycloplegia for diagnostic procedures | Adults | 1–2 drops (0.5%, 1%, or 2%) in eye; may repeat in 5–10 min PRN | ||
| Mydriasis/cycloplegia for diagnostic procedures | Children | 1–2 drops (0.5%, 1%, or 2%) in eye; may repeat with 0.5% or 1% in 5–10 min PRN | ||
| Mydriasis/cycloplegia for diagnostic procedures | Small infants | Single drop of 0.5% in eye (one instillation only) | 1 drop 0.5% |
Renal Undefined
Hepatic Undefined
Complete recovery of accommodation usually 6–24 h; recovery from mydriasis may take several days in some individuals
Instructions
- Topical ophthalmic use only — not for injection
- Apply pressure over nasolacrimal sac 2–3 min after instillation to minimize systemic absorption
- Observe infants closely for at least 30 min after instillation; withhold feeding 4 h after examination in infants
- Heavily pigmented irides may require higher strengths
- Do not touch dropper tip to any surface; advise against driving/hazardous activities and to protect eyes from bright light while dilated
Available strengths
- drops 0.5, 1, 2 %
- sol 10 mg/mL
Cautions
- CNS disturbances, especially in younger patients and with stronger (2%) solutions
- Infants especially prone to CNS and cardiopulmonary side effects — use only 1 drop of 0.5% per eye
- Transient IOP elevation — risk of angle closure in untreated narrow-angle glaucoma or anatomically narrow angles
- Psychotic reactions/behavioral disturbances in pediatrics (ataxia, incoherent speech, hallucinations, seizures); increased susceptibility in infants and children with spastic paralysis or brain damage
- Feeding intolerance and necrotizing enterocolitis reported in preterm infants
- Caution in Down's syndrome
Adverse reactions
- Ocular: increased IOP, burning, photophobia, blurred vision, irritation, hyperemia, conjunctivitis, blepharoconjunctivitis, punctate keratitis, synechiae
- CNS: psychotic reactions and behavioral disturbances (usually children): ataxia, restlessness, hallucinations, hyperactivity, seizures, disorientation
- Systemic anticholinergic effects: tachycardia, hyperpyrexia, vasodilation, urinary retention, decreased GI motility and secretions, abdominal distention in infants, drowsiness, rash
- Severe toxicity: coma, medullary paralysis, death
Pregnancy Animal reproduction studies not conducted; unknown fetal risk — give to pregnant women only if clearly needed
Lactation Unknown whether excreted in human milk — use caution in nursing women
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 0.5 % | drops | per unit | not offered | |
| 1 % | drops | per unit | not offered | |
| 2 % | drops | per unit | not offered |
Generic entry1983
Open Cyclopentolate in the interactive console ↗
Self-check
- How does cyclopentolate duration compare with atropine?
Shorter. - Which severe CNS effects can cyclopentolate cause in children?
Hallucinations and seizures.