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March 1995

Clinical Experience With the Long-term Use of 1% ApraclonidineIncidence of Allergic Reactions

Author Affiliations

From the Department of Ophthalmology, University of California—San Francisco. Dr Butler is now with the Division of Ophthalmology, Southern Illinois University School of Medicine, Springfield.

Arch Ophthalmol. 1995;113(3):293-296. doi:10.1001/archopht.1995.01100030047020

Objective:  To identify the incidence and characteristics of allergic reactions associated with the long-term use of 1% apraclonidine hydrochloride.

Methods:  We undertook a retrospective analysis of 64 patients receiving long-term 1% apraclonidine therapy at the University of California—San Francisco Glaucoma Service. Patients were excluded if the duration of treatment was less than 2 weeks. Demographic data, initial intraocular pressure response, and incidence and characteristics of allergic reactions were obtained through chart review. Student's t test and χ2 analysis were used to analyze the demographic data, and Kaplan-Meier survival analysis was used to estimate the long-term incidence of local reactions.

Results:  Sixty-four patients met the criteria for the study. Of these, 31 (48%) developed an allergic reaction (responders) that led to discontinuation of treatment with the medication, with a mean latency of 4.7 months. Mean follow-up was 13.3 months. Patients free of local reactions (nonresponders) for at least 10 months were able to successfully continue apraclonidine use. Responders tended to be older and female.

Conclusions:  Our data are specific for the 1% preparation; however, physicians prescribing apraclonidine on a long-term basis should be aware of possible allergic reactions. A substantial percentage of patients developed this side effect, but most tolerated the medication for up to 4 months, and those without a local reaction after 10 months appeared to be able to continue apraclonidine use indefinitely. This allergic reaction is likely related to the adrenergic agent itself, and not to preservatives.