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August 1988

Apraclonidine: A One-Week Dose-Response Study

Author Affiliations

From the Glaucoma Services, The Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine (Drs Jampel, Robin, Quigley, and Pollack), and Sinai Hospital (Drs Robin and Pollack), Baltimore. Dr Jampel is a Heed/Knapp fellow 1987-1988.

Arch Ophthalmol. 1988;106(8):1069-1073. doi:10.1001/archopht.1988.01060140225029

• We performed a double-masked, cross-over, dose-response study of apraclonidine hydrochloride (formerly known as ALO 2145) in 20 patients with elevated intraocular pressure (IOP). We administered three concentrations of apraclonidine (0.125%, 0.25%, 0.5%) and vehicle alone bilaterally every 12 hours for one week. Patients were examined 2, 5, and 8 hours after the initial dose, and then on day 2 and day 8. We studied IOP, pupillary diameter, interpalpebral fissure width, blood pressure, and pulse. There was a two-week washout period after each one-week session. All concentrations of apraclonidine significantly lowered IOP. The 0.5% and 0.25% concentrations had equal maximal effects, lowering IOP in each patient by an average of 27% relative to vehicle alone. This corresponded to a mean decrease in IOP of 8.7 mm Hg, from a baseline of 24.9 mm Hg to 16.2 mm Hg. The 0.5% and 0.25% concentrations were significantly more effective than the 0.125% concentration at two and eight hours. Mean interpalpebral fissure width increased in a dose-dependent fashion; the pupillary effect was minimal. Blood pressure and pulse were unchanged. Thirty percent of subjects reported transient dry nose or dry mouth. These symptoms may be dose-dependent.

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