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Omidria
Omidria (generic name: phenylephrine and ketorolac) is an ophthalmic irrigation solution used during cataract surgery or other intraocular procedures to prevent intraoperative miosis (pupil constriction) and reduce postoperative pain and inflammation. Phenylephrine is an alpha-1 adrenergic agonist that helps maintain pupil dilation, while ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce pain and inflammation. Omidria is used as part of an irrigation solution during eye surgeries to improve patient outcomes by maintaining a stable and dilated pupil.
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Frequently Asked Questions
How does Omidria help during cataract surgery?
Omidria helps by maintaining pupil dilation (which allows the surgeon better access to the lens) and reducing inflammation and pain during and after the procedure.
Can Omidria be used in all types of eye surgeries?
Omidria is specifically indicated for use in cataract and intraocular lens replacement surgeries. It may not be appropriate for other types of eye surgeries unless directed by a healthcare provider.
Can I use Omidria at home after surgery?
No, Omidria is intended for use during surgery and is administered by a healthcare professional. It is not for home use.
Can I use Omidria at home after surgery?
No, Omidria is intended for use during surgery and is administered by a healthcare professional. It is not for home use.
Does Omidria affect blood pressure?
Yes, Omidria contains phenylephrine, which can cause a rise in blood pressure. Patients with a history of high blood pressure should be monitored during surgery.
How long do the effects of Omidria last after surgery?
The effects of Omidria typically last through the duration of the surgery and a few hours postoperatively, helping to maintain pupil dilation and reduce pain and inflammation.
Comprehensive Drug Guide
How Does Omidria Work?
Omidria contains two active ingredients: phenylephrine, which works by stimulating alpha-1 adrenergic receptors to maintain pupil dilation (mydriasis) during surgery, and ketorolac, which blocks the action of cyclooxygenase (COX) enzymes to reduce the production of prostaglandins. This combination helps maintain pupil dilation and reduces pain and inflammation associated with the surgical procedure.
Common Dosages
- Phenylephrine 1% and ketorolac 0.3% solution, added to irrigation fluid during surgery.
Typical Dosing
- For intraocular use during surgery: 4 mL of Omidria solution is diluted in 500 mL of irrigation solution and used throughout the surgical procedure to maintain pupil dilation and reduce pain and inflammation.
- It is administered by the surgeon during surgery as part of the irrigation solution.
Typical Dosing
FDA Approved Indications
- Maintaining pupil dilation during cataract surgery or intraocular lens replacement surgery.
- Reducing postoperative pain and inflammation following surgery.
Who Shouldn't Take Omidria?
- Known hypersensitivity to phenylephrine, ketorolac, or any other ingredients in the formulation.
- Allergy to NSAIDs, including aspirin, as ketorolac is a member of the NSAID family.
Advice From The Pharmacist
- Omidria is administered by a healthcare professional during surgery. It is not intended for use outside of a surgical setting.
- Before undergoing surgery, inform your healthcare provider of any allergies to NSAIDs (such as aspirin, ibuprofen, or naproxen) or any history of asthma, bleeding disorders, or kidney problems.
- If you experience any unusual symptoms after surgery, such as vision changes, severe pain, or swelling, report them to your doctor immediately.
Side Effects of Omidria
Common Side Effects
- Eye irritation
- Eye pain
- Increased intraocular pressure
- Headache
Uncommon/Severe Side Effects
- Allergic reactions (rash, itching, swelling, or difficulty breathing)
- Bleeding complications
- Worsening of asthma in patients with a history of NSAID sensitivity
Risks and Warnings of Omidria
- Cardiovascular Risks: Phenylephrine can cause an increase in blood pressure due to its vasoconstrictive properties. Patients with a history of cardiovascular conditions, such as high blood pressure or heart disease, should be monitored closely.
- Bleeding Risk: Ketorolac, as an NSAID, may increase the risk of bleeding. This is particularly important for patients with a history of bleeding disorders or those taking anticoagulant medications.
- Asthma Exacerbation: Patients with asthma or NSAID sensitivity should use Omidria with caution, as ketorolac can cause bronchospasm in susceptible individuals.
Interactions with Omidria
Common Drug Interactions
- Anticoagulants (e.g., warfarin, heparin): Taking Omidria in combination with anticoagulants may increase the risk of bleeding.
- Other NSAIDs or aspirin: Concurrent use of additional NSAIDs may increase the risk of gastrointestinal or bleeding side effects.
- Blood pressure medications: Since phenylephrine can raise blood pressure, it may interact with medications used to lower blood pressure, requiring close monitoring during surgery.
Alternatives to Omidria
- Mydriatics (phenylephrine or tropicamide): Used separately during eye surgery to maintain pupil dilation, though these are not combined with an anti-inflammatory agent like Omidria.
- Ketorolac (Acular): An ophthalmic NSAID used postoperatively to reduce inflammation and pain after eye surgery.
- Cycloplegics: These are used to paralyze the ciliary muscles of the eye, sometimes used as part of eye surgeries to maintain pupil dilation.
