apraclonidine / Generic mfg. - LARVOL DELTA

Severe gastrointestinal dysmotility in autoimmune autonomic ganglionopathy: recognition, reclassification and reversal. (PubMed, Pract Neurol) - "She was noted incidentally to have tonic pupils; applying topical apraclonidine and dilute pilocarpine eye drops demonstrated both sympathetic and parasympathetic pupil denervation...After treatment with plasma exchange and pulsed intravenous cyclophosphamide, all features of autonomic dysfunction had improved by 3 months...Accurate diagnosis of autoimmune autonomic ganglionopathy can allow functional cure of chronic severe gastrointestinal dysmotility with appropriate immunosuppression. Neurologists and non-neurologists should be aware of this condition."

Journal • CNS Disorders • Depression • Immunology • Infectious Disease • Psychiatry • Septic Shock

Persistent Horner Syndrome Following Benign Gynaecological Surgery: A Case Report and Review of the Literature. (PubMed, Cureus) - "Horner syndrome was confirmed by apraclonidine testing...Symptoms persisted at six months despite normal imaging. This case highlights the importance of recognising Horner syndrome after non-cervical surgery, promptly excluding life-threatening causes and considering perioperative sympathetic dysfunction as a diagnosis of exclusion."

Journal • Anesthesia • CNS Disorders • Gynecology • Musculoskeletal Pain • Ophthalmology • Pain • Uterine Leiomyoma

Intraocular Pressure Spikes After Ophthalmic Laser Leading to Wipe-Out in Only-Eyed Patients: A Serious Complication Not to Be Overlooked. (PubMed, Ophthalmic Surg Lasers Imaging Retina) - "In certain places like the UK, only post-LPI IOP is measured, but not other ophthalmic lasers, nor is pre- and post-procedure brimonodine or apraclonidine routinely prescribed to mitigate the IOP spike. We advocate the importance of post-procedure IOP checking, especially in advanced glaucoma patients with narrow safety margins. Precautions and assessment within the first hour post-procedure are critical for patients with very advanced or end-stage glaucoma and narrow safety margins, as urgent treatment may potentially reverse the adverse outcome for these patients."

Journal • Glaucoma • Ophthalmology

The Prophylactic Effect of Dexmedetomidine 0.008% Versus Brimonidine 0.2% on IOP Elevation After Nd: YAG Laser Capsulotomy. (PubMed, Pharmacol Res Perspect) - "Brimonidine and apraclonidine are widely used to prevent such elevations. Although dexmedetomidine prevented acute IOP surges, its efficacy was inferior to brimonidine. Further studies should explore optimal dosing, formulations, and long-term safety to clarify its prophylactic potential."

Clinical • Journal • Cardiovascular • Cataract • Glaucoma • Ophthalmology

An Investigation of FID 123472 Ophthalmic Solution to Vehicle for the Reduction of Ocular Redness in Adults (clinicaltrials.gov) - P3 | N=178 | Not yet recruiting | Sponsor: Alcon Research

New P3 trial • Ophthalmology

An Evaluation of the Efficacy and Safety of FID 123472 Ophthalmic Solution for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=240 | Not yet recruiting | Sponsor: Alcon Research | Trial completion date: Nov 2027 ➔ Feb 2027 | Trial primary completion date: Nov 2027 ➔ Feb 2027

Trial completion date • Trial primary completion date • Ophthalmology

Topical pyridostigmine for ocular myasthenia gravis: a translational hypothesis. (PubMed, Med Hypothesis Discov Innov Ophthalmol) - "Pyridostigmine bromide is a small, hydrophilic quaternary ammonium compound with topical application properties that favor conjunctival permeability while limiting transcorneal penetration...Clinical precedent from alpha-adrenergic eye drops (e.g., apraclonidine) that elevate the eyelid via Müller's muscle support the plausibility of a topical approach...The feasibility of topical or periocular pyridostigmine as a localized treatment strategy for ocular MG deserves further investigation. If validated, this approach could shift management toward targeted, better-tolerated topical therapies with reduced systemic risk."

Journal • CNS Disorders • Immunology • Myasthenia Gravis • Ophthalmology • Strabismus

An Evaluation of the Efficacy and Safety of FID 123472 Ophthalmic Solution for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=240 | Not yet recruiting | Sponsor: Alcon Research

New P3 trial • Ophthalmology

Adverse Events and Intraocular Pressure-Lowering Effect of Topical 0.5% Apraclonidine in Childhood Glaucoma: A Retrospective Single-Center Study. (PubMed, Ophthalmol Glaucoma) - "Topical apraclonidine use demonstrated a low rate of reported adverse events and was associated with clinically meaningful IOP reduction as an adjunctive treatment in childhood glaucoma."

Adverse events • Journal • Retrospective data • Cataract • Glaucoma • Ophthalmology • Pediatrics

Horner Syndrome Following an Upper Thoracic Vertebral Column Resection for Congenital Scoliosis: A Case Report. (PubMed, JBJS Case Connect) - "This case highlights Horner syndrome as a rare potential complication of VCRs without epidural analgesia, emphasizing the need for additional counseling to families on this potential postoperative outcome."

Journal • Movement Disorders • Ophthalmology • Orthopedics

Management of Complications Following Botulinum Toxin Facial Injections: A Narrative Review. (PubMed, Cureus) - "Management is largely conservative, apraclonidine 0.5% is most commonly used for toxin-induced ptosis, and oxymetazoline 0.1% (FDA-approved for acquired blepharoptosis) is an additional option; other events are treated symptomatically. Overall, evidence is limited, supporting the need for prospective studies and standardized management pathways."

Journal • Review • Aesthetic Medicine • CNS Disorders • Pain

Systemic Toxicity With Use of Apraclonidine Ophthalmic Drops in Pediatric Patients. (PubMed, JAMA Ophthalmol) - "This case series suggests use of apraclonidine in pediatric patients poses a risk of central α-2 adrenergic agonist-induced central nervous system and respiratory depression. Clinicians who use apraclonidine in the pediatric population should be aware of potential serious systemic effects from ophthalmic use of the drug and be prepared to manage these."

Journal • Cardiovascular • CNS Disorders • Depression • Ophthalmology • Pediatrics • Psychiatry • Respiratory Diseases

Iatrogenic Blepharoptosis: Multimodal Management and Treatment Technique With Botulinum Toxin Type A. (PubMed, Dermatol Res Pract) - "Once it has happened, it is important to recognize the severity of the blepharoptosis (which is classified as mild, moderate, or severe), in order to decide whether to use oxymetazoline or apraclonidine eye drops, muscle exercises, vibrating devices, radiofrequency, and the latest option described with pretarsal BoNT-A application...Blepharoptosis following esthetic BoNT-A treatment is a rare complication among trained injectors. Knowledge of therapeutic options, including pretarsal BoNT-A injection techniques, is crucial for managing this complication, which can have significant esthetic and functional impacts."

Journal • Review • Aesthetic Medicine

Horner syndrome following endoscopic thyroid surgery (ETS): a report of two cases and literature review. (PubMed, Front Med (Lausanne)) - "Pharmacologic tests utilizing drugs such as Apraclonidine, Cocaine, and Hydroxyamphetamine aid in the diagnosis of HS, while short-term use of steroids and neurotrophins may expedite recovery...Preoperative patient counseling about HS risk is crucial. This study underscores HS as non-life-threatening yet distressing complication, advocating for refined surgical techniques and heightened anatomical awareness to avoid CSC injury during ETS."

Journal • Oncology • Ophthalmology • Solid Tumor • Thyroid Gland Carcinoma • Thyroid Gland Papillary Carcinoma • ERG

Oxymetazoline and Blepharoptosis: A Case Series and Proposed Treatment Algorithm. (PubMed, Cureus) - "Pharmacologic treatments such as apraclonidine and phenylephrine eyedrops have been used but are limited by significant adverse effects, including pupil dilation and ocular/systemic side effects...Its extended duration of effectiveness and favorable safety profile make it an attractive choice for patients. The proposed treatment algorithm simplifies decision-making for clinicians and enhances patient satisfaction and quality of life."

Journal • Aesthetic Medicine • Ophthalmology

A Comparative Assessment of Intraocular Pressure Changes After Aflibercept 8 mg and Faricimab-svoa Intravitreal Injections in Wet Age-Related Macular Degeneration. (PubMed, Cureus) - "Formulations with higher concentrations, such as aflibercept 8 mg (Eylea HD; Bayer AG, Leverkusen, Germany), which are administered in larger volumes, may raise concerns about potential increases in intraocular pressure (IOP) and other ocular complications...The research recorded lens condition, the need for paracentesis, and the application of Iopidine drops...Conclusions Intravitreal injections of aflibercept 8 mg and faricimab-svoa caused a small and temporary increase in IOP and there were no cases requiring urgent management. Our results confirm the short-term ocular safety of aflibercept 8 mg and faricimab-svoa for the treatment of WetAMD and highlight the need for individualized monitoring for patients at risk of increased IOP."

Journal • Age-related Macular Degeneration • Macular Degeneration • Ophthalmology • Retinal Disorders • Wet Age-related Macular Degeneration

Validation of Monocular Pupillometry in Healthy Controls and Patients With Autonomic Dysfunction: Pupillary Biomarkers for Autonomic Failure. (PubMed, Eur J Neurol) - "The presented device provides accurate, reproducible assessments of pupillary autonomic function in healthy controls and patients with autonomic disorders. With normative data provided, it is an easily accessible, well-tolerated tool to quantitatively assess pupillomotor innervation in a broad clinical setting. Further studies are warranted to explore its potential as a noninvasive biomarker, complementing standard autonomic function tests for early detection, monitoring disease progression, and evaluating treatment response in disorders with autonomic failure."

Biomarker • Journal • CNS Disorders • Immunology

Differentiation of Horner Syndrome and Physiological Anisocoria by Automated Pupillometry. (PubMed, J Neuroophthalmol) - "Our results indicate that pupillometry is a robust tool to measure the dilation lag in Horner syndrome and, therefore, to distinguish pathological from physiological anisocoria obviating pharmacological testing. The high sensitivity of the test will allow to identify the patients with Horner syndrome requiring further investigation."

Journal • Ophthalmology

Horner syndrome after parathyroidectomy: case report (SOE 2025) - "The diagnosis of Horner Syndrome was confirmed by pharmacological testing with apraclonidine... This case underscores the importance of recognizing Horner Syndrome as a rare but noteworthy complication of thyroid and parathyroid surgeries. General surgeons should be aware of the vulnerability of the oculosympathetic pathway due to its close anatomical relationship with these structures. Ophthalmologists must be proficient in identifying Horner Syndrome as a potential consequence of cervical interventions, highlighting the importance of obtaining a detailed clinical history for accurate diagnosis and treatment."

Case report • Clinical • Ophthalmology

Collaboration Between Emergency Medicine and Optometry Aids in Diagnosing Atypical Wallenberg Syndrome in a 37-Year-Old Female. (PubMed, J Binocul Vis Ocul Motil) - "This case report highlights an atypical clinical presentation featuring ipsilateral head, neck, shoulder, and eye pain with erythema, edema of the right eyelid and conjunctiva, alongside classic signs of dorsolateral medullary syndrome, also known as Wallenberg Syndrome, characterized by ipsilateral Horner's syndrome and contralateral loss of body pain and temperature in a 37-year-old female. The correct diagnosis of Wallenberg syndrome was achieved through the collaborative effort of eye care professionals, primary care, emergency, and neurology specialties in medicine."

Journal • Atherosclerosis • Cardiovascular • Dermatology • Infectious Disease • Pain

Pharmacologic Agents Used in the Assessment or Correction of Blepharoptosis: A Report by the American Academy of Ophthalmology. (PubMed, Ophthalmology) - "Phenylephrine, cocaine, hydroxyamphetamine, apraclonidine, naphazoline, and oxymetazoline can achieve short-term blepharoptosis correction. Phenylephrine, cocaine, and hydroxyamphetamine have been described only in the context of in-office evaluation of blepharoptosis or Horner syndrome, and their therapeutic role remains uncertain. Oxymetazoline hydrochloride ophthalmic solution 0.1% is the only medication approved by the United States Food and Drug Administration for treatment of acquired blepharoptosis in adults. Independent validation studies may be warranted for oxymetazoline hydrochloride and its long-term efficacy and safety data remain uncertain."

Journal • Dry Eye Disease • Keratitis • Ocular Inflammation • Ophthalmology • Pain • Xerostomia

DEW422-C001: A Double-Masked Comparison of FID 123320 Ophthalmic Solution to Vehicle for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=159 | Completed | Sponsor: Alcon Research | Active, not recruiting ➔ Completed

Trial completion • Ophthalmology

DEW422-C001: A Double-Masked Comparison of FID 123320 Ophthalmic Solution to Vehicle for the Reduction of Ocular Redness (clinicaltrials.gov) - P3 | N=159 | Active, not recruiting | Sponsor: Alcon Research | Recruiting ➔ Active, not recruiting | N=240 ➔ 159

Enrollment change • Enrollment closed • Ophthalmology

Differentiation of Horner Syndrome and Physiological Anisocoria by Automated Pupillometry. (PubMed, J Neuroophthalmol) - "Our results indicate that pupillometry is a robust tool to measure the dilation lag in Horner syndrome and, therefore, to distinguish pathological from physiological anisocoria obviating pharmacological testing. The high sensitivity of the test will allow to identify the patients with Horner syndrome requiring further investigation."

Journal • Ophthalmology

Investigation of the molecular interaction between apraclonidine, an α2-adrenergic receptor agonist, and bovine serum albumin using fluorescence and molecular docking techniques. (PubMed, Spectrochim Acta A Mol Biomol Spectrosc) - "Analysis of synchronous and 3-D fluorescence signals revealed microenvironmental variations close to BSA's Trp and Tyr residues upon APR addition. Both the competitive site marker as well as molecular docking results detected that APR exhibited a stronger binding affinity towards Drug Site 2 (DS2) compared to Drug Site 1 (DS1)."

Journal • Cardiovascular