Apraclonidine
Antiglaucoma agents
Antiglaucoma agents
An alpha-2 agonist eye drop for short-term extra pressure lowering in glaucoma, for example around laser surgery. Its effect fades with time.
Quick facts
- Group
- Antiglaucoma agents
- Target
- α2 adrenergic receptors of the ciliary body
- Used for
- Short-term add-on therapy
- Key effects
- Red · Dry mouth · Blanching of the conjunctiva
- Monitor
- Intraocular pressure · Pulse and blood pressure
- ATC
- S01EA03
No doses: the clinician sets them by the current guideline.
Mechanism of action
Apraclonidine is a relatively selective α2 agonist related to clonidine. Stimulating α2 receptors in the eye reduces aqueous humour flow, so intraocular pressure falls. It is also a vasoconstrictor, which causes eyelid and conjunctival blanching. In many patients the effect wanes over weeks (tachyphylaxis).
- Apraclonidine stimulates α2 receptors in the eye
- Aqueous humour flow falls
- Intraocular pressure drops; effect may fade (tachyphylaxis)
Indications
- Short-term add-on therapy in glaucoma on maximal medical treatment that needs more pressure lowering Open-angle glaucoma →
Adverse effects
Common
- Red, itchy, uncomfortable eye
- Dry mouth
- Blanching of the conjunctiva, eyelid swelling
- Tiredness and drowsiness
Contraindications
- Use of monoamine oxidase (MAO) inhibitors
- Hypersensitivity to apraclonidine or to clonidine
Key interactions
- MAO inhibitors
- Contraindicated
- CNS depressants (alcohol, opioids, sedatives, anaesthetics)
- Possible additive sedation
- Beta-blockers, antihypertensives, cardiac glycosides
- Lower pulse and blood pressure; both are checked
- Tricyclic antidepressants
- May blunt the effect, as they do with clonidine
What is monitored
- Intraocular pressure, closely, because of tachyphylaxis
- Visual fields when used to delay surgery
- Pulse and blood pressure with cardiovascular drugs
Administration and safety
- For eye use only; not for injection or swallowing.
- Contact lenses come out before the drop and go back in about 15 minutes later.
- Look-alike names: apraclonidine, clonidine and brimonidine are different products.
Pregnancy and breastfeeding
There are no adequate human studies; it is used only if the benefit justifies the risk.
Nursing care
- Check for MAO inhibitor use before the first dose.
- Warn about drowsiness and dizziness before driving or hazardous work.
- Teach to stop and report red, itchy, swollen eyes.
- Check mood in patients with a history of depression.
Pharmacokinetics
- Absorption
- Topical use leads to systemic absorption
- Onset and duration
- Effect usually within an hour, maximal at about three hours
Test yourself
Think of the answer, then tap the question to see it.
Why is apraclonidine used only short term?
Its pressure-lowering effect fades over time (tachyphylaxis) and allergic-like eye reactions are common.
Which drug class is contraindicated with it?
Monoamine oxidase inhibitors.
What receptor does it stimulate?
The α2 adrenergic receptor.
Connections
← Back to the class: Antiglaucoma agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - APRACLONIDINE solution (DailyMed (U.S. National Library of Medicine), 2024); Apraclonidine Ophthalmic: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.