Ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic Disease Interactions
There are 7 disease interactions with ketorolac / phenylephrine / proparacaine / tropicamide ophthalmic.
Anticholinergics (applies to ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic) glaucoma
Major Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension
Anticholinergic agents are contraindicated in patients with primary glaucoma, a tendency toward glaucoma (narrow anterior chamber angle), or adhesions (synechiae) between the iris and lens, as well as for the elderly and others in whom undiagnosed glaucoma or excessive pressure in the eye may be present. Because anticholinergics cause mydriasis, they may exacerbate these conditions.
NSAIDs (applies to ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic) asthma
Major Potential Hazard, High plausibility.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in patients with history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs; severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients. A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polyps, severe potentially fatal bronchospasm, and/or intolerance to aspirin and other NSAIDs. Since cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients, therapy with any NSAID should be avoided in patients with this form of aspirin sensitivity. NSAIDs should be used with caution in patients with preexisting asthma (without known aspirin sensitivity), and these patients should be monitored for changes in the signs and symptoms of asthma.
Ophthalmic sympathomimetics (applies to ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic) narrow angles
Major Potential Hazard, High plausibility. Applicable conditions: Glaucoma (Narrow Angle)
The use of nonspecific ophthalmic sympathomimetic agents is contraindicated in patients with narrow-angle glaucoma or anatomically narrow angles. These agents stimulate both alpha-1 and alpha-2 adrenergic receptors, thus topical administration can induce transient mydriasis. In patients with narrow angles, pupillary dilation can provoke an acute attack of angle-closure glaucoma. If possible, these agents (except for phenylephrine 2.5% or 10%) should also be avoided in patients with other forms of glaucoma, since mydriasis may occasionally increase intraocular pressure.
Ophthalmic NSAIDs (applies to ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic) platelet inhibition
Moderate Potential Hazard, Low plausibility. Applicable conditions: Coagulation Defect, Thrombocytopathy, Thrombocytopenia, Bleeding, Vitamin K Deficiency
Topically applied nonsteroidal anti-inflammatory drugs (NSAIDs) are systemically absorbed, with the potential for producing rare but clinically significant systemic effects. NSAIDs have been shown to reversibly inhibit platelet adhesion and aggregation and may slightly prolong bleeding time in healthy individuals. These effects may be more pronounced in patients with underlying hemostatic abnormalities. Thrombocytopenia has also been reported rarely during NSAID use. Therapy with ocular NSAIDs should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment.
Topical sympathomimetics (applies to ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic) BPH
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Benign Prostatic Hyperplasia, Prostate Tumor
Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In patients with prostate enlargement, urinary difficulty may develop or worsen due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with topical sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate. It is important that the recommended dosages of the individual products not be exceeded.
Topical sympathomimetics (applies to ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic) cardiovascular
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease, Cerebrovascular Insufficiency, Hyperthyroidism, Corneal Abrasion
Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta-1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, and coronary occlusion have been reported rarely during the use of ophthalmic and nasal sympathomimetic agents, but may be more likely if the corneal epithelium is damaged or if an excessive amount of drug is swallowed during nasal administration. Therapy with topical sympathomimetic agents should be administered cautiously in patients with corneal abrasion, sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders, especially coronary insufficiency, cardiac arrhythmia, or hypertension. The potent ophthalmic formulations (e.g., phenylephrine 2.5% or 10%) that are used for diagnostic and pre-surgical purposes should not be used in such patients. For other preparations, it is important that the recommended dosages of the individual products not be exceeded.
Topical sympathomimetics (applies to ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic) diabetes
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus
Topically applied sympathomimetic agents are systemically absorbed, particularly during prolonged or indiscriminate use. Slight increases in blood glucose concentrations may occur with the use of these drugs. Therapy with topical sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. It is important that the recommended dosages of the individual products not be exceeded.
Ketorolac/phenylephrine/proparacaine/tropicamide ophthalmic drug interactions
There are 220 drug interactions with ketorolac / phenylephrine / proparacaine / tropicamide ophthalmic.
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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