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Paremyd

Last reviewed on RxList: 8/1/2018
Drug Description

PAREMYD®
(hydroxyamphetamine Hydrobromide 1% and tropicamide 0.25%)

Convenient One-Drop Solution for Dilation

  • Convenient one-drop formulation is easier to administer than many current regimens consisting of a drop from two separate products.

For Patient and Practitioner Convenience

  • Formulated to work quickly to fit busy patients' schedules and your patient flow.
  • Only partial loss of accommodation, due to lower (0.25%) concentration of tropicamide.
  • Minimizes inconvenience: Recovery begins within 90 minutes, with complete recovery typically in 6 to 8 hours.

PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) Solution should not be used in patients with angle-closure glaucoma or in those with narrow angles in whom dilation of the pupil may precipitate an attack of angle-closure glaucoma. This product is also contraindicated in patients who are hypersensitive to any of its components.

DESCRIPTION

PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) sterile ophthalmic solution is a topical mydriatic combination product for ophthalmic use.

Indications & Dosage

INDICATIONS

PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) Solution is indicated for mydriasis in routine diagnostic procedures and in conditions where short-term pupil dilation is desired. PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) provides clinically significant mydriasis with partial cycloplegia.

DOSAGE AND ADMINISTRATION

One to two drops in the conjunctival sac. The onset of action with PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) Solution occurs within 15 minutes followed by maximum effect within 60 minutes. Clinically significant dilation, inhibition of pupillary light response, and partial cycloplegia last 3 hours. Mydriasis will reverse spontaneously with time, typically in 6 to 8 hours. However, in some cases, complete recovery may take up to 24 hours.

HOW SUPPLIED

PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) (hydroxyamphetamine hydrobromide/tropicamide ophthalmic solution) 1%/0.25% as a 15 mL solution in a 15 mL opaque white, low density polyethylene bottle with a natural low density polyethylene dropper tip and a red polypropylene cap. 15 mL - NDC 17478-704-12

Note: Protect from light. Store between 15° C to 25° C (59° F to 77° F).

Manufactured by: Akorn Buffalo Grove, IL 60089. For product enquiry call: 800-932-5676 or fax 800-943-3694 • www.akorn.com

Side Effects & Drug Interactions

SIDE EFFECTS

Increased intraocular pressure has been reported following use of mydriatics. Transient stinging, dryness of the mouth, blurred vision, photophobia with or without corneal staining, tachycardia, headache, allergic reactions, nausea, vomiting, pallor, and muscle rigidity have been reported with the use of tropicamide and/or hydroxyamphetamine hydrobromide, and thus may occur with PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) Solution. Central nervous system disturbances have also been reported. Psychotic reactions, behavioral disturbances, and vasomotor or cardiorespiratory collapse have been reported with the use of anticholinergic drugs. Rare but serious cardiovascular events, including death due to myocardialinfarction, ventricular fibrillation and significant hypotensive episodes have occurred shortly following PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) instillation.

DRUG INTERACTIONS

No information provided.

Warnings & Precautions

WARNINGS

For topical ophthalmic use only; not for injection. There is evidence that mydriatics may produce a transient elevation of intraocular pressure in patients with open-angle glaucoma. This preparation rarely may cause CNS disturbances which may be particularly dangerous in infants, children, or the aged. Psychotic reactions, behavioral disturbances, and vasomotor or cardiorespiratory collapse have been reported with the use of anticholinergic drugs.

PRECAUTIONS

General

Patients with hypertension, hyperthyroidism, diabetes, or cardiac disease (i.e., arrhythmias or chronic ischemic heart disease) should be monitored after instillation. The elderly and others in whom glaucoma or increased intraocular pressure may be encountered following administration of PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) Solution should also be monitored closely. To avoid inducing angle-closure glaucoma, an estimation of the depth of the angle of the anterior chamber should be made.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No studies have been performed to evaluate the carcinogenic, mutagenic or impairment of fertility potential of PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) .

Pregnancy

Pregnancy Category C: Animal reproduction studies have not been conducted with PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) . It is also not known whether PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) can cause fetal harm when administered to a pregnant woman or can affect reproduction capability. PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) should be given to a pregnant woman only if clearly needed.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) is administered to a nursing woman.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established. PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) may rarely cause CNS disturbances which may be dangerous in infants and children. Psychotic reactions, behavioral disturbances, and vasomotor or cardiorespiratory collapse in children have been reported with the use of anticholinergic drugs. (See WARNINGS.) Keep this and all medications out of the reach of children.

Geriatric Use

No overall differences in safety and effectiveness have been observed between elderly and younger patients.

Overdosage & Contraindications

OVERDOSE

Ocular overdosage will cause dilation of the pupils. Systemic overdosage or ingestion of large doses may result in hypertension, cardiac arrhythmias, sub-sternal discomfort, headache, sweating, nausea, vomiting, and gastrointestinal irritation. Patients with systemic overdosage should be carefully monitored and treated symptomatically.

CONTRAINDICATIONS

PAREMYD® (hydroxyamphetamine hydrobromide, tropicamide) Solution (hydroxyamphetamine hydrobromide/tropicamide ophthalmic solution)1%/0.25% should not be used in patients with angle-closure glaucoma or in those with narrow angles in whom dilation of the pupil may precipitate an attack of angle-closure glaucoma. This product is also contraindicated in patients who are hypersensitive to any of its components.

Clinical Pharmacology

CLINICAL PHARMACOLOGY

No information provided.

Medication Guide

PATIENT INFORMATION

Patients should be advised not to touch the dropper tip to any surface since this may contaminate the solution. Patients should be advised to use caution when driving or engaging in other hazardous activities while pupils are dilated. Patients may experience photophobia and/or blurred vision and should protect their eyes in bright illumination when pupils are dilated. Parents should be warned not to get this preparation in their child's mouth and to wash their own hands and the child's hands following administration.

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