[Effect and side effects of apraclonidine].

Apraclonidine is a alpha 2 adrenergic agonic which is a para-amino derivative of clonidine. This molecular alteration helps prevent apraclonidine from crossing the blood-brain barrier so it minimally influences the heart rate and blood pressure. Apraclonidine reduces the intraocular pressure primarily by an aqueous suppressant mechanism. Its ocular hypotensive efficacy as monotherapy is similar to timolol maleate 0.5% up to eight hours post dosing, but is less than timolol maleate by 12 hours following instillation. As an adjunctive agent apraclonidine decreases the intraocular pressure approximately 16% over that of timolol maleate done. These clinical effects are stable out of three months after the initiation of therapy. Apraclonidine is also additive to maximally tolerated medical therapy. As many as 60% of these patients do not require additional therapy after adding apraclonidine for as long as five months. Apraclonidine also is useful to prevent transiently increased intraocular pressure following anterior segment laser procedures and intraocular surgery. Apraclonidine is well tolerated systemically with no serious adverse event attributed previously to this medicine. The most common ocular side effect is anterior segment intolerance in between 8-36% of patients. Symptoms of itching, as well as burning, and signs of conjunctival inflammation may appear. The intolerance quickly resolves upon discontinuation of the medicine. In summary, apraclonidine is useful in chronic therapy for chronic open-angle glaucoma and helping to prevent acute increased intraocular pressure following anterior segment laser procedures.