Version May 2024
Mydriasis, cycloplegia: Ophthalmic: Instill 1 or 2 drops of 0.5%, 1%, or 2% solution; may repeat in 5 to 10 minutes; heavily pigmented irides may require use of higher strengths.
Anterior uveitis (off-label use): Ophthalmic: Instill 1 drop of 1% solution 3 times daily (Ref).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Cyclopentolate: Pediatric drug information")
Mydriasis, cycloplegia:
Infants: Ophthalmic: Instill 1 drop of 0.5% solution as a single dose. Note: The cyclopentolate and phenylephrine combination formulation may be preferred for use in infants due to lower cyclopentolate concentration (0.2%) and potentially reduced risk for systemic adverse reactions.
Children and Adolescents: Ophthalmic: Instill 1 or 2 drops of 0.5%, 1%, or 2% solution; may repeat with 0.5% or 1% solution in 5 to 10 minutes; heavy pigmented irides may require use of higher strengths
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
1% to 10%:
Cardiovascular: Tachycardia
Central nervous system: Ataxia, hallucination, hyperactivity, incoherent speech, psychosis, restlessness, seizure
Dermatologic: Burning sensation of skin
Hypersensitivity: Hypersensitivity reaction
Ophthalmic: Accommodation disturbance (loss), increased intraocular pressure
Hypersensitivity to cyclopentolate or any component of the formulation.
Canadian labeling: Additional contraindication (not in US labeling): Known or suspected angle-closure glaucoma; use in pediatric patients <6 years of age.
Concerns related to adverse effects:
• CNS effects: May cause CNS disturbances, especially with the higher concentrations. May occur with any age group, although children are more susceptible.
• Intraocular pressure: May cause a transient elevation in intraocular pressure; use with caution in patients with untreated narrow-angle glaucoma or anatomically narrow angles.
Disease-related concerns:
• Down syndrome: Patients with Down syndrome are predisposed to angle-closure glaucoma; use with caution.
Special populations:
• Contact lens wearers: Contains benzalkonium chloride which may be adsorbed by contact lenses; remove contacts prior to administration and wait 15 minutes before reinserting.
• Older adult: Use with caution in elderly patients; may be predisposed to increased intraocular pressure.
• Pediatric: May result in psychotic reactions and behavioral disturbances (disorientation, transient psychosis, seizures, incoherent speech, or visual disturbances) in pediatric patients, especially with the 2% solution; increased susceptibility to these effects has been reported in young infants, young children, and in children with preexisting behavioral/neurologic deficit, spastic paralysis, or brain damage; effects usually occur ~30 to 45 minutes after instillation; observe infants for at least 30 minutes following instillation. Effects are reversible and usually last 6 to 8 hours following the last dose; if these effects occur, monitor blood pressure and pulse closely (Pooniya 2012; Rajeev 2010). Severe cases have also been reported (Rajeev 2010); use of punctal occlusion and lowest dosage possible are recommended to reduce risk of systemic toxicity (Adcock 1971). Anticholinesterases (physostigmine) may be administered in severe life-threatening cases of systemic toxicity (Pooniya 2012). Feeding intolerance may occur in infants; withhold feeding for 4 hours after examination.
Other warnings and precautions:
• Appropriate use: For topical ophthalmic use only. To minimize absorption, apply pressure over the nasolacrimal sac for 2 to 3 minutes after instillation.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Ophthalmic, as hydrochloride:
Cyclogyl: 0.5% (15 mL); 1% (2 mL, 5 mL); 2% (2 mL, 5 mL, 15 mL)
Generic: 0.5% (15 mL [DSC]); 1% (2 mL, 15 mL); 2% (2 mL [DSC], 5 mL [DSC], 15 mL [DSC])
Yes
Solution (Cyclogyl Ophthalmic)
0.5% (per mL): $7.28
1% (per mL): $19.10
2% (per mL): $16.53
Solution (Cyclopentolate HCl Ophthalmic)
1% (per mL): $8.17 - $8.40
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Generic: 0.5% (0.5 mL); 1% (0.5 mL)
Solution, Ophthalmic, as hydrochloride:
Cyclogyl: 1% (15 mL) [contains benzalkonium chloride, edetate (edta) disodium]
Generic: 1% (15 mL)
Ophthalmic: To avoid excessive systemic absorption, finger pressure should be applied on the lacrimal sac during and for 2 to 3 minutes following application; monitor infants closely for at least 30 minutes after instillation.
Ophthalmic: Instill drops into conjunctival sac of affected eye(s); avoid contact of bottle tip with skin or eye; to avoid excessive systemic absorption, finger pressure should be applied on the lacrimal sac during and for 2 to 3 minutes following application
Mydriasis/Cycloplegia: Produce mydriasis and cycloplegia.
Anterior uveitis (acute)
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Risk C: Monitor therapy
Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination
Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy
Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Risk C: Monitor therapy
Botulinum Toxin-Containing Products: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy
Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Risk C: Monitor therapy
Carbachol: Cyclopentolate may diminish the therapeutic effect of Carbachol. Risk C: Monitor therapy
Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Risk C: Monitor therapy
Chlorprothixene: Anticholinergic Agents may enhance the anticholinergic effect of Chlorprothixene. Risk C: Monitor therapy
Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Risk X: Avoid combination
CloZAPine: Anticholinergic Agents may enhance the constipating effect of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider therapy modification
Echothiophate Iodide: Cyclopentolate may diminish the therapeutic effect of Echothiophate Iodide. Risk C: Monitor therapy
Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Risk X: Avoid combination
Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Risk C: Monitor therapy
Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor therapy
Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Risk X: Avoid combination
Glycopyrronium (Topical): May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination
Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination
Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Risk C: Monitor therapy
Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Risk X: Avoid combination
Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy
Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Risk C: Monitor therapy
Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor therapy
Opioid Agonists: Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Risk C: Monitor therapy
Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination
Pilocarpine (Ophthalmic): Cyclopentolate may diminish the therapeutic effect of Pilocarpine (Ophthalmic). Risk C: Monitor therapy
Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid combination
Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid combination
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Risk X: Avoid combination
Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Risk C: Monitor therapy
Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Risk X: Avoid combination
Rivastigmine: Anticholinergic Agents may diminish the therapeutic effect of Rivastigmine. Rivastigmine may diminish the therapeutic effect of Anticholinergic Agents. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider therapy modification
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider therapy modification
Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy
Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Risk X: Avoid combination
Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Risk C: Monitor therapy
Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination
Animal reproduction studies have not been conducted.
It is not known if cyclopentolate is excreted in breast milk. The manufacturer recommends that caution be exercised when administering cyclopentolate to nursing women.
Prevents the muscle of the ciliary body and the sphincter muscle of the iris from responding to cholinergic stimulation, causing mydriasis and cycloplegia
Onset of action: Peak effect: Cycloplegia: 25 to 75 minutes; Mydriasis: Within 15-60 minutes, with recovery taking up to 24 hours
Duration: Cycloplegia: 6 to 24 hours; Mydriasis: ≤24 hours (Frazier 2008)
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