Clinical experience with the long-term use of 1% apraclonidine. Incidence of allergic reactions.
OBJECTIVE
To identify the incidence and characteristics of allergic reactions associated with the long-term use of 1% apraclonidine hydrochloride.


METHODS
We undertook a retrospective analysis of 64 patients receiving long-term 1% apraclonidine therapy at the University of California-San Francisco Glaucoma Service. Patients were excluded if the duration of treatment was less than 2 weeks. Demographic data, initial intraocular pressure response, and incidence and characteristics of allergic reactions were obtained through chart review. Student's t test and chi 2 analysis were used to analyze the demographic data, and Kaplan-Meier survival analysis was used to estimate the long-term incidence of local reactions.


RESULTS
Sixty-four patients met the criteria for the study. Of these, 31 (48%) developed an allergic reaction (responders) that led to discontinuation of treatment with the medication, with a mean latency of 4.7 months. Mean follow-up was 13.3 months. Patients free of local reactions (nonresponders) for at least 10 months were able to successfully continue apraclonidine use. Responders tended to be older and female.


CONCLUSIONS
Our data are specific for the 1% preparation; however, physicians prescribing apraclonidine on a long-term basis should be aware of possible allergic reactions. A substantial percentage of patients developed this side effect, but most tolerated the medication for up to 4 months, and those without a local reaction after 10 months appeared to be able to continue apraclonidine use indefinitely. This allergic reaction is likely related to the adrenergic agent itself, and not to preservatives.
Butler
P
P
Department of Ophthalmology, University of California, San Francisco.
Mannschreck
M
M
Lin
S
S
Hwang
I
I
Alvarado
J
J
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D003000:Clonidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D012189:Retrospective Studies; D016019:Survival Analysis
D000316:Adrenergic alpha-Agonists; D009883:Ophthalmic Solutions; C016986:apraclonidine; D003000:Clonidine