Sandol

One of the muscarinic antagonists with pharmacologic action similar to atropine and used mainly as an ophthalmic parasympatholytic or mydriatic. [PubChem]

Ophthalmic

Production of mydriasis

Adult: Instill 1-2 drops of a 0.5% solution 15-20 minutes before examination.

Ophthalmic

Production of cycloplegia

Adult: Instill 1-2 drops of a 1% solution repeated after 5 minutes. An additional drop may be admin after 20-30 minutes for prolonged effect.

Sandol ophthalmic causes muscles in the eye to become relaxed. This dilates (widens) the pupil so that it does not contract (narrow) when your doctor shines an examination light into your eye.

Sandol ophthalmic is used to dilate the pupil for an eye examination or other diagnostic procedure.

Sandol ophthalmic may also be used for purposes other than those listed in this medication guide.

Usual Adult Dose for Refraction

Cycloplegic Refraction:

-Instill 1 or 2 drops of the 1% solution into eye(s); repeat in 5 minutes.

Comment:

-An additional drop may be given if the examination is not done within 20 to 30 minutes.

Use: To produce mydriasis and cycloplegia for diagnostic procedures.

Usual Adult Dose for Pupillary Dilation

Fundoscopy:

-Instill 1 or 2 drops of 0.5% solution into eye(s) 15 or 20 minutes prior to examination.

Comments:

-Heavily pigmented irides may require higher strength or more doses.

Use: To produce mydriasis and cycloplegia for diagnostic procedures.

Usual Pediatric Dose for Refraction

Cycloplegic Refraction:

-Instill 1 or 2 drops of the 1% solution into eye(s); repeat in 5 minutes.

Comment:

-An additional drop may be given if the examination is not done within 20 to 30 minutes.

Use: To produce mydriasis and cycloplegia for diagnostic procedures.

Usual Pediatric Dose for Pupillary Dilation

Fundoscopy:

-Instill 1 or 2 drops of 0.5% solution into eye(s) 15 or 20 minutes prior to examination.

Comments:

-Heavily pigmented irides may require higher strength or more doses.

Use: To produce mydriasis and cycloplegia for diagnostic procedures.

Renal Dose Adjustments

No dosage adjustment is recommended.

Liver Dose Adjustments

No dosage adjustment is recommended.

Dose Adjustments

Use caution in inflamed eyes as hyperemia greatly increases the rate of systemic absorption through the conjunctiva.

Heavily pigmented irides may require higher strength or more doses.

Systemic absorption can be minimized by applying pressure to the lacrimal duct for 1 to 2 minutes after instillation.

Precautions

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

-For topical use only, not for injection

-Contact lenses should be removed before use.

-Wash hands after administration to avoid accidental ingestion.

-Systemic absorption may be minimized by applying pressure to the lacrimal duct for 1 minute after instillation.

Storage requirements:

Store at 8C to 27C (46F to 80F); do not refrigerate; protect from light; keep container tightly closed.

General:

-Patients with heavily pigmented irides may require higher strength or more doses.

-Complete recovery from mydriasis may take up to 24 hours.

Patient advice:

-Patients should be advised to apply pressure to the lacrimal sac for 1 to 3 minutes after instillation, to minimize systemic absorption (especially in children).

-Parents should be warned about oral toxicity with accidental ingestion, and advised to wash their hands and the child's hands after use.

-Patients should be advised to protect eyes from bright light during dilation.

-Patients should be advised not to drive or perform potentially hazardous activities while pupils are dilated.

See also:
What is the most important information I should know about Sandol?

PAREMYD® Solution (hydroxyamphetamine hydrobromide/Sandol 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.

Use Sandol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Remove contact lenses before using Sandol.
• First, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 2 or 3 minutes after using the medicine. Do not blink. Keep your eyes closed for 2 or 3 minutes. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
• To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
• Use Sandol only in the eye. Do not get Sandol in your mouth or nose.
• Wash your hands after using Sandol. If the patient is a child, wash the child's hands as well.
• If you miss a dose of Sandol, contact your doctor for instructions.

Ask your health care provider any questions you may have about how to use Sandol.

This medication is used to widen (dilate) the pupil of the eye in preparation for certain eye examinations. It belongs to a class of drugs known as anticholinergics. Sandol works by relaxing certain eye muscles.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication is also used to treat swelling in different parts of the eye (e.g., iritis, iridocyclitis, keratitis).

How to use Sandol ophthalmic

To apply eye drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your eye or any other surface.

If you are wearing contact lenses, remove them before using this medication. Ask your doctor when you may replace your contact lenses.

Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place 1 or 2 drops into the pouch, usually 15 to 20 minutes before an eye examination or as directed by your doctor. Look downward and gently close your eyes for 1 to 2 minutes. Place one finger at the corner of your eye (near the nose) and apply gentle pressure for 2 to 3 minutes. This will prevent the medication from draining out and being absorbed by your body. Try not to blink and do not rub your eye. Repeat these steps for your other eye if so directed.

Do not rinse the dropper. Replace the dropper cap after each use.

If you are using another kind of eye medication (e.g., drops or ointments), wait at least 5 to 10 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.

Wash your hands after using this medication. If giving this medication to a child, do not let the medication get into the child's mouth. Also wash the child's hands after giving this medication.

See also:
What other drugs will affect Sandol?

The risks of using Olanzapine in combination with other drugs have not been extensively evaluated in systematic studies. Given the primary CNS effects of Olanzapine, caution should be used when Olanzapine is taken in combination with other centrally acting drugs and alcohol.

Because of its potential for inducing hypotension, Olanzapine may enhance the effects of certain antihypertensive agents.

Olanzapine may antagonize the effects of levodopa and dopamine agonists.

The Effect of Other Drugs on Olanzapine — Agents that induce CYP1A2 or glucuronyl transferase enzymes, such as omeprazole and rifampin, may cause an increase in Olanzapine clearance. Inhibitors of CYP1A2 could potentially inhibit Olanzapine clearance. Although Olanzapine is metabolized by multiple enzyme systems, induction or inhibition of a single enzyme may appreciably alter Olanzapine clearance. Therefore, a dosage increase (for induction) or a dosage decrease (for inhibition) may need to be considered with specific drugs.

Charcoal — The administration of activated charcoal (1 g) reduced the Cmax and AUC of oral Olanzapine by about 60%. As peak Olanzapine levels are not typically obtained until about 6 hours after dosing, charcoal may be a useful treatment for Olanzapine overdose.

Cimetidine and Antacids — Single doses of cimetidine (800 mg) or aluminum- and magnesium-containing antacids did not affect the oral bioavailability of Olanzapine.

Carbamazepine — Carbamazepine therapy (200 mg bid) causes an approximately 50% increase in the clearance of Olanzapine. This increase is likely due to the fact that carbamazepine is a potent inducer of CYP1A2 activity. Higher daily doses of carbamazepine may cause an even greater increase in Olanzapine clearance.

Ethanol — Ethanol (45 mg/70 kg single dose) did not have an effect on Olanzapine pharmacokinetics.

Fluoxetine — Fluoxetine (60 mg single dose or 60 mg daily for 8 days) causes a small (mean 16%) increase in the maximum concentration of Olanzapine and a small (mean 16%) decrease in Olanzapine clearance. The magnitude of the impact of this factor is small in comparison to the overall variability between individuals, and therefore dose modification is not routinely recommended.

Fluvoxamine — Fluvoxamine, a CYP1A2 inhibitor, decreases the clearance of Olanzapine. This results in a mean increase in Olanzapine Cmax following fluvoxamine of 54% in female nonsmokers and 77% in male smokers. The mean increase in Olanzapine AUC is 52% and 108%, respectively. Lower doses of Olanzapine should be considered in patients receiving concomitant treatment with fluvoxamine.

Warfarin — Warfarin (20 mg single dose) did not affect Olanzapine pharmacokinetics.

Lithium — Multiple doses of Olanzapine (10 mg for 8 days) did not influence the kinetics of lithium. Therefore, concomitant Olanzapine administration does not require dosage adjustment of lithium.

Valproate —In vivo administration of Olanzapine (10 mg daily for 2 weeks) did not affect the steady state plasma concentrations of valproate. Therefore, concomitant Olanzapine administration does not require dosage adjustment of valproate.

The co-administration of either diazepam or ethanol with Olanzapine potentiated the orthostatic hypotension observed with Olanzapine. Multiple doses of Olanzapine did not affect the pharmacokinetics of theophylline or its metabolites.

See also:
What are the possible side effects of Sandol?

Applies to Sandol ophthalmic: ophthalmic solution

In addition to its needed effects, some unwanted effects may be caused by Sandol ophthalmic (the active ingredient contained in Sandol). In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking Sandol ophthalmic, check with your doctor or nurse as soon as possible:

Symptoms of too much medicine being absorbed into the body

• Clumsiness or unsteadiness
• confusion
• fast heartbeat
• flushing or redness of face
• hallucinations (seeing, hearing, or feeling things that are not there)
• increased thirst or dryness of mouth
• skin rash
• slurred speech
• swollen stomach in infants
• unusual behavior, especially in children
• unusual drowsiness, tiredness, or weakness

Minor Side Effects

Some of the side effects that can occur with Sandol ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

• Blurred vision
• headache
• sensitivity of eyes to light
• stinging of the eye when the medicine is applied