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Apraclonidine 1% w/v Eye Drops, Solution (apraclonidine hydrochloride) Prescribing Information can be found here. Adverse Event Reporting Information can be found at the end of this page.

Keeping intraocular pressure in check

Apraclonidine 1% w/v 2-dose regimen offers simple integration into existing clinical work flows and it's use in Anterior segment laser surgery could help in reducing burden on opthalmic services.1-6

Apraclonidine 1% w/v offers a simple 2-dose regimen

Apraclonidine 1% w/v is administered as two single drops, offering simple integration into existing workflows:1

One drop should be instilled into the eye scheduled for operation one hour before initiating anterior segment laser surgery

A second drop should be instilled into the same eye immediately upon completion of the laser surgical procedure

Apraclonidine 1% w/v use in anterior segment laser surgery may help alleviate burden on ophthalmic services2-6

Controlling IOP spikes post-operatively could reduce need for additional treatment2-6

By minimising the occurrence of IOP elevations, Apraclonidine 1% w/v may reduce the need for additional intervention burden on ophthalmic services.

Apraclonidine 1% w/v’s low price point allows inclusion without significant strain on budgets7,8

The cost of peri-operative IOP control with Apraclonidine 1% w/v represents a small fraction of the total cost of the anterior segment laser surgery. For example, a 2-dose vial of Apraclonidine 1% w/v represents only 6.1% of the cost of an SLT procedure.

One 2-dose vial of Apraclonidine 1% w/v costs £9.22 whilst the SLT procedure itself costs £151.

Apraclonidine 1% w/v is available as a unit dose preservative-free treatment9

Jaenen et al (2007) conducted a multicentre cross-sectional survey of 9,658 patients with open-angle glaucoma using preservative-containing (n = 8,092) or preservative-free (n = 1,138) beta-blocker eyedrops. At the first visit, patient demographics, treatment type/duration, and symptoms were recorded. Patients were recruited across four European countries (Italy, France, Belgium, and Portugal) and were enrolled between June 1997 and December 2003.10

The study showed that showed that participants receiving preservative-free eyedrops experienced significantly lower rates of ocular side effects than those receiving preserved eyedrops (p<0.0001).10

Most common ocular symptoms and side effects in persevered vs. preservative-free groups:*²
Ocular symptom/sign Preserved eyedrops**
(n = 8092)		 Preservative-free eyedrops
(n = 1138)
Pain or discomfort during instillation 47.6% [3,826] 18.5% [202]
Foreign body sensation 41.9% [3,369] 14.8% [163]
Stinging or burning 47.5% [3,811] 19.6% [216]
Dry eye sensation 34.9% [2,798] 16.0% [176]
Tearing 27.3% [2,187] 12.4% [137]
Conjunctival hyperaemia 53.0% [4,278] 20.5% [231]
Superficial punctate keratitis 25.6% [1,941] 8.9% [89]

*Table shows side effects occurring in >25% of participants. Other ocular side effects assessed: eyelid itching, anterior and posterior blepharitis, eczema and conjunctival follicles. **Includes patients receiving at least one eye drop medication that contained preservatives.

Preservative-free eyedrops such as Apraclonidine 1% w/v9 may reduce ocular signs and symptoms like pain, stinging, and conjunctival hyperaemia when compared to preserved formulations.10

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Essential Pharma on +44 (0)1423 850700 or at MedicalInformation-UK@essentialpharmagroup.com.

IOP, intraocular pressure.

References
  1. Apraclonidine 1% w/v eye drops solution. Summary of Product Characteristics.
  2. Silverstone DE et al. Am J Ophthalmol. 1992;113(4):401–405.
  3. Pollack IP et al. Arch Ophthalmol. 1988;106(6):754–757.
  4. Robin AL et al. Arch Ophthalmol. 1987;105(5):646–650.
  5. Zhang L, Weizer JS, Musch DC. Cochrane Database Syst Rev. 2017;2(2):CD010746.
  6. National Institute for Health and Care Excellence. NICE guideline NG81 – Glaucoma: diagnosis and management. Available at: http://www.nice.org.uk/guidance/ng81 [Accessed March 2026].
  7. NHS Business Services Authority. Electronic Drug Tariff – Part VIIIA Products A. Available at: https://www.drugtariff.nhsbsa.nhs.uk/ [Accessed March 2026].
  8. National Institute for Health and Care Excellence. Resource impact report NG81. Glaucoma: diagnosis and management - partial update. Available at: https://www.nice.org.uk/guidance/ng81/resources/resource-impact-reportpdf-10951377517 [Accessed March 2026]
  9. NHS Business Services Authority. Dictionary of Medicines and Devices (dm+d) Browser: Apraclonidine 1% eye drops. Available at: https://dmdbrowser.nhsbsa.nhs.uk/vmp/view/4257/ [Accessed March 2026].
  10. Jaenen N et al. Eur J Ophthalmol. 2007;17(3):341–349.

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Jaenen et al (2007): study design

Study overview

Objective: To compare the prevalence of side effects between eyedrops with or without preservatives, in terms of subjective symptoms and objective signs in patients with open-angle glaucoma.

Jaenen et al was a multicentre, cross-sectional epidemiological survey, assessing side effect burden in patients using preserved (P) or preservative-free (PF) beta blocking eye drops. The study recruited 9,658 non-consecutive patients across four European countries (Italy, France, Belgium and Portugal), of which 6,083 patients were included in final analysis of outcomes. Patients were enrolled between June 1997 and December 2003.

At first visit, clinicians recorded patient demographics and treatment details. At the end of the first visit, therapy could be changed. Stated reasons for this included intolerance of eyedrops, progression of glaucoma and nonresponse to treatment. At second visit, approximately 2 months later (mean interval 67 days), clinicians assessed side-effect burden after switching to preservative-free drops. Patient outcomes were assessed in 5 subgroups according to their treatment regimen at first and second visits: P-P, P-PF, PF-P, PF-PF, and P-fewer P drops.

For statistical analysis, a χ2 test was used to calculate any significant difference in the prevalence of ocular symptoms and signs between the preserved and preservative-free groups.

Patient demographics

Demographic Number (%)
Patients enrolled 9,658 (100)
Italy (country recruited) 4,977 (51.5)
France (country recruited) 4,107 (42.5)
Belgium (country recruited) 330 (3.4)
Portugal (country recruited) 244 (2.5)
Patients with two visits performed 6,532 (67.6)
Patients evaluated for treatment difference 6,083 (63.0)

P, preserved; PF, preservative-free.
Jaenen N et al. Eur J Ophthalmol. 2007;17(3):341-349.