Potential API Contraindications

Prednisolone Phosphate

• Adverse Reactions: 
  • Secondary ocular infection 
  • Glaucoma 
  • Increased intraocular pressure 
  • Optic nerve damage 
  • Subcapsular posterior cataract
  • Blurred vision 
  • Dysgeusia (altered taste) 
  • Eye irritation 
  • Eye pain
  • Foreign body sensation of eye
  • Headache 
  • Hypersensitivity reaction 
  • Pruritis (itching)
  • Skin rash 
  • Transient burning 
  • Stinging of the eyes 
  • Urticaria (rash of round red welts or swelling) 
  • Visual Disturbance 
• Contraindications:
  • Cataracts
  • Corneal thinning 
  • Glaucoma 
  • Immunosuppression 
  • Systemic Absorption 

Moxifloxacin

• Adverse Reactions: 
  • Eye irritation 
  • Conjunctivitis 
  • Decreases visual acuity 
  • Eye discomfort or pain 
  • Pruritus
  • Lacrimation 
  • Ocular hyperemia (dilation and redness of the conjunctival vessels) 
  • Subconjunctival hemorrhage (bright red patch appearing in the white of the eye)
  • Xerophthalmia (abnormal dryness of the conjunctiva and cornea of the eye) 
• Contraindications: 
  • Hypersensitivity to moxifloxacin or other quinolones in any component or other forms 

Bromfenac

• Adverse Reactions: 
  • Anterior chamber inflammation 
  • Iritis (inflammation of the iris)
  • Ocular hypertension 
  • Vitreous Opacity (seeing floaters on the eye)
  • Eye pain 
  • Abnormal sensation in the eyes
  • Conjunctival Hyperemia (dilation and redness of the conjunctival vessels)
  • Eye irritation (burning/stinging) 
  • Eye pruritus 
  • Eye redness 
• Contraindications:
  • Allergic cross-reactivity to nonsteroidal anti-inflammatory drugs (NSAIDS) 

Gatifloxacin

• Adverse Reactions:
  • Conjunctival hemorrhage (red patch appearing in the white of the eye) 
  • Conjunctival irritation 
  • Conjunctivitis 
  • Decreased visual acuity 
  • Dry eye syndrome 
  • Eye discharge 
  • Eye irritation 
  • Eye pain and redness 
  • Eyelid edema (eyelid swelling)
  • Blepharitis (inflammation of eyelid)
  • Increased lacrimation 
  • Keratitis (inflammation of the cornea of the eye)
  • Papillary conjunctivitis (allergic reaction of the eye)
    • Small round bumps develop on the underside of the eyelid 
  • Blurred vision 
• Contraindications:
  • Hypersensitivity to Gatifloxacin or quinolones in any component or form 

Dexamethasone

• Adverse Reactions: Implant or Injection 
  • Cataract (incidence increases in patients requiring a second injection) 
  • Conjunctival hemorrhage
  • Corneal edema 
  • Increased intraocular pressure 
  • Iritis 
  • Anterior chamber inflammation 
  • Blepharitis
  • Blepharoptosis (drooping of the upper eyelid) 
  • Blurred vision 
  • Conjunctival edema 
  • Conjunctival hyperemia 
  • Conjunctivitis 
  • Corneal erosion 
  • Cystoid macular edema 
  • Decreased visual acuity 
  • Eye pain 
  • Foreign body sensation 
  • Keratitis
  • Ocular hypertension
  • Ophthalmic inflammation 
  • Photophobia 
  • Retinal hole without detachment 
  • Secondary cataract 
  • Vitreous detachment 
  • Vitreous opacity 
  • Xerophthalmia (abnormal dryness of the conjunctiva and cornea of the eye)
• Adverse Reactions: solution or suspension 
  • Eye discomfort 
  • Eye irritation 
  • Abnormal sensation in the eyes (foreign body sensation of eye) 
  • Blurred vision 
  • Conjunctivitis 
  • Crusting of eyelid 
  • Dry eye syndrome 
  • Eye pruritis 
  • Increased lacrimation 
  • Keratitis 
  • Ocular hyperemia 
  • Photophobia 
  • Burning sensation 
  • Cataract 
  • Decreased visual acuity 
  • Eye perforation 
  • Glaucoma (with optic nerve damage) 
  • Inadvertent filtering bleb 
  • Stinging of the eyes 
  • Visual field defect 
  • Blepharoptosis (drooping of the upper eye lid)
  • Corneal erosion 
  • Endophthalmitis (infection inside the eye) 
  • Eye pain 
  • Hypotony of eye (vitreous leakage from injection) 
  • Injury to the eye region 
  • Mydriasis (dilation of the pupil) 
  • Retinal detachment 
• Contraindications: Implant or Injection 
  • Intracanalicular insert: 
    • Active corneal, conjunctival or canalicular infections including epithelial herpes simplex keratitis, vaccinia, varicella, mycobacterial infections and fungal diseases
    • In patients with a posterior lens capsule that is torn or ruptured 
  • Intravitreal ocular implant: 
    • Hypersensitivity to dexamethasone or any component of the formulation
    • Glaucoma with a cup to disc ratio of >0.8
    • Active corneal, conjunctival or canalicular infections including epithelial herpes simplex keratitis, vaccinia, varicella, mycobacterial infections and fungal diseases
    • In patients with a posterior lens capsule that is torn or ruptured
  • Ophthalmic suspension, solution, ointment:
    • Hypersensitivity to dexamethasone or any component of the formulation
    • Active corneal, conjunctival or canalicular infections including epithelial herpes simplex keratitis, vaccinia, varicella, mycobacterial infections and fungal diseases
    • In patients with a posterior lens capsule that is torn or ruptured

Tropicamide

• Adverse Reactions:
  • Blurred vision 
  • Photophobia 
  • Stinging of eyes 
  • Superficial punctate keratitis
  • Increased intraocular pressure 
• Contraindications: 
  • Hypersensitivity to tropicamide or any component of the formulation 

Phenylephrine

• Adverse Reactions:
  • Burning sensation of eyes
  • Eye irritation
  • Miosis (excessive constriction of the pupil of the eye) 
  • Visual disturbance
  • Vitreous opacity 
• Contraindications:
  • Hypertension and thyrotoxicosis in infants younger than 1 year 

Timolol

• Adverse Reactions:
  • Burning sensation of eyes 
  • Stinging of the eyes 
  • Blepharitis 
  • Blepharoptosis (drooping of the upper eye lid)
  • Blurred vision 
  • Cataract 
  • Choroidal detachment following filtration surgery 
  • Conjunctival injection 
  • Conjunctivitis 
  • Cystoid macular edema 
  • Decreased corneal sensitivity 
  • Decreased visual acuity
  • Diplopia (double vision)  
  • Eye discharge 
  • Eye pain 
  • Eye pruritus 
  • Foreign body sensation of the eye 
  • Hyperemia 
  • Keratitis
  • Lacrimation 
  • Visual disturbance 
  • Xerophthalmia (abnormal dryness of the conjunctiva and cornea of the eye)
• Contraindications:
  • Documented cross-reactivity for other ophthalmic beta-adrenergic blocking agents 

Brimonidine

• Adverse Reactions:
  • Burning 
  • Follicular conjunctivitis 
  • Visual disturbance 
  • Blepharitis 
  • Blepharoconjunctivitis (inflammation of the eye lid and conjunctiva)
  • Blurred vision 
  • Cataract 
  • Conjunctival edema 
  • Conjunctival hemorrhage 
  • Conjunctivitis 
  • Decreased visual acuity 
  • Dry eye syndrome 
  • Epiphora (watery eye)
  • Eye discharge 
  • Eye irritation 
  • Eyelid disease 
  • Eyelid edema 
  • Eye pain 
  • Keratitis 
  • Photophobia 
  • Sting of eyes
  • Superficial punctate keratitis 
  • Visual field defect 
  • Vitreous detachment 
  • Vitreous opacity 
• Contraindications:
  • Hypersensitivity to Brimonidine 
  • Use in infants 
  • Concomitant use of MOA inhibitors 

Dorzolamide

• Adverse Reactions:
  • Burning sensation of eyes 
  • Eye discomfort 
  • Stinging of eyes
  • Superficial punctate keratitis 
  • Blurred vision 
  • Conjunctivitis 
  • Eyelid irritation 
  • Eye redness 
  • Lacrimation 
  • Photophobia 
  • Xerophthalmia (abnormal dryness of the conjunctiva and cornea of the eye)
  • Iridocyclitis (inflammation of the iris and the ciliary body)
  • Crusting of the eyelid
  • Epistaxis 
  • Myopia
  • Ocular pain 
• Contraindications:
  • Hypersensitivity to Dorzolamide or any other form

Latanoprost

• Adverse Reactions: 
  • Eye Pain 
  • Stinging of the eyes
  • Ocular Hyperemia 
  • Conjunctival Hyperemia 
  • Eye Discharge 
  • Increased eyelash length 
  • Increased eyelash thickness
  • Punctuate keratitis 
  • Blurred vision 
  • Eye pruritis
  • Burning sensation of the eyes 
  • Iris hyperpigmentation 
  • Decreased visual acuity 
  • Eyelid pain 
  • Lacrimation 
  • Crusting of eyelid 
  • Dry eye syndrome 
  • Photophobia 
  • Eyelid Edema 
  • Conjunctival edema 
• Contraindications:
  • Hypersensitivity to latanoprost 
  • Hypersensitivity to benzalkonium chloride (preservative)  

Bimatoprost

• Adverse Reactions: 
  • Eye hyperemia (dilation and redness of the conjunctival vessels)
  • Eye edema
  • Eye hemorrhage
  • Eye irritation
  • Eye pain
  • Eye pruritus (itching)
  • Erythema of eyelid (Redness)
  • Eyelids pruritus (itching)
  • Growth of eyelashes
  • Instillation site irritation
  • Punctate keratitis
  • Skin hyperpigmentation
  • Vision blurred
  • Visual acuity reduced
  • Dry eye
• Contraindications:
  • Bimatoprost is contraindicated in patients with hypersensitivity to bimatoprost or to any of the ingredients.

Atropine

• Adverse Reactions:
  • Blurred Vision 
  • Decreased lacrimation 
  • Decreased visual acuity (reversible, healthy eye) 
  • Eye irritation 
  • Eye pain 
  • Eyelid edema 
  • Papillary conjunctivitis 
  • Photophobia 
  • Stinging of eyes 
  • Superficial Keratitis 
• Contraindications:
  • Hypersensitivity to Atropine or any form 
  • Primary Glaucoma or tendency toward angle-closure glaucoma (narrowing or closure of anterior chamber)
  • Documentation of an allergic cross-sensitivity for anticholinergic medication 

Ketorolac

• Adverse Reactions:
  • Burning sensation of the eyes
  • Stinging of the eyes 
  • Blurred vision 
  • Conjunctival hyperemia 
  • Corneal edema 
  • Corneal infiltrates 
  • Eye irritation or pain 
  • Eyelid edema 
  • Increased intraocular pressure 
  • Lacrimation 
  • Ocular edema 
  • Ocular hyperemia 
  • Superficial eye infection 
  • Superficial keratitis 
  • Swelling of the eye 
  • Corneal ulcer 
  • Dry eye syndrome 
  • Corneal erosion 
  • Corneal perforation
  • Corneal thinning
• Contraindications:
  • Hypersensitivity to ketorolac or any other form 
  • Documentation of a cross-sensitivity reaction to other NSAIDs 

Reference: 

• Lexi-Comp Online®, Lexi-drugs, Hudson, Ohio: Lexi-comp, Inc.; September 9th, 2021.