Tropicamide
Dilation & diagnostic · Rx
Trade namesMydriacyl, Tropicacyl
Drug classShort-acting anticholinergic mydriatic/cycloplegic
Strength0.5%, 1%
AvailabilityRx
Mechanism of actionMuscarinic antagonist; blocks the iris sphincter and ciliary muscle. Fastest onset and shortest duration of the anticholinergic mydriatics.
Indication / reason for useRoutine dilated fundus examination; weak cycloplegic refraction in adults/older children.
Usual adult dosing1 drop of 1% (repeat once at 5 min if needed); mydriasis in 15-30 min, recovery 4-8 h. Cycloplegia is incomplete.
PreservativeBAK 0.01%
Contact lensesRemove lenses before instillation; reinsert once dilated / after 15 minutes.
Common / important adverse effectsPhotophobia, blurred near vision, stinging; rare CNS effects in children (restlessness, flushing); can precipitate angle-closure in anatomically narrow angles.
Contraindications & cautionsUntreated narrow angles / prior angle-closure without patent iridotomy. Caution with Down syndrome and in infants (systemic sensitivity).
Pregnancy / lactationSingle diagnostic dose considered low risk; use punctal occlusion.
Practice notesFor a true cycloplegic refraction in a young hyperope, cyclopentolate or atropine is needed, tropicamide leaves too much accommodation.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.