Oxymetazoline Hydrochloride ophthalmic solution is indicated for the treatment of acquired blepharoptosis (drooping of the upper eyelid) in adults.

Oxymetazoline is an alpha-adrenoceptor agonist that selectively targets a subset of adrenoceptors located in Müller’s muscle of the eyelid. Activation of these receptors leads to mild contraction of the muscle, resulting in elevation of the upper eyelid.

Instill one drop of oxymetazoline into one or both ptotic eye(s) once daily. Discard the single patient-use container immediately after dosing.

Contact lenses should be removed prior to instillation of oxymetazoline and may be reinserted 15 minutes following its administration.

If more than one topical ophthalmic drug is being used, the drugs should be administered at least 15 minutes between applications.

Pediatric Use: Safety and effectiveness of UPNEEQ have not been established in pediatric patients under 13 years of age.

Antihypertensives/Cardiac Glycosides: Alpha-adrenergic agonists may affect blood pressure. Caution is advised when using drugs such as beta-blockers, antihypertensive agents, and cardiac glycosides. Care is also required in patients receiving alpha-adrenergic receptor antagonists used for cardiovascular disease or benign prostatic hypertrophy.

Monoamine Oxidase Inhibitors (MAOIs): Caution is advised in patients taking MAO inhibitors, as they may affect the metabolism and uptake of circulating amines.

Most common adverse reactions (1–5%) include punctate keratitis, conjunctival hyperemia, dry eye, blurred vision, instillation site pain, eye irritation, and headache.

There are no adequate data in pregnant women to determine drug-associated risk of birth defects or miscarriage. No clinical data are available regarding its effect on breast milk production or presence in human milk. However, oxymetazoline has been detected in the milk of lactating rats. The benefits of breastfeeding should be weighed against the mother’s clinical need for the drug and any potential risk to the infant.

Cardiovascular Effects: Alpha-adrenergic agonists may affect blood pressure. Use with caution in patients with severe or unstable cardiovascular disease, orthostatic hypotension, or uncontrolled hypertension/hypotension. Patients should seek immediate medical attention if symptoms worsen.

Vascular Insufficiency: Use cautiously in patients with cerebral or coronary insufficiency or Sjögren’s syndrome. Seek medical help if symptoms of vascular insufficiency worsen.

Angle-Closure Glaucoma: May increase risk in patients with untreated narrow-angle glaucoma. Immediate medical attention is required if symptoms occur.

Contamination Risk: Do not touch the dropper tip to the eye or any surface to avoid contamination or injury.

Accidental oral ingestion of topical formulations containing imidazoline derivatives (such as oxymetazoline) in children has caused serious adverse effects requiring hospitalization. Symptoms may include nausea, vomiting, lethargy, tachycardia, respiratory depression, bradycardia, blood pressure changes, sedation, drowsiness, mydriasis, stupor, hypothermia, drooling, and coma. Keep the product out of reach of children.

Other ophthalmic preparations.

Store at 20°C to 25°C. Protect from excessive heat. Keep out of reach of children.