1% ophthalmic preparation: Used as a cycloplegic and mydriatic agent for refraction and for producing pupil dilation in acute inflammatory conditions affecting the iris or uveal tract.

0.01% ophthalmic preparation: Indicated for slowing the progression of myopia in children aged 4 to 14 years. Treatment may be initiated when progressive myopia is diagnosed.

The mechanism by which atropine sulfate slows the progression of myopia is not fully understood. Muscarinic receptors are widely present in ocular tissues and are involved in eye growth, development, and accommodation. Atropine is believed to act by binding to muscarinic receptors located in scleral fibroblasts and possibly in the retina, particularly the M1, M3, and M4 subtypes. This interaction influences intracellular signaling pathways such as MEK-ERK-MAPK and enzymes like transglutaminases, and may also affect dopamine release. These changes contribute to scleral remodeling and strengthening, leading to reduced axial elongation of the eye and decreased vitreous chamber depth, thereby slowing the progression of myopia.

1% ophthalmic preparation

• For uveitis: One drop three times daily
• For refraction: One drop in the eyes twice daily for one or two days before examination, and one hour before examination. Pressure should be maintained over lacrimal sac, occluding lacrimal duct for one minute after instillation.

0.01% ophthalmic preparation- This paediatric eye drops should be administered as one drop to each eye at night. The maximum benefit of treatment may not be achieved with less than a 2-year continued administration period. To minimize the risk of systemic absorption, gentle pressure should be applied to the tear duct for one minute after application.

Atropine Sulfate should not be used concomitantly with certain medications due to the risk of significant interactions. These include other anticholinergic agents, antiglaucoma drugs, potassium citrate, potassium supplements, and cholinergic agents such as carbachol, physostigmine, or pilocarpine. Caution is also advised when used with central nervous system (CNS) medications.

This ophthalmic preparation is contraindicated in patients with angle-closure glaucoma or in those suspected of having it. In patients at risk, the anterior chamber angle should be evaluated before initiating treatment.

Atropine Sulfate may be systemically absorbed after ocular use; however, significant harmful effects on the fetus have not been reported. Small amounts may pass into breast milk and could cause effects such as tachycardia, fever, or dry skin in nursing infants.

Atropine Sulfate should not be used in children with a history of severe systemic reactions to atropine. Increased sensitivity has been reported in children with Down’s syndrome, spastic paralysis, or brain injury; therefore, it should be used with caution in these patients. For long-term therapy, regular ophthalmic evaluations are recommended, including monitoring of anterior segment development, intraocular pressure (IOP), retinal health, and progression of myopia. This preparation is not recommended for use in children under 4 years of age.

In case of overdose, rinse the eyes with water and seek immediate medical attention. Symptoms may include headache, rapid heartbeat, dry mouth and skin, drowsiness, and flushing.

Mydriatic and cycloplegic agents.

Store below 30°C in a dry place, protected from light. Keep out of reach of children. Avoid touching the dropper tip to prevent contamination. Do not use the eye drops more than one month after opening.