click here for details           Atropine  (U.S.N.L.M.)
Dosing  (uveitis/iritis) 1 or 2 drops up to 4 times daily   (1% bid typically)
Dosing (cycloplegia) 1 or 2 drops 0.5% bid for 1 to 3 days before examination
(Consider cyclopentolate 1% administered 30 min before refraction.)
 (myopia prevention) 1 or 2 drops 0.05% qhs for mild progression3.
1 or 2 drops 0.5% or 1% weekly to qhs for strong progression.
Chem Specs atropine sulfate 0.5%, 1%, 2%
Quantities 2,5,15ml
Cost 45.00 5ml generic
Class anticholinergic
Action Competitive antagonist for the muscarinic acetylcholine receptor.
Usage Indicated for cycloplegic refraction or for pupil dilation in acute iritis and uveitis.
Used off label to prevent myopic progression.
Myopia Prevention Photophobia and cycloplegia is generally absent at low concentrations (0.01% to 0.05%).
With higher concentrations (0.5% or 1%) these side effects should be addressed with pro-
gressive and photochromic lenses. Higher concentrations may be associated with a steroid-
like rebound on cessation.1
Warnings Increased susceptibility in infants, young children, and in children with blond hair, blue eyes, Down's
syndrome, spastic paralysis, or brain damage. Ointment form thought to reduce systemic absorption.
Contraindications Primary glaucoma or a predisposition toward narrow angle glaucoma. Iris lens synechiae.
Pediatric patients who have previously had a severe systemic reaction to atropine. The elderly
and others where undiagnosed glaucoma or excessive pressure in the eye may be present.
Hypersensitivity to atropine or product contents.
Pediatric use > 3 months
Pregnancy Category C
Peak mydriasis 30-40 min. Peak cycloplegia 1-2 hrs. Recovery 6-12 days.
Nasolacrimal pressure recommended.
Compounding Note   Compounded 0.01% atropine typically labelled "0.1mg/ml atropine sulfate".
Systemic anticholinergics may be associated with increased risk of dementia.2
1. Virgilio GALVIS et. al., Med Hypothesis Discov Innov Ophthalmol. 2016 Autumn; 5(3): 78–88.
2. Shannon L. Risacher, PhD; Brenna C. McDonald, PsyD, MBA; Eileen F. Tallman, BS, et al. JAMA April 18, 2016.
3. Jason C. Yam, DOI: Published online: July 6, 2018