Mydrane (Lidocaine Hydrochloride Monohydrate, Phenylephrine Hydrochloride, Tropicamide)

Mydrane is employed in ophthalmic procedures to achieve rapid pupil dilation and intraocular anesthesia.

• Cataract surgery: provides rapid pupil dilation and intraocular anesthesia for safe lens removal.
• Intraocular lens implantation: facilitates adequate mydriasis and analgesia during lens placement.
• Other ocular surgeries: enables pupil dilation and anesthesia for procedures such as trabeculectomy or vitrectomy.

• Mydrane combines three agents that act synergistically: lidocaine blocks voltage‑gated sodium channels, producing local anesthesia of intraocular tissues; phenylephrine stimulates α1‑adrenergic receptors on the iris dilator muscle, causing contraction and pupil dilation; tropicamide antagonizes muscarinic receptors in the iris sphincter, further relaxing the muscle and enhancing dilation. The combined effect yields prompt mydriasis and analgesia for intra‑ocular surgery.

Mydrane may cause a range of ocular and systemic reactions following intracameral administration.

Common Side Effects

• Transient ocular pain or discomfort.
• Mild conjunctival redness.
• Temporary increase in intraocular pressure.
• Blurred vision lasting a few minutes.
• Headache.
• Nausea.

Serious or Rare Side Effects

• Allergic reaction (rash, swelling, anaphylaxis).
• Persistent mydriasis leading to photophobia.
• Corneal edema or endothelial damage.
• Retinal toxicity.
• Systemic lidocaine toxicity (central nervous system or cardiac effects).
• Severe hypotension or hypertension from phenylephrine imbalance.

Prior to using Mydrane, clinicians should observe several safety measures.

• Assess patient allergy: verify no known hypersensitivity to lidocaine, phenylephrine or tropicamide.
• Monitor intraocular pressure: check IOP before and after injection.
• Use appropriate dose: administer only by a qualified ophthalmic surgeon.
• Avoid in patients with narrow‑angle glaucoma: risk of angle‑closure crisis.
• Avoid in patients with severe cardiovascular disease: phenylephrine may raise blood pressure.
• Store at ambient temperature: keep in original container, protect from light and moisture.

Mydrane can interact with other medications that affect ocular or systemic physiology.

Major Interactions (Avoid)

• MAO inhibitors: phenylephrine may precipitate hypertensive crisis.
• Beta‑blockers: may potentiate ocular hypotensive effects.
• Systemic anesthetics: lidocaine may increase risk of toxicity.

Moderate Interactions (Monitor Closely)

• Anticholinergic drugs: additive mydriasis.
• Alpha‑adrenergic agonists: additive cardiovascular effects.
• Other ocular vasoconstrictors: increased risk of ocular ischemia.