Mydrane (Lidocaine Hydrochloride Monohydrate, Phenylephrine Hydrochloride, Tropicamide)

Mydrane is used in ophthalmic procedures to achieve intra‑operative pupil dilation and anesthesia.

• Cataract surgery: provides rapid pupil dilation and corneal anesthesia during the procedure.
• Intra‑operative ocular examination: facilitates visualization of intra‑ocular structures.
• Combined anterior segment surgeries: enables adequate mydriasis and analgesia for procedures such as phacoemulsification.

• Mydrane combines three agents: lidocaine blocks voltage‑gated sodium channels in ocular nerves, producing local anesthesia; phenylephrine acts as an α1‑adrenergic agonist, contracting the dilator pupillae muscle; tropicamide antagonizes muscarinic receptors, relaxing the sphincter pupillae muscle. The combined actions result in rapid, sustained mydriasis and corneal anesthesia suitable for intra‑operative use.

Mydrane may cause ocular and systemic reactions, which are categorized by frequency.

Common Side Effects

• Transient blurred vision: temporary reduction in visual clarity after administration.
• Mild ocular discomfort: brief sensation of irritation or pressure.
• Conjunctival hyperemia: mild redness of the eye.
• Increased intra‑ocular pressure: temporary rise in eye pressure.

Serious or Rare Side Effects

• Allergic reaction: signs such as swelling, rash, or anaphylaxis.
• Persistent mydriasis: prolonged pupil dilation beyond the expected period.
• Corneal endothelial toxicity: rare damage to corneal cells.
• Endophthalmitis: severe intra‑ocular infection.

Prior to using Mydrane, clinicians should observe the following precautions.

• Patient history: verify no known hypersensitivity to lidocaine, phenylephrine, or tropicamide.
• Cardiovascular status: avoid in patients with uncontrolled hypertension or severe cardiac disease.
• Glaucoma: use cautiously in eyes with narrow angles or uncontrolled glaucoma.
• Pregnancy and lactation: safety not established; consider risk‑benefit before use.
• Drug interactions: review concomitant ocular or systemic adrenergic agents.
• Store at controlled room temperature: keep in original container, protect from light and moisture.

Mydrane can interact with other medications; awareness of these interactions helps prevent adverse outcomes.

Major Interactions (Avoid)

• Systemic phenylephrine: may cause excessive hypertension when combined.
• MAO inhibitors: increase risk of hypertensive crisis with phenylephrine component.
• Other mydriatics: additive pupil dilation leading to prolonged mydriasis.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may blunt cardiovascular response to phenylephrine.
• Anticholinergic drugs: may enhance tropicamide effects.
• Topical anesthetics: overlapping lidocaine exposure may increase local toxicity.