Dipivefrine


Dipivefrine or dipivefrin, trade name Propine among others, is a prodrug of epinephrine, and is used to treat open-angle glaucoma. It is available as a 0.1% ophthalmic solution. It is no longer available in the United States.

Contraindications

Use in narrow-angle glaucoma may be dangerous because it could make the eye susceptible to an attack of angle closure, causing an increase in pressure and pain, and possibly loss of vision.

Side effects

The most common side effects of dipivefrine are burning, stinging and other irritations of the eye. Possible, but uncommon, side effects are those of epinephrine: tachycardia, hypertension and arrhythmias.

Pharmacology

Dipivefrine penetrates the cornea and is then hydrolysed to epinephrine by esterase enzymes. It increases outflow of the aqueous humour and also reduces its formation, thus reducing pressure inside the eye. It also increases the conductivity of trabecular filtering cells. It is preferred to epinephrine because it is longer acting, more consistent in its action and better tolerated.