Neonatal Intensive Care Drug Manual

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Special comments
Cyclomydril is an unapproved medicine in Australia and New Zealand.
Evidence	Efficacy Trials comparing mydriatics: Several controlled studies have reported the mydriatic effect of cyclopentolate 0.2% + phenylephrine 1% [Cyclomydril] in preterm infants screened for ROP. Isenberg et al [1], in 30 preterm infants, reported that the cyclopentolate 0.2% + phenylephrine 1% combination produced greater mydriasis and longer duration of mydriasis than cyclopentolate 0.5% + tropicamide 0.5% or cyclopentolate 0.5% alone [LOE III-2]. Chew et al[2], in 39 infants with dark irides randomly allocated to cyclopentolate 1% + phenylephrine 2.5% versus tropicamide 1% + phenylephrine 2.5% versus cyclopentolate 0.2% with phenylephrine 1%, reported all three mydriatic regimens provided adequate pupillary dilation at 45 minutes, with dilation sustained at 60 minutes. They concluded the combination cyclopentolate 0.2% + phenylephrine 1% provided adequate pupillary dilation with the least systemic side effects [LOE II].

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