Atropine 0.01% eye drops are not commercially available and Atropt 1% should not be supplied.
Despite warning its pharmacist members against this error in 2018, PDL continues to receive incident reports relating to the dispensing of Atropine eye drops 1%, when 0.01% was prescribed. The weaker form of atropine eye drops (0.01%) is typically prescribed to children to treat myopia and these eye drops must be compounded by a pharmacy that is equipped to provide sterile compounding services.
Using the full strength atropine in the eye of a child will naturally result in extreme discomfort in the treated eye and an aversion to bright light which will often require a period of absence from school.
PDL has warned of this.
Case Scenario
An ophthalmologist prescribed “0.01% atropine eye drops in each eye daily for myopic control” for a 13 year old. It is assumed the prescribing software used by the doctor did not accommodate the writing of a strength of 0.01%, so the 1% standard script was computer generated, with an alteration to 0.01% by hand. This alteration may have confused the dispensing pharmacist who provided Atropt1%, which caused a ‘loss of vision’ as reported by the mother of the patient. If a changed or altered script is presented to a pharmacist, and the intended order is unclear, the prescriber should always be contacted for clarification.
Myopia is nearsightedness which results in distant objects being blurred. This condition is corrected in adults by glasses or laser surgery.
As myopia does not generally stabilise until the age of 18-20 years old, children are treated with low dose atropine in any attempt to stop or slow the progression to established myopia. Children aged between 5 and 15 years are typically treated for at least 6 months. If improvement is noted, treatment can last for up to 2 years or until age of 15 is reached. There are no reported side effects and accommodation is not affected, unlike the full strength atropine.
For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7, Australia-wide.
