The Medical Letter TML n. 13 / 2024
Nr. 13 del 24/06/2024
TML n. 13 / 2024 Fentolamina oftalmica per la midriasi indotta da farmaci
La US Food and Drug Administration (FDA) ha approvato una soluzione oftalmica allo 0,75% dell'antagonista alfa-adrenergico fentolamina (Ryzumvi - Viatris in USA; non disponibile in commercio in Italia) per il trattamento della midriasi indotta da agonisti adrenergici come la fenilefrina o da agenti parasimpaticolitici come la tropicamide in pazienti di età ≥3 anni. Ryzumvi è il primo farmaco approvato negli Stati Uniti per la cura della midriasi indotta farmacologicamente.
FARMACOLOGIA – I farmaci che provocano midriasi, come la combinazione di un agonista alfa-adrenergico e di un agente parasimpaticolitico, vengono somministrati comunemente per poter effettuare valutazioni o procedure chirurgiche oftalmiche; possono causare fotofobia e visione offuscata fino a 24 ore. (1) La fentolamina si lega ai recettori adrenergici alfa-1 sul muscolo dilatatore radiale dell'iride, riducendo il diametro della pupilla e invertendo la midriasi indotta farmacologicamente. La fentolamina ha un inizio d'azione di circa 30 minuti; gli effetti massimi si osservano solitamente entro 60-90 minuti.
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