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Mydcombi

tropicamide / phenylephrine
Used for Pupil Dilation
Used for Pupil Dilation

Mydcombi (tropicamide / phenylephrine) is a spray containing two medications: tropicamide and phenylephrine that work together to dilate (widen) the pupil of your eye(s). This helps your provider examine your eye better. You will receive this medication at a clinic, where your provider will spray a mist onto the eye that needs to be dilated. Common side effects include blurred vision, changes in your vision, and some minor eye discomfort. This medication comes as a brand name only, so it's not available in a generic version.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Kristianne Hannemann, PharmD
Last reviewed on July 23, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageContraindicationsAlternativesReferencesPricesMedicare
basics-icon

What is Mydcombi (tropicamide / phenylephrine)?

What is Mydcombi (tropicamide / phenylephrine) used for?

  • Dilate pupils for eye examinations

How Mydcombi (tropicamide / phenylephrine) works

Mydcombi (tropicamide / phenylephrine) is a combination of two medications:

Are you looking for information on tropicamide (Mydriacyl) or phenylephrine eye drops instead?

Drug Facts

Common BrandsMydcombi
Drug ClassAnticholinergic / Alpha-1 agonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Mydcombi (tropicamide / phenylephrine)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Temporary blurred vision
  • High pressure in the eye
  • Light sensitivity
  • Eye discomfort

Other Side Effects

  • Dry mouth
  • Fast heart rate
  • High blood pressure
  • Headache
  • Nausea
  • Vomiting
  • Muscle stiffness

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Brain and nervous system problems: hallucinations (seeing things that aren't real), confusion, abnormal behavior

Source: DailyMed

pros-and-cons

Pros and cons of Mydcombi (tropicamide / phenylephrine)

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Pros

Starts dilating pupils within minutes

Can be used in adults and children

Combination of two medications in a single spray

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Cons

Dilating effects can last for up to 24 hours

Can raise your blood pressure or heart rate

Can cause side effects to other parts of your body, like dry mouth and headache

pharmacist-tips

Pharmacist tips for Mydcombi (tropicamide / phenylephrine)

pharmacist

  • Before receiving Mydcombi (tropicamide / phenylephrine), let your provider know if you take any other anticholinergic medication, pilocarpine, artificial tears, or any other eye medications. This is because certain medications can interact with Mydcombi (tropicamide / phenylephrine) and raise your risk for side effects.

    • Before receiving Mydcombi (tropicamide / phenylephrine), make sure to follow your provider's instructions for when to remove and put back your contact lens in your eye.

      • Mydcombi (tropicamide / phenylephrine) can cause blurry vision and light sensitivity for up to 24 hours after receiving your dose. Don't drive or do anything that requires you to focus while your pupils are dilated.

        • After receiving Mydcombi (tropicamide / phenylephrine), your eyes might be more sensitive to light while your pupils are dilated. It's important that you protect your eyes from light as much as possible until the medication's effects wear off.

          • Mydcombi (tropicamide / phenylephrine) can cause side effects to other parts of your body, including dry mouth, headache, fast heart rate, nausea, and vomiting. If you get any of these side effects, let your provider know.

            faqs

            Frequently asked questions about Mydcombi (tropicamide / phenylephrine)

            What should I expect after receiving Mydcombi (tropicamide / phenylephrine)?
            After receiving Mydcombi (tropicamide / phenylephrine), your eyes won't be able to naturally react to light as they usually do. This means you'll be sensitive to light. To avoid discomfort and pain, you should wear sunglasses when you're outside during the day until your eyes have fully recovered. Additionally, your vision might be a little blurry. Don't drive until your eyes have recovered.
            How quickly does Mydcombi (tropicamide / phenylephrine) start to work?
            Mydcombi (tropicamide / phenylephrine) starts to work within 15 to 30 minutes, reaching its peak effect within 20 to 90 minutes. Your provider will use a device to spray a mist onto the outside of your eye before the examination. Depending on how your eye responds, you might need more doses.
            When does Mydcombi (tropicamide / phenylephrine) wear off?
            After receiving Mydcombi (tropicamide / phenylephrine), your eyes should go back to normal after 3 to 8 hours. But, in some cases, it can take up to 24 hours for complete recovery.
            Do I need to take out my contact lenses before receiving Mydcombi (tropicamide / phenylephrine)?
            If you wear contact lenses, take them out at least 10 minutes before receiving Mydcombi (tropicamide / phenylephrine). Then, your provider will let you know when it's safe for you to put the contact lenses back in your eyes.
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            What are the risks and warnings for Mydcombi (tropicamide / phenylephrine)?

            Mydcombi (tropicamide / phenylephrine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

            risk-warning

            High blood pressure

            • Risk factors: Heart problems | Thyroid problems | Children younger than 5 years old

              Mydcombi (tropicamide / phenylephrine) can raise your blood pressure, especially in children younger than 5 years old. Additionally, you have a higher risk if you've a history of heart conditions or thyroid problems. For people at higher risk, your provider might ask you to monitor your blood pressure after receiving treatment.

              risk-warning

              Behavioral problems in children

              Although very rare, Mydcombi (tropicamide / phenylephrine), can cause psychotic and behavior changes in children potentially caused by the phenylephrine component of the medication. Watch for any signs, including abnormal behavior, hallucinations, or aggression, and let your child's provider know right away.

              risk-warning

              High eye pressure

              Mydcombi (tropicamide / phenylephrine) can temporarily raise the pressure in your eye, which can interfere with medications that are used to lower eye pressure. Make sure to tell your provider about all the medications you're taking before using Mydcombi (tropicamide / phenylephrine), especially if you're taking medications for your eye.

              risk-warning

              Rebound pupil constriction

              Mydcombi (tropicamide / phenylephrine) is used to widen your pupils, but it's possible for your pupils to be more constricted (tighter) more than usual a day after receiving the medication. This could mean that Mydcombi (tropicamide / phenylephrine) won't work as well the next time you receive it.

              dosage

              Mydcombi (tropicamide / phenylephrine) dosage forms

              Typical dosing for Mydcombi (tropicamide / phenylephrine)

              The typical dose is 1 spray into the cornea of each eye that needs dilation.

              If necessary, your provider might repeat the dose after 5 minutes.

              contraindications-icon

              Mydcombi (tropicamide / phenylephrine) contraindications

              Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Mydcombi (tropicamide / phenylephrine) will not be safe for you to take.

              • Allergy to tropicamide or phenylephrine

              alternatives

              What are alternatives to Mydcombi (tropicamide / phenylephrine)?

              There are a number of medications that your doctor can prescribe in place of Mydcombi (tropicamide / phenylephrine). Compare a few possible alternatives below.
              Mydcombi (tropicamide / phenylephrine)
              Used for:

              • Dilate pupils for eye examinations

              View Prices
              Tropicamide (Mydriacyl)
              Used for:

              • Dilate pupils for diagnostic procedures

              $17.96 Lowest GoodRx priceView Prices
              Phenylephrine eye drops
              Used for:

              • Dilate (widen) pupils

              $18.86 Lowest GoodRx priceView Prices

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              References

              Best studies we found

              Boyd, K. (2023). What are dilating eye drops? American Academy of Ophthalmology.

              Eyenovia, Inc. (2023).  Mydcombi- tropicamide and phenylephrine hydrochloride spray, metered [package insert]. DailyMed.

              National Eye Institute. (n.d.). Parts of the eye.

              View All References (1)

              National Eye Institute. (2021). Get a dilated eye exam.

              GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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