Medications to AVOID in NAION

Medications to AVOID in Acute NON ARTERITIC ISCHEMIC OPTIC NEUROPATHY (NAION), especially in predisposed patients

1. All ED (Erectile dysfunction) medications (PDE5 inhibitors)

2. Cough and Cold medications containing Pseudoephedrine and medications containing phenylephrine

Predisposed patients:

  1. Those with a small or a ‘tight’ optic cup of the optic nerve head, “disk-at-risk”

  2. Patients suffering from risk factors:-

    1. Had an NAION diagnosed in the fellow or the

      opposite eye

    2. History of Risk Factors including -

      i. Sleep apnea ii. Hypertension

      iii. Nocturnal Hypotension iv. Diabetes

      v. High blood cholesterol vi. Ischemic heart disease

    3. Unproven associations: Smoking, carotid disease, hypercoagulable state (disorders of clotting)

Note: There is No effective treatment for NAION and there is No effective prevention for second eye involvement. Baby Aspirin 81mg daily is generally recommended. Other drugs to improve blood flow, vitamins, anti-oxidants etc. may be recommended but there is no current proof of its effectiveness in NAION.

Author
Dr. Swaraj Bose Neuro-Ophthalmologist & Orbital Surgeon

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