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Name That Eye Drop! A Cap Color Guide to Ophthalmic Drops



Have you ever wondered why the medication you were prescribed to treat your eye condition has a colored cap? As it turns out, it wasn't the manufacturer's design choice.

For topical ophthalmic preparations, bottle cap colors have been standardized so that the cap color corresponds with the therapeutic class of the drug(s). Yet, there are sometimes exceptions, especially with generic versions. Here is a list of some of the most commonly prescribed ophthalmic medications and their cap colors...

Topical Ophthalmic Preparations Cap Colors and Common Uses

1. Red = Mydriatics and Cycloplegics

  • MOA: Either a disruption of the parasympathetic nerve supply to the iris constrictor muscle (which normally constricts the pupil) or overactivity of the sympathetic nervous system to the iris dilator muscle.

  • Use: pupillary dilation during routine eye exams, reduce painful ciliary muscle spasm in ocular inflammation (such as uveitis/iritis), diagnostic test for Horner's syndrome

  • Examples of medications: Atropine, Cyclopentolate, Homatropine, Phenylephrine, Tropicamide

2. Orange = Carbonic Anhydrase Inhibitors

  • MOA: Reduce the body's uptake of bicarbonate ions and decrease salt absorption, which has the effect of lowering fluid levels in the body. Lowers intraocular pressure by decreasing production of aqueous humor in the eye.

  • Use: treatment of glaucoma

  • Examples of medications: Azopt (brinzolamide), Trusopt (dorzolamide)

3. Yellow or Light Blue = Beta Blockers

  • MOA: Inhibit beta 1 and beta 2 adrenergic receptors located on the ciliary epithelium, thereby preventing synthesis of cyclic adenosine monophosphate (c-AMP). Lowers intraocular pressure by decreasing production of aqueous humor in the eye.

  • Use: treatment of glaucoma

  • Examples of medications: Betagan (levobunolol), Betoptic (betaxolol), Timoptic (timolol)

Why are there two different colored caps for beta blockers?

A light blue cap (0.25%) has a lower concentration of the drug compared to the yellow cap (0.50%).

4. Mint Green = Alpha Agonist Combinations

  • Use: treatment of glaucoma

  • Examples of medications: Simbrinza (brinzolamide-brimonidine)

5. Dark Green = Miotics

  • MOA: Cholinergic agonists (parasympathomimetics) that act by stimulating the muscarinic receptors on the pupillary sphincter muscle and ciliary body to contract. This contraction helps pull the peripheral iris away from the trabeculum (in angle closure) and lower intraocular pressure by increasing aqueous outflow through the trabecular meshwork.

  • Use: pupillary constriction, treatment of glaucoma

  • Examples of medications: Pilocarpine

6. Turquoise = Prostaglandin Analogues

  • MOA: Lowers intraocular pressure by increasing uveoscleral outflow of aqueous humor from the eye. The exact mechanism is not fully known.

  • Use: treatment of glaucoma

  • Examples of medications: Lumigan (bimatoprost), Travatan Z (travoprost), Xalatan (latanoprost)

BONUS!

Are you a visual learner? You can download the FREE cap color reference guide PDF below!

7. Dark Blue = Beta Blocker Combinations

  • Use: treatment of glaucoma

  • Examples of medications: Combigan (brimonidine-timolol), Cosopt (dorzolamide-timolol)

8. Purple = Alpha-Adrenergic Agonists

  • MOA: Selective and non-selective stimulation of the alpha-2 receptors in the ciliary epithelium. Lowers intraocular pressure by decreasing production of aqueous humor in the eye AND by increasing uveoscleral outflow of aqueous humor from the eye.

  • Use: treatment of glaucoma, chronic ocular redness

  • Examples of medications: Alphagan P (brimonidine 0.1% or 0.15%), Lumify (brominidine 0.025%)

9. Pink = Steroids (Anti-Inflammatory)

  • Use: treatment of ocular inflammation (such as uveitis/iritis), seasonal allergic conjunctivitis

  • Examples of medications: Alrex/Lotemax (loteprednol etabonate, Durezol (difluprednate), FML (fluoromethalone), Pred Forte/Pred Mild (prednisolone acetate), Vexol (rimexolone)

  • * Exception: some have a white cap

10. Gray = NSAIDs (Non-Steroidal Anti-Inflammatory)

  • Use: treatment of ocular inflammation and pain relief post-op

  • Examples of medications: Acular/Acuvail (ketorolac), Bromsite (bromfenac), Voltaren (diclofenac)

11. Tan = Antibiotics

  • Use: prevention or treatment of bacterial infections (such as conjunctivitis and corneal ulcers)

  • Examples of medications: Besivance (besifloxacin), Ciloxan (ciprofloxacin), Moxeza/Vigamox (moxifloxacin), Ocuflox (ofloxacin), Zymar/Zymaxid (gatifloxacin)

12. White = Miscellaneous

  • Other common ophthalmic preparations including anesthetics, over-the-counter products, such as artificial tears, anti-allergy eye drops, etc.

  • Examples of medications: Proparacaine, Alaway/Zaditor (ketotifen fumarate), Systane Tears

OD to OD Tip: Unknown Name? “Know” Problem.

If a patient comes into your office for their post-operative follow-up and they are unable to recall the name of the drop(s) they are taking, don't fret. This is a common problem with a simple solution: Ask the patient to tell you their drop regimen by cap colors, as patients tend to remember this more readily. This is one way you can verify a patient’s compliance to treatment without the patient having to recall the exact name of the medication. Most commonly, cataract surgery patients are prescribed three medications to take post-op: a steroid (pink), NSAID (gray), and antibiotic (tan).

Here's a handy cap color reference guide for you to save to your phone or print out and keep in your exam lane. Click the image to download.


Share your thoughts in the comment section below for others in the community to read, and connect with OEL on Instagram @OptomEyesLife.

#Pharmaceuticals #EyeCare #Glaucoma #PatientCare

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