Is Atropine 0.01% for myopia licensed in Singapore?

Hi, yes, Atropine 0.01% is HSA approved and 'licensed' as a prescription only medicine in Singapore.

Atropine itself in other concentrations should be available in most countries around the world, because it is a very important medicine for other conditions. It is used in certain kinds of poisonings (like organophosphate poisoning), slow heart rate, and in the eye for pupil dilation and cycloplegia eg in cases of iritis/uveitis.

In the very low 0.01% concentration, its only use is to slow the progression of myopia. As such, it is possible that in certain countries where rates of progressive myopia are lower, drug companies may not feel it cost effective for them to manufacture and market this formulation of atropine, which compounding pharmacies may also be able to make up relatively easily.

It is important to note that atropine 0.01% remains a prescription only medicine. That means doctors cannot prescribe it for anyone except their own patients whom they have seen and determined that the medicine is necessary. Neither is this medicine available over the counter at pharmacies. Unfortunately, that means that if you live in a country where 0.01% atropine is not commercially available, your doctor will have to get a compounding pharmacy to dilute the atropine to the required concentration.

Yes, atropine 0.01% is indeed licensed and legal in Singapore, and dispensed by private and public eye centres, such as the Singapore National Eye Centre.

Do note that it is NOT used to TREAT myopia, ie it cannot REVERSE myopia. It’s purpose is to PREVENT the worsening of myopia in children, typically from the ages of 6 – 12 years old.

The reason why it’s not available in other countries, is likely because Singapore was one of the first countries to demonstrate that very low dose atropine (0.01%, as opposed to 0.1% and 1%), could be just as effective in slowing the worsening of myopia, without any side effects like sensitivity to light, or reading problems.

I imagine that, following these studies, the 0.01% atropine concentration was patented to a local company to produce, hence it’s not available in other developed countries.

In the local context, doctors normally dispense the 0.01% atropine initially, then “step up” the dose only if the retardation of myopic progression is unsatisfactory.

1% atropine concentration is more effective at slowing the progression of myopia, but also has more side effects, and can be associated with a greater rebound phenomenon once treatment is stopped. Also with 1% atropine, special glasses which turn dark outdoors (Transitions lenses) and which have progressive lenses (having a near section below for near focus) are required.

Cheers