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Generic name: alcaftadine ophthalmic

Brand names: Lastacaft

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic:

Lastacaft: 0.25% (3 mL) [contains benzalkonium chloride, edetate disodium]


Mechanism of Action

Direct H1-receptor antagonist and inhibitor of histamine release from mast cells



Minimal systemic absorption


Non-CYP450 cytosolic enzymes to the active metabolite carboxylic acid

Half-Life Elimination

Carboxylic acid: ~2 hours

Protein Binding

~40%; Carboxylic acid (metabolite): ~60%

Use: Labeled Indications

Allergic conjunctivitis: Prevention of itching associated with allergic conjunctivitis


Hypersensitivity to alcaftadine or any component of the formulation.

Dosage and Administration

Dosing: Adult

Allergic conjunctivitis: Ophthalmic: Instill 1 drop into each eye once daily.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Allergic conjunctivitis: Children ≥2 years and Adolescents: Ophthalmic: Instill 1 drop in each eye once daily


For topical ophthalmic use only. Contact lenses should be removed prior to application, and may be reinserted 10 minutes after administration. Separate administration of other ophthalmic agents by 5 minutes. Do not insert contacts if eyes are red. Avoid contaminating the applicator tip with affected eye(s).


Store at 15°C to 25°C (59°F to 77°F).

Drug Interactions

There are no known significant interactions.

Adverse Reactions

1% to 10%:

Central nervous system: Headache (<3%)

Ophthalmic: Burning sensation of eyes (<4%), eye irritation (<4%), eye pruritus (<4%), eye redness (<4%), stinging of eyes (<4%)

Respiratory: Nasopharyngitis (<3%)

<1%, postmarketing, and/or case reports: Allergic dermatitis, blurred vision, drowsiness, erythema of eyelid, eye discharge, eyelid edema, facial edema, hypersensitivity, increased lacrimation, swelling of eye


Special populations:

  • Contact lens wearers: Contains benzalkonium chloride which may be absorbed by soft contact lenses; remove lenses prior to administration and wait 10 minutes before reinserting. Not for the treatment of contact lens irritation; do not wear contact lens if eye is red.

Other warnings/precautions:

  • Appropriate use: For topical ophthalmic use only. To avoid eye injury and contamination, do not touch dropper tip to eyelids or any surface.


Pregnancy Risk Factor


Pregnancy Considerations

Adverse events were not observed in animal reproduction studies. The amount of alcaftadine absorbed systemically following ophthalmic administration is minimal.

Patient Education

  • Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
  • Patient may experience headache, burning, stinging, redness, stuffy nose, or sore throat. Have patient report immediately to prescriber vision changes, eye pain, or severe eye irritation (HCAHPS).
  • Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

Source: Wolters Kluwer Health. Last updated November 4, 2019.