What is the Right Dosege for Lopidine for Botox-caused Drooping?

You can use Apraclonidine 0.5, 1-2 drops, 3 times per day.The average improvement in the lid droop is about 2mm.Make sure you put in one drop at a time, tilt your head back, and close your eyes to make sure none of the eye-drop leaks out.  I would recommend that your injecting physician go over ALL the potential side-effects of the eye-drops such as "adrenaline-like" symptoms like anxiety or heart pounding; you may also experience eye irritation, eye dryness, and eye pain, amongst other symptoms.  If that happens you will likely need to take some lubricating eye drops, lower the dose, switch the eye-drops, or stop the drops altogether...Good luck

Hi,

70 Units is a little on the high side for the treatment of crow's feet ( I usually use about 12 units per side, 24 total).

You may continue to use Lopidine as you are without overdosing.  Unfortunately it does take some time for the Botox to wear off in the affected muscles, usually a few weeks.

Good luck and be well.

Dr. P

This dose would be unusually high.  

The dose for the iopodine is twice per day.

Now here is the bad news.  The initial subjective response to the iopodine predicts when the ptosis will resolve. When the drops work in the first week, it generally means that the amount of BOTOX that is weakening the muscle that raises the eyelid was small and the effect typically resolves in 4 to 6 weeks. When the drop does not improve the eyelid ptosis, it implies a more profound paralysis of this muscle. This can be associated with a much more persistent ptosis last 3 to 6 months and occasionally longer.  I would recommend assessment by an independent eyelid plastic surgeon to document your status and monitor your recovery.  And yes I would advise you to find a different doctor for future BOTOX treatments.

Iopidine 0.5% can help to improve eyelid drooping (blepharoptosis) induced by botulinum toxin A (Botox). It works by stimulating one of the muscles that lifts the eyelid (Mueller's muscle).  This medication can raise the eyelid several millimeters and it can last for a few hours.  Using Iopidine in this manner is considered an "off-label" use, meaning it is not approved by the FDA. The most common dosing is 1 or 2 drops at a time, either several times a day or just before social events. It should not really be used more than 3 times a day. 

Luckily, a droopy eyelid after Botox resolves within weeks and rarely months.

Usually the drop is used twice a day if necessary. For more information on BOTOX visit my website.