Which pupil-dilation drug is no longer manufactured?

• A. Homatropine 2%
• B. Atropine 1%
• C. Tropicamide 1%
• D. Cyclopentolate 1%

Answer: (A)

Homatropine 2% is largely a historical mydriatic with a longer and less predictable duration and more variable anticholinergic effects. Because of these drawbacks, many manufacturers have stopped producing it, and it has been phased out in favor of newer agents. The drugs that are still routinely manufactured and used for dilation—tropicamide, cyclopentolate, and atropine—offer shorter, more predictable durations (tropicamide) or are chosen for longer-acting needs (atropine) with clearer dosing and safety profiles. That combination of being withdrawn from production in many markets and being less favorable in practice is why homatropine 2% is the one no longer manufactured.