Ryzumvi

Ryzumvi is an in-office eye drop (phentolamine ophthalmic solution 0.75%) used to reverse pupil dilation after routine eye exams or procedures. It works for dilations caused by common exam drops like phenylephrine or tropicamide, helping your pupils return toward normal size more quickly so you can get back to reading, screens, and comfortable vision sooner.1 In everyday terms, it speeds up the “undilating” process that otherwise can take hours.

Ryzumvi can be used in adults and children (age 3 and up) after a dilated exam. It is given by your eye care professional right after the exam—typically one drop per eye, sometimes two—so you don’t need to fill a prescription at a pharmacy. You should still expect some light sensitivity; wearing the disposable sunglasses many clinics provide is a good idea.2

After your exam is finished, your provider places 1–2 drops of Ryzumvi in each dilated eye. Phentolamine is an alpha-1 and alpha-2 adrenergic blocker that relaxes the iris dilator muscle, allowing the pupil to constrict back toward its usual size. Onset is generally seen in about 30 minutes, with greatest effect between 60–90 minutes.3 The vial is single-use to lower contamination risk—don’t touch the tip to your eye or lashes.

Alternatives include simply waiting for the dilation to wear off naturally and using sunglasses and artificial tears for comfort. Your clinician may also time dilated exams for days you don’t need to drive or do near work right away. Ryzumvi does not replace other treatments aimed at vision problems (like glasses or contacts); it just shortens the time your pupils stay large after the exam. 4

Good candidates are people—adults and kids (3+)—who just had their eyes dilated with standard exam drops and want vision to normalize sooner (for reading, school, work, driving with caution, or light comfort). Ryzumvi was studied in a broad age range and can be given immediately after the exam by your eye care professional.5 Do not use if you have active eye inflammation (like iritis or uveitis) unless your ophthalmologist advises it, because inflammation can worsen when the iris moves.

Ryzumvi is not a treatment for reading vision loss from presbyopia (age-related near-vision blur); you may still need readers or other options for that separate issue.6 Contact lens wearers should remove lenses before the drop and can usually re-insert them after 10 minutes per label.

What most patients pay: Ryzumvi is typically administered in the clinic right after your exam, so you don’t buy it at a retail pharmacy. Practices usually purchase boxes of single-use vials and may include the drop in the exam fee or bill it to your medical insurance as part of the visit. Ask your clinic whether the charge is bundled with the dilation visit or itemized separately.7

Helpful tips to get a clear number:

• When scheduling, ask: “If I choose Ryzumvi after dilation, what is my out-of-pocket estimate with my plan?”
• Confirm whether it’s billed under medical benefits and if a separate copay applies.
• If paying cash, request the exact per-encounter price (clinics buy cartons of 30 single-patient vials; knowing this helps them quote transparently).

Packaging details: Cartons contain 30 single-patient vials (NDC 83368-075-30), which may influence office purchasing and pricing policies. 8

Benefits: In randomized studies, phentolamine 0.75% (Ryzumvi) produced a faster return to baseline pupil size compared with placebo from 60 minutes through 24 hours, helping patients resume near tasks and reduce light sensitivity sooner.9 It is suitable across a wide age range, including adolescents, with dosing tailored by age and clinical judgment.

Limitations & side effects: Ryzumvi is not a cure for any eye disease and does not replace glasses or contacts. The most common effects are instillation site discomfort (sting), eye redness, and a brief metallic taste; these are usually mild and short-lived.10 People with active eye inflammation should generally avoid it unless advised otherwise by an ophthalmologist.

Most patients notice improvement within an hour, with the strongest effect by 60–90 minutes. The change in pupil size can last through the day; sunglasses remain helpful, especially outdoors.11 If you wear contacts, remove them for dosing and wait at least 10 minutes before reinsertion as directed.

Self-care tips: keep artificial tears handy if your eyes feel dry; avoid rubbing your eyes; and follow any specific instructions your eye doctor gives you. If you ever use prescription drops at home, review safe drop technique (hand hygiene, don’t touch the tip, count each drop) and storage guidance with your provider.12 Seek urgent care for severe pain, sudden vision loss, or symptoms that worry you.

Two pivotal Phase 3 trials (MIRA-2 and MIRA-3) showed that phentolamine 0.75% significantly increased the proportion of eyes returning to near-baseline pupil size starting at 60 minutes and maintained benefit through 24 hours compared with vehicle, across mydriatic types and iris colors. These data support routine, office-based use after dilated exams when quicker recovery is desired.13

Beyond dilation reversal, research has explored dim-light vision disturbances (glare, halos) using phentolamine mesylate drops; a randomized Phase 2 study reported reduced pupil size with improvements in contrast measures, prompting ongoing interest in pupil-modulating strategies. Ask your specialist whether any trials or new indications may be relevant to you.14

If you’re planning a dilated exam and want to get back to near work or bright environments sooner, discuss Ryzumvi ahead of time so your visit can be scheduled and billed appropriately. Clinicians should also review driving safety and informed consent points related to dilation and reversal.15 Remember, Ryzumvi does not treat presbyopia or replace regular eye care—keep up with routine exams and vision correction as advised.16

Most relevant specialist: ophthalmologist (MD/DO) with experience in comprehensive eye care; optometrists can also coordinate dilation and after-care. You can connect with the right specialist on Kerbside for a medical education consult to learn your options (this is not a physician-patient relationship or medical diagnosis).