CHAMP, 3 years
In 489 children aged 6 to 10, 0.01% atropine slowed refractive progression by 0.24 D and axial growth by 0.13 mm versus placebo.
Myopia management · Prescription drops
Low-Dose Atropine The most studied drop for childhood myopia.
Nightly low-dose atropine slows myopia progression in many children. In the US it is prescribed off-label and filled by compounding pharmacies, because no atropine product had FDA approval for myopia as of October 2026.
0FDA-approved atropine products for myopia, Oct 2026
0.01%Met its 3-year endpoints vs placebo in CHAMP
0.05%Most effective dose in the 2-year LAMP study
June 2025EU authorization of Ryjunea
How it works
A muscarinic blocker at a fraction of the usual dose
Atropine's anti-myopia mechanism is not fully settled, but trials consistently show slower eye growth at low concentrations with fewer of the light sensitivity and near blur problems seen at 1%.
LAMP, 2 years
0.05% roughly doubled the effect of 0.01% and was the best of the three concentrations tested.
Dose matters
In CHAMP, 0.02% slowed eye growth but missed the refractive endpoint, a reminder that results vary by concentration.
Tolerability
Low doses were well tolerated in these trials, with small changes in pupil size and accommodation.
Combination use
Some clinicians pair atropine with optical treatments. That is a judgment call for the prescriber.
Where atropine stands in the US
Every US prescription today is compounded, and the regulatory picture is still moving.
- Off-label, compounded prescription
- Consistency varies by pharmacy
- Watch the FDA review of SYD-101
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Compounded supply
Pharmacies prepare 0.01% to 0.05% solutions. Concentration, pH and preservative can differ between pharmacies.
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SYD-101
Sydnexis received an FDA complete response letter in October 2025. In July 2026 the FDA said it plans an advisory committee review.
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Ryjunea in Europe
The European Commission authorized this low-dose atropine in June 2025; Santen markets it there.
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Choose a pharmacy
Ask how the drop is made, its stability and beyond-use dating, and whether it ships to your state.
In the practice
Prescribing and following atropine
The drop is simple. The program around it is what families pay for.
Consent and baseline
Explain the off-label status, record cycloplegic refraction and axial length, and agree on the follow-up plan.
Prescribe
Send the concentration and directions to a compounding pharmacy; most regimens are one drop at bedtime.
Recheck
Review progression, light sensitivity and near vision at each visit and adjust the plan.
Status and safety notes
Regulatory status
No low-dose atropine product is FDA approved for myopia in the US as of October 2026. Prescriptions are compounded and used off-label.
Safety considerations
Possible effects include light sensitivity, blurred near vision and larger pupils. Store compounded drops as the pharmacy directs and keep them away from young siblings.
Vision Rescue does not sell compounded atropine.
Questions doctors ask about atropine
Which concentration should I prescribe?
Trials support 0.01% to 0.05%. LAMP found 0.05% most effective over two years; CHAMP showed 0.01% beat placebo over three years. The choice stays with the prescriber.
Is atropine FDA approved for myopia?
Not as of October 2026. SYD-101 received a complete response letter in October 2025, and an FDA advisory committee review was announced in July 2026.
How long do children stay on it?
Trials ran two to three years. Duration and tapering are clinical decisions.
Can it be combined with lenses?
Some clinicians combine atropine with ortho-k, myopia-control soft lenses or spectacles.
Do Rx products earn the participation credit?
No. The 15% participation credit applies only to eligible OTC orders on VisionRescue.com through RescueLink.
References
- Zadnik K, Schulman E, Flitcroft I, et al. Efficacy and safety of 0.01% and 0.02% atropine for the treatment of pediatric myopia progression over 3 years. JAMA Ophthalmol. 2023;141(10):990-999. PubMed
- Yam JC, Li FF, Zhang X, et al. Two-year clinical trial of the Low-Concentration Atropine for Myopia Progression (LAMP) study: phase 2 report. Ophthalmology. 2020;127(7):910-919. PubMed
- Sydnexis SYD-101 receives US FDA complete response letter. Ophthalmology Times, October 23, 2025. Ophthalmology Times
- Sydnexis announces FDA advisory committee meeting to review NDA for SYD-101. July 31, 2026. Release
Add atropine to a measured program.
Pair the prescription with baseline biometry, consent and scheduled follow-up.
Low-dose atropine for myopia is an off-label, compounded prescription in the US. This page is information for licensed prescribers, not dosing guidance. Ryjunea is a trademark of its owner.