Pilocarpine Ophthalmic

What is Pilocarpine Ophthalmic?

• Pilocarpine Ophthalmic (Isopto Carpine; Pilopine HS) solution is a muscarinic cholinergic agonist used to manage angle closure glaucoma until surgery can be performed, ocular hypertension, primary open angle glaucoma, and to bring about constriction of the pupil following its dilation.
• Pilocarpine ophthalmic ( under brand name Vuity) is used to treat presbyopia (a condition in which the lens of the eye loses its ability to focus making hard to see objects up close).

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Pilocarpine

Pilocarpine Structural Formulae

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Pilocarpine molecule ball

What are the uses of this medicine?

Pilocarpine Ophthalmic is used for the:

• Reduction of Elevated Intraocular Pressure (IOP) in Patients With Open-Angle Glaucoma or Ocular Hypertension
• Management of Acute Angle-Closure Glaucoma
• Prevention of Postoperative Elevated IOP Associated With Laser Surgery
• Induction of Miosis

• Pilocarpine ophthalmic (Vuity) is used to treat presbyopia (a condition in which the lens of the eye loses its ability to focus making hard to see objects up close).

How does this medicine work?

• Pilocarpine hydrochloride is a direct acting cholinergic parasympathomimetic agent which acts through direct stimulation of muscarinic receptors and smooth muscle such as the iris and secretory glands.
• Pilocarpine contracts the ciliary muscle, causing increased tension on the scleral spur and opening of the trabecular meshwork spaces to facilitate outflow of aqueous humor.
• Pilocarpine also produces miosis through contraction of the iris sphincter muscle.
• Miosis relieves appositional angle narrowing and closure, which lowers IOP in certain types of angle-closure glaucoma.

Who Should Not Use this medicine ?

• This medicine have no usage limitations.

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Is this medicine FDA approved?

• Pilocarpine for oral use was approved for use in the United States in the 1990s.

How should this medicine be used?

Recommended dosage: Reduction of Elevated IOP in Patients With Open-Angle Glaucoma or Ocular Hypertension:

• For the treatment of glaucoma or ocular hypertension, one drop of the 1, 2, or 4% solution is usually into the affected eye(s) up to four times daily.

Management of Acute Angle-Closure Glaucoma:

• For initial management of acute angle-closure glaucoma, one drop of pilocarpine hydrochloride ophthalmic solution 1% or 2% may be applied topically in the eye(s) up to three times over a 30-minute period.

Prevention of Postoperative Elevated IOP Associated With Laser Surgery:

• One drop of pilocarpine hydrochloride ophthalmic solution 1%, 2%, or 4% should be applied topically in the eye(s) 15 to 60 minutes prior to surgery.

Induction of Miosis:

• One drop of pilocarpine hydrochloride ophthalmic solution 1%, 2%, or 4% should be applied topically in the eye(s).

Pediatric Patients:

• In children under 2 years of age, one drop of pilocarpine hydrochloride ophthalmic solution 1% should be applied topically in the eye(s) three times daily.
• Children 2 years of age and over should be dosed as for adults.

Presbyopia:

• Pilocarpine ophthalmic (Vuity) comes as a 1.25% solution to instill in the eyes to treat presbyopia.

Administration:

• Pilocarpine ophthalmic comes as a 1, 2, and 4% solution (liquid) to instill in the eyes.
• If you are using another topical eye medication, instill it at least 5 minutes before or after you instill pilocarpine eye drops.
• Be careful not to let the tip of the bottle touch your eye, fingers, face, or any surface. If the tip does touch another surface, bacteria may get into the eye drops.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Solution containing 1% (10 mg/mL), 2% (20 mg/mL) or 4% (40 mg/mL) pilocarpine hydrochloride.

This medicine is available in fallowing brand namesː

• Isopto Carpine; Pilopine HS; Vuity

What side effects can this medication cause?

The most common side effects of this medicine include:

• headache/browache, accommodative change, eye irritation, eye pain, blurred vision, and/or visual impairment.

Pilocarpine ophthalmic can cause the following serious side effects:

• sudden loss of vision
• sweating
• nausea
• vomiting
• diarrhea

What special precautions should I follow?

• Patients should be advised to exercise caution in night driving and other hazardous occupations in poor illumination. Patients should be advised not to drive or use machinery if vision is not clear.
• Rare cases of retinal detachment have been reported; a thorough examination of the retina, including funduscopy is advised in all patients prior to the initiation of therapy.
• Pilocarpine hydrochloride ophthalmic solution is not recommended to be used when iritis is present.
• Caution is advised in pediatric patients with primary congenital glaucoma for control of IOP as cases of a paradoxical increase in IOP have been reported.
• Contact lens wearers should be advised to remove their lenses prior to the instillation of pilocarpine hydrochloride ophthalmic solution and to wait 10 minutes after dosing before reinserting their contact lenses.
• Do not touch dropper tip to any surface, as this may contaminate the contents.
• If more than one topical ophthalmic medication is being used, the medicines must be administered at least 5 minutes apart.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• sweating
• salivation
• nausea
• tremors
• slowing of the pulse and a decrease in blood pressure

Treatment of overdosage:

• In moderate overdosage, spontaneous recovery is to be expected and is aided by intravenous fluids to compensate for dehydration.
• For patients demonstrating severe poisoning, atropine, the pharmacologic antagonist to pilocarpine, should be used.

Can this medicine be used in pregnancy?

• Pregnancy Category C.
• It is also not known whether pilocarpine hydrochloride can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.
• Pilocarpine hydrochloride ophthalmic solution should be given to a pregnant woman only if clearly needed.

Can this medicine be used in children?

• Safety and effectiveness of pilocarpine hydrochloride ophthalmic solution in pediatric patients have been established.

What are the active and inactive ingredients in this medicine?

Active Ingredient:

• Pilocarpine Hydrochloride

Inactive Ingredients:

• Benzalkonium Chloride
• Hypromellose
• Boric Acid
• SODIUM CITRATE, UNSPECIFIED FORM
• Sodium Chloride
• Hydrochloric Acid
• Sodium Hydroxide
• Water

Who manufactures and distributes this medicine?

Distributed by:

• Sandoz Inc.
• Princeton, NJ

What should I know about storage and disposal of this medication?

• Store at 20°C to 25°C (68°F to 77°F), excursions permitted between 15°C and 30°C (59°F and 86°F).

• Dailymed label info on Pilocarpine Ophthalmic
• FDA Pilocarpine Ophthalmic

Pilocarpine Ophthalmic Resources
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