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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIGLAUCOMA PREPARATIONS AND MIOTICS › Parasympathomimetics
pilocarpine
S01EB01
Forms & Strengths
- Ophthalmic Solution: 1%, 2%, 4%
Adult Dosing
- Open-angle glaucoma: Instill 1 drop up to 4 times daily
- Acute angle-closure glaucoma: Instill 1 drop every 5-10 minutes for 3-6 doses, then every 1-3 hours until pressure is controlled
Pediatric Dosing
- Glaucoma: Instill 1 drop up to 4 times daily as directed by ophthalmologist
Indications
- Reduction of intraocular pressure in open-angle glaucoma
- Management of acute angle-closure glaucoma
- Induction of miosis before or after ocular surgery
Mechanism of Action
- Direct-acting muscarinic cholinergic agonist
- Contracts the iris sphincter muscle causing miosis
- Contracts the ciliary muscle, opening the trabecular meshwork and increasing aqueous humor outflow to reduce intraocular pressure
Contraindications
- Hypersensitivity to pilocarpine
- Acute inflammatory disease of the anterior segment
- Conditions where miosis is undesirable (e.g., suspected pupillary block glaucoma)
Adverse Reactions
- Transient stinging or burning upon instillation
- Blurred vision and decreased night vision (due to miosis)
- Ciliary spasm, brow ache, and headache
- Conjunctival vascular congestion
- Rarely: retinal detachment, systemic cholinergic effects
Drug Interactions
- Concurrent use with beta-blockers may result in additive intraocular pressure-lowering effects
- Anticholinergic agents (e.g., atropine) may antagonize the therapeutic effects of pilocarpine
Curated Content: Needs Vetting Before Put to Clinical Use