Drug Action
Pilocarpine acts by opening the inefficient drainage channels in the trabecular meshwork.
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Drug reference
Pilocarpine acts by opening the inefficient drainage channels in the trabecular meshwork.
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Primary angle-closure glaucoma | Some secondary glaucomas ▶TO THE EYE ▶Adult: Apply up to 4 times a day
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Acute iritis. anterior uveitis. conditions where pupillary constriction is undesirable. some forms of secondary glaucoma (where pupillary constriction is undesirable)
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A darkly pigmented iris may require a higher concentration of the miotic or more frequent administration and care should be taken to avoid overdosage. asthma. cardiac disease. care in conjunctival damage. care in corneal damage. epilepsy. gastro- intestinal spasm. hypertension. hyperthyroidism. hypotension. marked vasomotor instability. Parkinson’s disease. peptic ulceration. retinal detachment has occurred in susceptible individuals and those with retinal disease. urinary-tract obstruction
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Fundus examination is advised before starting treatment with a miotic (retinal detachment has occurred).
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Although multi-dose pilocarpine eye drops commonly contain preservatives, preservative-free unit dose vials may be available.
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→Appendix 1: pilocarpine
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▶Common or very common Diarrhoea. headache. hyperhidrosis. hypersalivation. nausea. skin reactions. vision disorders. vomiting ▶Frequency not known Bradycardia. bronchospasm. conjunctival vascular congestion. eye disorder (long term use). eye disorders. hypotension. lens changes (long term use). pain. paraesthesia. pulmonary oedema. sensitisation. vitreous haemorrhage
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Avoid unless the potential benefit outweighs risk—limited information available.
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Avoid unless the potential benefit outweighs risk—no information available.
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Intra-ocular pressure and visual fields should be monitored in those with chronic simple glaucoma and those receiving long-term treatment with a miotic.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: eye drops Eye drops EXCIPIENTS: May contain Benzalkonium chloride ▶Pilocarpine (Non-proprietary) Eye Pilocarpine hydrochloride 10 mg per 1 ml Pilocarpine hydrochloride 1% eye drops | 10 ml P £22.20 DT = £22.20 Pilocarpine hydrochloride 20 mg per 1 ml Pilocarpine hydrochloride 2% eye drops | 10 ml P £22.79 DT = £22.79 Pilocarpine hydrochloride 40 mg per 1 ml Pilocarpine hydrochloride 4% eye drops | 10 ml P £28.40 DT = £28.40 ▶Pilocarpine nitrate (Bausch & Lomb UK Ltd) Pilocarpine nitrate 20 mg per 1 ml Minims pilocarpine nitrate 2% eye drops 0.5ml unit dose | 20 unit dose P £12.47 DT = £12.47 PROSTAGLANDINS AND ANALOGUES
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Driving and skilled tasks Blurred vision may affect performance of skilled tasks (e.g. driving) particularly at night or in reduced lighting.
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Apply up to 4 times a day
First-line fragment. Read the complete Indications and Dose section above.
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