International generic name

Pilocarpine

Drug form and composition

Solution, eye drops. One vial of 10 ml (1%) contains 100 mg of Pilocarpin hydrochloride (10 mg/ml). One vial of 10 ml (2%) contains 200 mg of Pilocarpin hydrochloride (20 mg/ml).

Indications

Glaucoma (open angle, closed angle glaucoma, secondary glaucoma); for induction of myosis after surgery and after ophthalmoscopy; before iridectomy.

Dosage and administration

In chronic glaucoma, 1 - 2 drops of Pilocarpin solution (1% or 2%) are applied in the conjunctival sack 2 - 4 times daily, depending on the intraocular pressure. In acute open angle glaucoma, the preparation is used on the conjunctiva in a dose of 1 drop of 1% or 2% solution every 5 to 10 minutes (from 3 to 6 doses) and after that 1 drop every 1 - 3 hours up to the intraocular pressure reduction. For myosis induction the preparation is used on the conjunctiva in a dose of 1 drop 1% or 2% solution.

Contraindications

Hypersensitivity to the drug; iridocyclitis.

Special warnings and precautions

Pilocarpin is used with increased caution in cases of severe heart failure, bronchial asthma, hyperthyroidism, peptic ulcer, disturbed urinary bladder emptying, stenotic changes in the gastrointestinal tract and urinary passages. In pregnancy and lactation, the preparation is used after a strict assessment of the risk/benefit ratio. During the treatment with Pilocarpin there is a possibility of visual disturbances, because of which driving and working with machines should be avoided.

Drug interactions

In chronic interventions should be kept in mind that Pilocarpin potentiates the action of the curare type agents. Atropin and other M-cholinolytics are Pilocarpin antagonists. Combination of the preparation with myotics and adrenomimetics is possible.

Adverse reactions

Myosis; visual disturbances; transitory accommodation spasms, generally disappearing up to the second hour after drug administration; lacrimal secretion increase, conjunctival vasodilation, contact allergy in susceptible patients.

Pharmacological mechanisms

Pilocarpin is a direct parasymatholytic agent and directly acts on the M-cholinoreceptors. When used in the conjunctival sack, myosis and accommodation spasm follow due to stimulation of the cholinoreceptors in m. sphincter pupillae and m. ciliaris. In cases of increased intraocular pressure, lowering of this pressure follows. In the ophthalmology this drug is used widely for the treatment of glaucoma (facilitates of intraocular fluid drainage through the canal of Schlemm) and for improvement of eye trophics. The drug is also used for termination of mydriasis after atropine use. The myosis develops after 15 minutes and lasts for several hours.

Supplied

Vials, containing 10 ml (1%) solution. Vials, containing 10 ml (2%) solution.

Expiry

2 years.