Pilocarpine

Administration

• Type: Cholinergic agonist, Miotic
• Dosage Forms: Ophthalmic solution (1%, 2%, 4%); Tablets (5mg, 7.5mg)
• Routes of Administration: Ophthalmic, PO
• Common Trade Names: Isopto Carpine, Salagen

Adult Dosing

General

• Acute angle-closure glaucoma: 1-2% solution, 1-2 drops q15min x 3-4 doses

Pediatric Dosing

General

• Same as adult ophthalmic dosing

Special Populations

• Pregnancy Rating: C
• Lactation risk: Not defined

Renal Dosing

• No adjustment for ophthalmic use

Hepatic Dosing

• Reduce oral dose in hepatic impairment

Contraindications

• Allergy to class/drug
• Acute iritis
• Pupillary block glaucoma

Adverse Drug Reactions

Serious

• Retinal detachment (rare)
• Bronchospasm (systemic absorption)

Common

• Miosis
• Brow ache
• Blurred vision
• Increased lacrimation

Pharmacology

• Onset of action: 10-30 minutes (ophthalmic)
• Duration: 4-8 hours
• Metabolism: At neuromuscular junction and plasma
• Excretion: Renal

Mechanism of Action

• Direct-acting parasympathomimetic that stimulates muscarinic receptors
• Contracts iris sphincter muscle (miosis) and ciliary muscle, opening trabecular meshwork

See Also

• Acute angle-closure glaucoma
• Glaucoma