Dosing and uses of IsoptoCarpine, Pilopine HS (pilocarpine ophthalmic)
Adult dosage forms and strengths
ophthalmic solution
- 1%
- 2%
- 4%
geL
- 4%
Intraocular Pressure
Solution: Apply 1-2 gtt up to q6hr; adjust concentration and frequency as necessary to control IOp
Gel: Apply 0.5-inch ribbon in lower conjunctival sac of affected eye(s) qHs
Counteract Mydriatic Effects of Sympathomimetic Agents (Off-label)
Ophthalmic solution: 1 gtt of 1% solution in affected eye
Other Indications & Uses
Antiglaucoma, miotic, green-top; reduces intraocular pressure (IOP) in patients with open & closed angle glaucoma
NOT effective in very high IOP seen in some closed angle attacks, should be used in combination with acetazolamide IV and mannitol IV
Pediatric dosage forms and strengths
Safety and efficacy not established
IsoptoCarpine, Pilopine HS (pilocarpine ophthalmic) adverse (side) effects
Frequency not defined
Accomodative spasm
Miosis
Ocular irritation
Difficulty seeing in poorly lit areas, especially in patients with cataracts
Ocular burning/itching
Temporal or supraorbital headache
Decreased visual acuity
Hypertension
Corneal glanularity (gel)
Tachycardia
Myopia
Conjunctival vascular congestion
Lacrimation
Salivation
Nausea
Vomiting
Headache
Bronchial spasm
Diaphoresis
Retinal detachment (rare)
Warnings
Contraindications
Hypersensitivity to drug or component; acute inflammatory disease of the anterior chamber
Pregnancy and lactation
Pregnancy category: C
Lactation: Excretion in breast milk unknown; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of IsoptoCarpine, Pilopine HS (pilocarpine ophthalmic)
Mechanism of action
Causes miosis by stimulating cholinergic receptors by contracting the sphincter; loss of accomodation by constriction of ciliary muscle; lowers intraocular pressure
Pharmacokinetics
Onset: 10-30 min (miosis); 1 hr (IOP)
Duration: 4-8hr (miosis); 4-12hr (IOP)
