Classes
DEA Class; Rx
Common Brand Names; Pilocarpine PO, Salagen, Isopto Carpine, Vuity
- Salivary Stimulants
- Miotics, Direct-Acting
Description
Cholinergic agonist that activates muscarinic receptors on smooth muscles
Ophthalmic formulation used for glaucoma and as a miosis inducting agent; a 1.25% ophthalmic solution (Vuity) used for presbyopia
Oral formulation used for symptoms of xerostomia caused by radiotherapy and for symptoms associated with Sjogren’s syndrome
Indications
Used for intraocular miosis induction during surgery and to reduce increased intraocular pressure during the first 24 hours after cataract surgery.
For lowering intraocular pressure in the treatment of glaucoma.
Contraindications
Uncontrolled asthma, anterior eye inflammation, any time miosis in undesirable (eg, narrow-angle glaucoma, acute iritis)
Hypersensitivity
Adverse Effects
>10%
- Sweating (29%)
- Headache (11%)
- Flushing (8-13%)
- Dizziness (5-12%)
- Chills (3-15%)
- Nausea (6-15%)
- Urinary frequency (9-12%)
- Rhinitis (5-14%)
- Diaphoresis (29-68%)
1-10%
- Pain (4%)
- Asthenia (>3%)
- Dyspepsia (7%)
- Vomiting (3-4%)
- Hypertension (3%)
- Lacrimation (6%)
- Amblyopia (4%)
Warnings
Patients with significant cardiovascular disease may be unable to compensate for transient changes in hemodynamics or rhythm induced by therapy; pulmonary edema has been reported as a complication of pilocarpine toxicity from high ocular doses given for acute angle-closure glaucoma; pilocarpine should be administered with caution in and under close medical supervision of patients with significant cardiovascular disease
Pregnancy and Lactation
Pregnancy Category: C
Lactation: unknown if drug is distributed into breast milk; use caution
Maximum Dosage
10 mg/dose or 30 mg/day PO; ophthalmic maximum is dependent on indication and dosage form.
10 mg/dose or 30 mg/day PO; ophthalmic maximum is dependent on indication and dosage form.
Safety and efficacy of the oral formulation has not been established; ophthalmic solution maximum is dependent on indication.
Safety and efficacy of the oral formulation has not been established; ophthalmic solution maximum is dependent on indication.