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Acetylcholine

    Brands

    DEA Class;  Rx

    Common Brand Names; Miochol E

    • Miotics, Direct-Acting
     
     

    Direct-acting parasympathomimetic ophthalmic agent; naturally-occurring neurohormone that mediates nerve impulse transmission at cholinergic sites.
    Used intraocularly to produce rapid miosis during ophthalmic surgery.

    Indicated for miosis induction in cataract surgery, in penetrating keratoplasty, iridectomy and other anterior segment ocular surgery where rapid miosis may be required.

    –

    • Corneal edema
    • Corneal clouding
    • Corneal decompensation
    • Bradycardia
    • Flushing
    • Hypotension
    • Breathing difficulty
    • Sweating

    Use reconstituted solution immediately; aqueous solution unstable

    Instill gently; forceful jet may rupture the hyaloid, cause vitreous loss, or traumatize/perforate iris

    Systemic effects (rare) can cause problems for patients with asthma, acute heart failure, GI spasm, peptic ulcer disease, urinary tract obstruction, acute heart failure, and hyperthyroidism

    Pregnancy Category: C

    Lactation: Excretion in milk unknown; use with caution

    Adults

    20 mg (2 mL of 1% Miochol-E solution) intraocularly per eye is usually sufficient. A second application may be needed for prolonged miosis.

    Geriatric

    20 mg (2 mL of 1% Miochol-E solution) intraocularly per eye is usually sufficient. A second application may be needed for prolonged miosis.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Acetylcholine chloride

    powder for injection

    • 20mg