Classes
DEA Class; Rx
Common Brand Names; Miostat
- Direct-Acting;
- Antiglaucoma, Miotics
Description
Direct-acting ophthalmic miotic agent.
Used to lower intraocular pressure (IOP) in glaucoma, induce miosis during surgery, and reduce IOP after cataract surgery.
Eye preparations can produce systemic cholinergic side effects, even with intact epithelium.
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
Hypersensitivity
Acute iritis
Acute inflammatory disease of the anterior chamber
Adverse Effects
Ocular
- Corneal clouding
- Stinging (transient)
- Ciliary spasm
- Bullous keratopathy
- Persistent bullous keratopathy
- Postoperative iritis following cataract extraction
- Retinal detachment (rare)
- Corneal edema, drug effect prolonged miosis, eye inflammation, eye pain, intraocular pressure increased, ocular hyperemia, vision blurred, and visual impairment
Systemic
- Abdominal cramps
- Epigastric distress
- Flushing
- Arrhythmia
- Hypotension
- Syncope
- Epigastric stress
- Salivation
- Vomiting
Warnings
Use caution in asthma, acute heart failure, corneal abrasion, hyperthyroidism, urinary tract obstruction, Parkinson’s disease, active peptic ulcer, GI spasm
Does not penetrate cornea readily, benzalkonium chloride is added in some formulations to enhance corneal penetration (Isopto-Carbachol)
Topical ophthalmic solution produces transient ocular & frontal headache
Use with caution in patients undergoing general anesthesia
The vial stopper contains natural rubber (latex) which may cause severe allergic reactions
Pregnancy and Lactation
Pregnancy Category: C
Lactation: Excretion in milk unknown; use with caution
Maximum Dosage
Intraocular injection (Miostat): 0.5 mL/dose intraocularly for induction of miosis.
Ophthalmic solution: 6 drops/day per affected eye.
Intraocular injection (Miostat): 0.5 mL/dose intraocularly for induction of miosis.
Ophthalmic solution: 6 drops/day per affected eye.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.