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Miostat

carbachol
Used for Eye Pressure
Used for Eye Pressure

Miostat, also known by its generic name carbachol, is an eye injection. It's a cholinergic agonist that works to help control the size of your pupil and lower your eye pressure. A healthcare professional will make sure you get the right dosage and inject the medication into your eye during eye surgery. Side effects can include blurred vision and eye pain.

Reviewed by:
reviewer
Aileen Chu, PharmD, BCPS
reviewer
Kristianne Hannemann, PharmD
Last reviewed on July 23, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsAlternativesReferencesPricesMedicare
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What is Miostat (carbachol)?

What is Miostat (carbachol) used for?

  • Making the pupils smaller (miosis) during eye surgery to control eye pressure

How Miostat (carbachol) works

Miostat (carbachol) is a cholinergic agonist. It works by tightening certain muscles in the eye. This makes the pupil (black middle part of the eye) smaller. The medication also helps lower eye pressure after eye surgery by helping fluid drain from the eye.

Drug Facts

Common BrandsMiostat
Drug ClassCholinergic agonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Miostat (carbachol)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

See Risks and Warnings.

Other Side Effects

  • Eye injury after cataract surgery
  • Cloudy cornea
  • Flushing
  • Sweating
  • Upset stomach
  • Stomach or bladder cramps
  • Headache

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious eye injury (such as retinal detachment): flashes of light in your vision, gray or black spots in your vision, dimming of your vision, eye floaters

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Rare

Veil or curtain appearing across part of vision

Symptoms of too much medicine being absorbed into the body

Diarrhea, stomach cramps or pain, or vomiting

fainting

flushing or redness of face

frequent urge to urinate

increased sweating

irregular heartbeat

shortness of breath, wheezing, or tightness in chest

unusual tiredness or weakness

watering of mouth

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Blurred vision or change in near or distance vision

eye pain

stinging or burning of the eye

Less common

Headache

irritation or redness of eyes

twitching of eyelids

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Miostat (carbachol)

thumbs-up

Pros

Makes your pupil smaller within 2 to 5 minutes

Might be used with other medications during your eye surgery

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Cons

Injected into the eye by an eye surgeon

No lower-cost generic available; brand-name medication only

pharmacist-tips

Pharmacist tips for Miostat (carbachol)

pharmacist

  • Tell your care team if you have a latex allergy before your eye surgery. The stopper on the vial of Miostat (carbachol) contains natural rubber (latex), which can lead to an allergic reaction if you have a latex allergy.

    • Avoid driving after your eye procedure. It might be a good idea to have someone help drive you home. Miostat (carbachol) and possibly other medications that are placed into your eye for your procedure can affect your eyesight afterwards. For example, your vision might not be clear after your eye procedure.

      • Contact your eye specialist if you experience eye pain, eye inflammation, or concerning vision changes after your surgery.

        faqs

        Frequently asked questions about Miostat (carbachol)

        How long does Miostat (carbachol) take to work?
        Miostat (carbachol) helps make the pupil smaller within 2 to 5 minutes of the injection. And the pressure in the eye goes down within the first 24 hours after the eye surgery.
        How long does Miostat (carbachol) last?
        The effects of Miostat (carbachol) last for up to 24 hours for most people. During this time, the pressure in your eye will be lower and your pupil will look small.
        What's the difference between Miochol and Miostat?
        Both Miostat (carbachol) and Miochol (acetylcholine chloride) are eye injections that are given during cataract surgery. They both work to make the pupil smaller. But the effects of Miostat (carbachol) last longer than Miochol (acetylcholine chloride). Your eye specialist will decide which medication is most appropriate for you.
        Is Miostat (carbachol) used for glaucoma?
        No. Miostat (carbachol) is FDA approved for use during eye surgery only. Discuss with your optometrist or ophthalmologist about your treatment options if you have glaucoma.
        What is Miostat (carbachol) used for in cataract surgery?
        Miostat (carbachol) is used during certain eye surgeries, including cataract surgeries. The medication makes the pupil smaller, which helps lower the pressure in the eye(s) after the surgery.
        Is Miostat (carbachol) available as eye drops?
        No. Miostat (carbachol) is only available as an injection into the eye that you get during eye surgery.
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        What are the risks and warnings for Miostat (carbachol)?

        Miostat (carbachol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

        risk-warning

        Caution with certain medical conditions

        • Risk factors: Heart failure | Asthma | Stomach ulcer | Hyperactive thyroid (hyperthyroidism) | Spasm in the digestive tract | Blockage of the urinary tract | Parkinson's disease

          Miostat (carbachol) can cause various problems if you have certain medical conditions. Before any eye surgery, it's important to tell your eye specialist about all of your medical conditions so they can make sure Miostat (carbachol) is safe for you.

          risk-warning

          Latex allergy

          The stopper on the vial containing Miostat (carbachol) has latex in it. Make sure to tell your care team before surgery if you have a latex allergy. Get medical help right away if you experience hives, swelling in your face or throat, or trouble breathing.

          dosage

          Miostat (carbachol) dosage forms

          Typical dosing for Miostat (carbachol)

          Miostat (carbachol) is given by trained healthcare professionals in a hospital setting only. The healthcare professional will inject a small amount of medication into the eye during eye surgery.

          interactions

          Interactions between Miostat (carbachol) and other drugs

          Miostat (carbachol) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Miostat (carbachol). Please note that only the generic name of each medication is listed below.

          Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

          alternatives

          What are alternatives to Miostat (carbachol)?

          There are a number of medications that your doctor can prescribe in place of Miostat (carbachol). Compare a few possible alternatives below.
          Miostat (carbachol)
          Used for:

          • Making the pupils smaller (miosis) during eye surgery to control eye pressure

          View Prices
          Pilocarpine eye drops
          Used for:

          • High pressure in the eye

          • Glaucoma (open-angle or acute angle-closure)

          • Prevention of high eye pressure due to laser eye surgery

          • Shrinking the size of the pupils (miosis)

          $20.59 Lowest GoodRx priceView Prices

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          References

          Best studies we found

          Alcon Laboratories, Inc. (2023). Miostat- carbachol solution [package insert]. DailyMed.

          Bausch & Lomb Incorporated. (2023). Miochol E- acetylcholine chloride [package insert]. DailyMed.

          Kaptı, H. B., et al. (2022). Effect of intracameral carbachol and epinephrine use on choroidal thickness after uncomplicated phacoemulsification. Medical Science Monitor. 

          View All References (3)

          MedlinePlus. (2022). Cloudy cornea.

          Nam Patton, D., et al. (2024). Chemical insights into topical agents in intraocular pressure management: From glaucoma etiopathology to therapeutic approaches. Pharmaceutics.

          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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