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Phospholine Iodide

echothiophate
Used for Glaucoma
Used for Glaucoma

Phospholine Iodide (echothiophate) is an older eye drop used to lower pressure inside of the eye. It's also used to diagnose and treat a type of eye crossing in children. It's brand name only and might be expensive.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on July 19, 2022
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsPricesMedicare
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What is Phospholine Iodide (echothiophate)?

What is Phospholine Iodide (echothiophate) used for?

How Phospholine Iodide (echothiophate) works

Phospholine Iodide (echothiophate) is an acetylcholinesterase inhibitor. It blocks enzymes (proteins) that break down acetylcholine, which is a natural chemical in your body that lowers in pressure in the eye. In children with crossed eyes, it works on muscles in the eye that help adjust focus.

Are you looking for information on potassium iodide (SSKI) instead?

Drug Facts

Common BrandsPhospholine Iodide
Drug ClassAcetylcholinesterase inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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$2948.97(save 0.36%)
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What are the side effects of Phospholine Iodide (echothiophate)?

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

  • Eye stinging
  • Eye burning
  • Watery eyes
  • Eye twitching
  • Eye redness
  • Browache
  • Nearsightedness with blurred vision

Other Side Effects

  • Detachment of your retina (a light-sensitive tissue at the back of the eye)
  • Reactivation of eye inflammation
  • Iris cysts
  • Thickening of the conjunctiva (tissue that covers the whites of the eyes and inside the eyelids)
  • Abnormal heart rate or rhythm

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 immediately if any of the following side effects occur:

Rare

Burning, redness, stinging, or other eye irritation

eye pain

veil or curtain appearing across part of vision

Symptoms of too much medicine being absorbed into the body

Increased sweating

loss of bladder control

muscle weakness

nausea, vomiting, diarrhea, or stomach cramps or pain

shortness of breath, tightness in chest, or wheezing

slow or irregular heartbeat

unusual tiredness or weakness

watering of mouth

The most common of these symptoms, especially in children, are nausea, vomiting, diarrhea, and stomach cramps or pain. Your doctor may tell you to stop taking the medicine if any of these side effects occur.

Too much medicine being absorbed is rare with the eye ointment form of this medicine.

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:

Blurred vision or change in near or distance vision

difficulty in seeing at night or in dim light

headache or browache

twitching of eyelids

watering of eyes

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 Phospholine Iodide (echothiophate)

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Pros

Conveniently stored at room temperature

Dose can be personalized based on response

Not many interactions with other medications or supplements

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Cons

Might cause burning or stinging eyes

Drops can be uncomfortable to use

Unknown if safe to use during pregnancy

pharmacist-tips

Pharmacist tips for Phospholine Iodide (echothiophate)

pharmacist

  • Your provider will prepare the Phospholine Iodide (echothiophate) eye drops for you before it's ready to use.

    • Wash your hands before and after using Phospholine Iodide (echothiophate) to prevent contamination (spread of germs). This will also help prevent the medication from absorbing into your skin if it gets on your hands.

      • Avoid touching the tip of the eye drop bottle with your eye or anything else to keep it clean.

        • To use Phospholine Iodide (echothiophate), use clean fingers to make a pocket between your eye and your lower eyelid. Look up while gently squeezing a drop of Phospholine Iodide (echothiophate) into your eye. Apply pressure on the inner corner of your eye with a finger for 1 to 2 minutes to keep the drop in your eye. Remove extra medication around your eye with a tissue.

          • Stop using Phospholine Iodide (echothiophate) and call your provider if you experience abnormal heart rate or rhythm, trouble urinating, excessive drooling, diarrhea, extreme sweating, muscle weakness, or breathing problems.

            faqs

            Frequently asked questions about Phospholine Iodide (echothiophate)

            When should I use Phospholine Iodide (echothiophate)?
            If your provider instructed you to use Phospholine Iodide (echothiophate) once daily, the best time to use it is before bedtime. This is because Phospholine Iodide (echothiophate) causes miosis (when your pupils get smaller), which can lead to vision problems. If you're using it twice daily, one of the doses should be in the morning and the other one at bedtime.
            How long does Phospholine Iodide (echothiophate) take to work to lower my eye pressure?
            For most people, Phospholine Iodide (echothiophate) should work within a few weeks of using it.
            How long is treatment with Phospholine Iodide (echothiophate) for crossed eyes?
            There isn't a set amount of time your child will take Phospholine Iodide (echothiophate) for their crossed eyes. The eye drops can be taken as long as it's well tolerated. Your child's provider will work with you to make a treatment plan. Let them know if symptoms come back, since your child might need a rest period for the medication to work better again. After 1 or 2 years, the provider might slowly stop the eye drops and check if the eye crossing returns. If this is the case, other treatment options might be considered.
            Is Phospholine Iodide (echothiophate) over the counter?
            No. You need to get a prescription for Phospholine Iodide (echothiophate) from your healthcare provider. Your provider will adjust the dose if needed and monitor if it's working well for you.
            How long can I use my open bottle of Phospholine Iodide (echothiophate)?
            Once Phospholine Iodide (echothiophate) is opened, it should only be used for 4 weeks. After this time, throw your bottle away and ask for a refill.
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            What are the risks and warnings for Phospholine Iodide (echothiophate)?

            Phospholine Iodide (echothiophate) 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

            Interactions with other medications

            It's important to let your providers know all of the medications you're taking before having surgery requiring general anesthesia. A medication called succinylcholine (Anectine) is sometimes used during procedures, and it could cause serious heart and breathing problems in people taking Phospholine Iodide (echothiophate). In addition, people who are taking other anticholinesterase medications (e.g., pyridostigmine (Mestinon)) are at a higher risk for more side effects when taking Phospholine Iodide (echothiophate) at the same time.

            risk-warning

            Worsening of certain medical conditions

            • Risk factors: History of retinal detachment | Vagotonia (overstimulation of the vagus nerve) | Asthma | Gut or stomach problems | Slow heart rate | Low blood pressure | Recent heart attack | Seizures | Parkinsonism

              Phospholine Iodide (echothiophate) can make certain conditions worse. Make sure to go over your full medical history with your provider so they can determine if Phospholine Iodide (echothiophate) is safe for you. If you have any of the risk factors listed above, your provider will monitor you more closely while you're using this medication. Let them know if any of your symptoms get worse.

              risk-warning

              Risk of more side effects with exposure to insecticides and pesticides

              If you're exposed to insecticides or pesticides while receiving Phospholine Iodide (echothiophate), you might experience more side effects. This is because these chemicals have similar effects as Phospholine Iodide (echothiophate) in your body. Make sure to wear a mask and avoid getting insecticides or pesticides on your skin if you need to be near them. Wash your body and change your clothing often. If you're exposed to these chemicals and notice more side effects like trouble breathing, more sweating, diarrhea, vomiting, or very watery eyes, get medical help right away.

              dosage

              Phospholine Iodide (echothiophate) dosage forms

              The average cost for 1 kit of 5ml of 1.25% of Phospholine Iodide (echothiophate) is $2938.21 with a free GoodRx coupon. This is 0.36% off the average retail price of $2948.97.
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              Kit
              DosageQuantityPrice as low asPrice per unit
              5ml of 1.25%1 kit$2938.21$2938.21

              Typical dosing for Phospholine Iodide (echothiophate)

              Your dose depends on the condition you're using Phospholine Iodide (echothiophate) for. Your provider will adjust the dose based on your response.

              • High eye pressure: The typical starting dose is 1 drop into the affected eye(s) in the morning and at bedtime.

              • Crossed eyes: The typical starting dose is 1 drop into both eyes every night at bedtime for 2 to 3 weeks.

              interactions

              Interactions between Phospholine Iodide (echothiophate) and other drugs

              Phospholine Iodide (echothiophate) 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 Phospholine Iodide (echothiophate). 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. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

              Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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              How much does Phospholine Iodide (echothiophate) cost?

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              Phospholine Iodide (echothiophate) contraindications

              Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Phospholine Iodide (echothiophate) will not be safe for you to take.

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