pilocarpine
Generic pilocarpine eye drops, formerly known by the brand name Isopto Carpine, are used to treat and prevent high eye pressure. They're also used to shrink the pupil (the black part of your eye), typically before certain eye procedures. This medication belongs to the drug class called cholinergic agonists. The usual dosage is 1 drop in the eye(s) up to 4 times a day. Side effects can include headache, temporary blurry vision, and eye irritation.
What is Pilocarpine eye drops?
What is 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)
How Pilocarpine eye drops works
Pilocarpine eye drops is a cholinergic agonist. It drains fluid out of the eye, which lessens the amount of fluid in the eye. When there's less fluid inside the eye, the eye pressure goes down. This medication also makes the pupils smaller, which helps lower eye pressure in certain types of glaucoma.
Drug facts
Side effects of Pilocarpine eye drops
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
Side effects occurring in 5% or more of people:
- Headache or eyebrow ache
- Difficulty focusing when looking at objects at different distances
- Blurry vision
- Eye irritation
- Worse vision
- Eye pain
Note: Side effects listed were reported by people who used the 2% strength of pilocarpine eye drops with Betoptic-S (betaxolol) 0.25% eye drops.
The following Pilocarpine eye drops 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:
Symptoms of too much medicine being absorbed into the body
Increased sweating
muscle tremors
troubled breathing or wheezing
watering of mouth
Less common or rare
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 far vision
decrease in night vision
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.
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Pros and cons of Pilocarpine eye drops
Pros
- Lowers eye pressure to prevent long-term damage, such as blindness
- Can use for adults and children
- Available as a lower-cost generic
Cons
- Not a first-choice medication for treating glaucoma long term
- Sometimes need to use up to 4 times a day
- Can make it hard to see clearly at night or to focus on objects at different distances, so might not be safe for you to drive after you use the eye drops
Pharmacist tips for Pilocarpine eye drops
- Wash your hands before you put pilocarpine eye drops in your eye(s). Don't let the dropper tip touch your eye or any other surface, and don't touch the tip with your hands. This will help prevent germs and bacteria from spreading into the medication, which will help lower the risk for eye infections.
- Take out your contact lenses before each time you use pilocarpine eye drops. Then, wait 10 minutes after you place the drop(s) in your eye(s) to put your contacts back in. This medication contains a preservative that can damage contact lenses.
- Avoid driving and doing important tasks at night or in low light conditions. Pilocarpine eye drops can make your vision worse when it's dark.
- Pilocarpine eye drops can make it harder for you to clearly see objects that are at different distances. For example, it'll take your eyes longer to focus when you're looking at something far away and then at something else that's right in front of you. Don't drive or use heavy machinery if you notice this side effect.
- It's not easy to tell whether your eye pressure is improving at home. Make sure to use pilocarpine eye drops as prescribed, even if you don't notice any difference in your symptoms or vision right away. Follow up with your eye specialist to check how the medication is improving your eye pressure.
How to use pilocarpine eye drops:
- Tilt your head back and pull your lower eyelid down to make a pocket.
- Hold the pilocarpine eye drop bottle just above the pocket and squeeze a drop of medication into it.
- After you place a drop in the eye, close your eye and press a finger to the inner corner of your eye by the nose for at least a minute. This helps make sure that your eye absorbs the drop and that the medication doesn't drain into your nose instead.
- If you're using pilocarpine eye drops at the same time as other eye medications, wait at least 5 minutes between each medication to give your eyes time to absorb each medication.
Common questions about Pilocarpine eye drops
No, pilocarpine is a cholinergic agonist. It mimics the actions of acetylcholine, a natural chemical found in the body, to make the pupil smaller and lower eye pressure. Anticholinergic medications do the opposite; they block the actions of acetylcholine.
Yes, most side effects from pilocarpine eye drops are temporary and go away with time. For example, you might experience blurry vision for 2 to 3 hours after you place pilocarpine eye drops into your eye. Other temporary side effects can include pain around the eyebrows and eye irritation. Contact your prescriber if any side effects seem severe or if they don't seem to get better after several hours.
Pilocarpine eye drops can rarely cause retinal detachment, but the risk might be higher in people who already have problems with their retina. Your eye specialist will carefully examine your retina to make sure pilocarpine eye drops are safe for you to use. Contact your eye specialist or go to the emergency room right away if you notice more floaters (small spots or lines in your vision), flashes of light, or a shadow in your vision. These can be signs of retinal detachment.
There isn't enough information to know how well pilocarpine eye drops help with dry eyes, and they aren't FDA approved for this use. Talk to a healthcare professional about treatment options if you have dry eye.
It takes about 10 to 30 minutes for the pilocarpine eye drops to start making your pupil smaller. The pressure in your eye should drop within 60 minutes after you place the eye drop into your eye.
The effects of pilocarpine eye drops can last for around 4 to 8 hours. In some rare situations, effects can last for up to 20 hours. This can depend on which strength of the pilocarpine eye drops you're using.
Pilocarpine eye drops constrict your pupils. It makes your pupils look smaller but only temporarily. Your pupils will go back to its normal size within several hours after you use the eye drops.
Don't stop taking pilocarpine eye drops without talking to your prescriber first. This medication helps to lower eye pressure. So when you stop taking pilocarpine eye drops earlier than instructed, your eye pressure might climb up again. Very high eye pressure can sometimes lead to permanent damage to your vision. Speak with your eye specialist about when your eye pressure is stable enough to stop using pilocarpine eye drops.
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Risks and warnings for Pilocarpine eye drops
Pilocarpine eye drops 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.
Worse vision
Using pilocarpine eye drops can make it harder to see clearly, especially when it's dark. Be careful driving, using machinery, or performing tasks at night or in low light conditions. Tell your prescriber if this side effect is too bothersome and if it affects your daily lifestyle.
Retinal detachment
- Risk factors: History of retinal problems
Although rare, pilocarpine eye drops can cause retinal detachment, a serious injury in the eye that could potentially lead to blindness. Let your prescriber know about any of your past or current eye conditions. Depending on your medical history, you might need to visit an eye specialist for a retinal exam before you start pilocarpine eye drops. Call your prescriber right away if you start seeing "floaters," flashes of light, or shadows in your vision. Also contact your prescriber if your vision dims or if you have any other changes in your vision.
Not recommended for people with inflamed iris
Pilocarpine eye drops aren't recommended for use if you have iritis, which is inflammation of the colored part of your eye (the iris).
Higher eye pressure in children
Pilocarpine eye drops aren't recommended for children with certain types of glaucoma, since the medication can sometimes raise eye pressure rather than lower it. Let your child's prescriber know about any past or current eye conditions that your child has.
Don't wear soft contact lenses when you use pilocarpine eye drops
The preservative in pilocarpine eye drops, benzalkonium chloride, can get absorbed by soft contact lenses and damage the lenses. Remove soft contact lenses from your eye(s) before you put the pilocarpine eye drops into your eye(s). Wait at least 10 minutes after you put the eye drop(s) in before putting your contacts back onto your eye(s).
Pilocarpine eye drops dosage
Eye dropper| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 15ml of 2% | 1 eye dropper | $33.18 | $33.18 |
| 15ml of 1% | 1 eye dropper | $32.81 | $32.81 |
| 15ml of 4% | 1 eye dropper | $35.89 | $35.89 |
Typical dosage for Pilocarpine eye drops
People 2 years of age and older
- Open-angle glaucoma or high pressure in the eye: The typical dose is 1 drop in the affected eye(s) up to 4 times daily. It's best to start with the 1% strength (the lowest strength) of pilocarpine eye drops to avoid side effects. Your prescriber might adjust the number of drops or the strength of pilocarpine eye drops you need depending on your eye pressure.
- Acute angle-closure glaucoma: This condition is usually treated with pilocarpine eye drops and other medications in a clinic or hospital. In most cases, the typical starting dose is 1 drop of the 1% or 2% strength in the affected eye(s) up to 3 times within a 30-minute period. Your eye specialist might tell you to continue using the 1% strength as 1 drop in the affected eye(s) 4 times a day while you wait for laser treatment.
- To prepare for laser eye surgery or to make the pupils smaller: Pilocarpine eye drops are usually given by an eye specialist before your eye procedure at a clinic or hospital. Your eye specialist will place 1 or 2 drops into the affected eye(s), 15 to 60 minutes before the surgery or procedure.
Children younger than 2 years old should use the 1% strength of pilocarpine eye drops as 1 drop in the affected eye(s) no more than 3 times a day. Ask your child's eye specialist for more information about dosing for specific situations.
Interactions between Pilocarpine eye drops and other drugs
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 this medicine, 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 this medicine 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.
- Tegafur
How much does Pilocarpine eye drops cost?
$32.81
What are alternatives to Pilocarpine eye drops?
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