| Pilocarpine (U.S.N.L.M.) | ||
|---|---|---|
| Dosing: | For acute angle closure: one drop 2% solution every 15-60 minutes up to 4 doses. (Used when IOP is below 40-50 mm Hg) |
|
| Chem Specs | pilocarpine HCL 1%, 2%, 4% | |
| Quantities | 15ml | |
| Cost | $95.81/15ml/1% | |
| Class | Muscarinic Cholinergic Agonist | |
| Action | Increases aqueous outflow through trabecular meshwork. | |
| Usage | Lowers IOP in acute angle closure glaucoma. Though ineffective at pressures above 40 - 50 mm Hg due to sphincter ischemia initial instillation makes the drug immediately available once the IOP is reduced by other means. |
|
| Used to prevent postoperative elevated IOP associated with laser surgery, and as adjunctive qhs therapy for exfoliative glaucoma. |
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| Contraindications | Paradoxical angle shallowing can occur if used in malignant glaucoma or lens induced narrow angle. |
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| Pediatric use | Safety and effectiveness in pediatric patients has been established. | |
| Pregnancy | Category C. Animal reproduction studies have not been conducted with pilocarpine. | |
| Used as maintenance therapy prior to Laser Peripheral Iridotomy. Headache, qid dosing, and miosis, make it inappropriate for POAG except where possible angle closure is an issue. |
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| Overdose can lead to cholinergic crisis (nausea, vomiting, diarrhea, sweating, bradycardia,and hypotension). | ||