Monograph: |
Pilocarpine nitrate
The properties are the same as pilocarpine hcl, so see below at pilocarpine hcl record for the
details.
PILOCARPINE HCL
ACTIONS/CLINICAL PHARMACOLOGY:
Pilocarpine is a direct acting cholinergic parasympathomimetic agent which acts
through direct stimulation of muscarinic neuro receptors and smooth muscle such
as the iris and secretory glands. Pilocarpine produces miosis through
contraction of the iris sphincter, causing increased tension on the scleral spur
and opening of the trabecular mesh work spaces to facilitate outflow of aqueous
humor. Outflow resistance is thereby reduced, lowering intraocular pressure.
INDICATIONS AND USAGE:
Pilocarpine Hydrochloride is a miotic (parasympathomimetic) used to control
intraocular pressure. It may be used in combination with other miotics, beta
blockers, carbonic anhydrase inhibitors, sympathomimetics, or hyperosmotic
agents.
CONTRAINDICATIONS:
Miotics are contraindicated where constriction is undesirable such as in acute
iritis, in those persons showing hypersensitivity to any of their components,
and in pupillary block glaucoma.
WARNINGS:
For topical use only. NOT FOR INJECTION.
PRECAUTIONS:
GENERAL. The miosis usually causes difficulty in dark adaptation. Patient should
be advised to exercise caution in night driving and other hazardous occupations
in poor illumination.
CARCINOGENESIS, MUTAGENESIS, IMPAIRMENT OF FERTILITY: There have been no long-
term studies done using pilocarpine in animals to evaluate carcinogenic
potential.
PREGNANCY: Pregnancy Category C. Animal reproduction studies have not been
conducted with pilocarpine. It is also not known whether pilocarpine can cause
fetal harm when administered to a pregnant woman or can affect reproduction
capacity. Pilocarpine should be given to a pregnant woman only if clearly
needed.
NURSING MOTHERS: It is not known whether this drug is excreted in human milk.
Because many drugs are excreted in human milk, caution should be exercised when
pilocarpine is administered to a nursing woman.
INFORMATION FOR PATIENTS: Do not touch dropper tip to any surface, as this may
contaminate the solution.
ADVERSE REACTIONS:
Transient symptoms of stinging and burning may occur. Ciliary spasm,
conjunctival vascular congestion, temporal or supraorbital headache, and induced
myopia may occur. This is especially true in younger individuals who have
recently started administration. Reduced visual acuity in poor illumination is
frequently experienced by older individuals and individuals with lens opacity.
As with all miotics, rare cases of retinal detachment have been reported when
used in certain susceptible individuals. Lens opacity may occur with prolonged
use of pilocarpine.
OVERDOSAGE:
Systemic toxicity following topical ocular administration of pilocarpine is
rare, but occasional patients are peculiarly sensitive and develop sweating and
gastrointestinal overactivity following suggested dosage and administration.
Overdosage can produce sweating, salivation, nausea, tremors and slowing of the
pulse and a decrease in blood pressure. In moderate overdosage, spontaneous
recovery is to be expected and is aided by intravenous fluids to compensate for
dehydration. For cases demonstrating severe poisoning, atropine is the
pharmacologic antagonist to pilocarpine. (REF. 1)
A topical ocular overdose of an ophthalmic product containing pilocarpine may be
flushed from the eye(s) with warm tap water.
DOSAGE AND ADMINISTRATION:
Two drops topically in the eye(s) up to three or four times daily as directed by
a physician. Under selected conditions, more frequent instillations may be
indicated. Individuals with heavily pigmented irides may require higher
strengths.
REFERENCES:
1 Grant, W. M., Toxicology Of The Eye, 3rd Edition (1986). Charles Thomas
Publishing, Springfield, Il.
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