Pilocarpine

Description

Pilocarpine is a cholinergic agonist used for the treatment of abnormal dryness of the mouth (xerostomia) in patients undergoing radiotherapy for head and neck cancer and in patients with Sjogren's syndrome, a condition that affects the immune system and causes dryness of mouth and eyes. The ophthalmic form of this medicine is used for the treatment of increased fluid pressure inside the eye (intraocular hypertension); glaucoma (open and narrow-angle), a condition that may eventually lead to vision loss; and for the production of miosis (excessive constriction of the pupil of the eye) prior to or during ophthalmic surgeries.

Side effects

Major & minor side effects for Pilocarpine

  • Increased sweating
  • Tremors
  • Nausea and vomiting
  • Diarrhea
  • Troubled breathing
  • Watering of mouth
  • Eye pain
  • Blurred vision
  • Eye irritation
  • Headache
  • Chills
  • Runny Nose
  • Frequent urination
  • Dizziness
  • Weakness
  • Heartburn
  • Stomach pain
  • Fast or slow heartbeat

Uses of Pilocarpine

What is it prescribed for?

  • Xerostomia
  • Intraocular hypertension
  • Open angle Glaucoma
  • Narrow-angle glaucoma
  • Production of miosis
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Concerns

Commonly asked questions

  • Onset of action
    The effect of the oral form of this medicine can be observed within 20 minutes of administration of the dose. The effect of the ophthalmic form of this medicine can be observed within 10 to 30 minutes of administration of the dose. The effect of the intracameral form of this medicine (injection into the eye chamber) is rapid.
  • Duration of effect
    The effect of the oral form of this medicine lasts for an average duration of 3 to 5 hours. The effect of the ophthalmic form of this medicine lasts for an average duration of 4 to 8 hours. The amount of time for which the intracameral (injection into the eye chamber) form of this medicine remains active is not clinically established.
  • Safe with alcohol?
    Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
  • Is it habit forming?
    No habit-forming tendencies were reported.
  • Usage in pregnancy?
    This medicine is not recommended for use in pregnant women unless necessary. All the risks and benefits should be discussed with the doctor before using this medicine.
  • Usage while breast-feeding?
    This medicine is not recommended for use in breastfeeding women unless necessary. All the risks and benefits should be discussed with the doctor before using this medicine. Your doctor may prescribe a safer alternative based on your clinical condition. If the medicine is used, monitor the infant closely for any adverse effects.

Allergy

This medicine is not recommended for use in patients with a known allergy to pilocarpine or any other inactive ingredients present along with this medicine.

Asthma

This medicine is not recommended for use in patients with uncontrolled asthma since it may worsen the patient's condition.

Uveitis

This medicine is not recommended for use in patients suffering from uveitis since it may worsen the patient's condition.

Undesirable pupillary constriction

This medicine is not recommended for use where pupillary constriction is undesirable such as acute iritis, anterior uveitis, etc.
Warnings for special population

Pregnancy

This medicine is not recommended for use in pregnant women unless necessary. All the risks and benefits should be discussed with the doctor before using this medicine.

Breast-feeding

This medicine is not recommended for use in breastfeeding women unless necessary. All the risks and benefits should be discussed with the doctor before using this medicine. Your doctor may prescribe a safer alternative based on your clinical condition. If the medicine is used, monitor the infant closely for any adverse effects.
General warnings

Contact lens

This ophthalmic form of this medicine is not recommended for use if you are wearing soft contact lenses in your eyes. The lens should be removed prior to administration and can be reinserted after 10 to 15 minutes of administration of the dose.

Driving or operating machines

This medicine may cause blurred vision and dizziness in some patients. It is advised that you do not perform any activities such as driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine.

Dehydration

This medicine should be used with caution in patients who are known or expected to sweat excessively due to the increased risk of dehydration. Patients are advised to drink an adequate amount of water or liquids to maintain hydration.

Peptic ulcer

The oral form of this medicine should be used with caution in patients with peptic ulcer disease due to the increased risk of worsening of the patient's condition. Appropriate patient education, dose adjustments, or replacement with a suitable alternative may be required based on the clinical condition of the patient.

Renal impairment

The oral form of this medicine should be used with caution in patients with renal impairment due to the increased risk of severe adverse effects. Close monitoring of renal function, appropriate dose adjustments, or replacement with a suitable alternative may be required based on the clinical condition of the patient.

Cardiovascular diseases

The oral form of this medicine should be used with caution in patients with cardiovascular diseases due to the increased risk of worsening of the patient's condition. Appropriate patient education, dose adjustments, or replacement with a suitable alternative may be required based on the clinical condition of the patient.

Pulmonary diseases

The oral form of this medicine should be used with caution in patients suffering from lung diseases such as controlled asthma, chronic bronchitis, or chronic obstructive pulmonary disease due to the increased risk of worsening of the patient's condition. Appropriate patient education, dose adjustments, or replacement with a suitable alternative may be required based on the clinical condition of the patient.

Missed Dose

Oral form: Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double your dose to make up for the missed one. Eye drops: Administer the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not double your dose to make up for the missed one. Injection: Since this medicine is administered by a qualified healthcare professional, the likelihood of missing a dose is very low.

Overdose

Oral form and eye drops: Seek emergency medical treatment or contact the doctor in case of an overdose. Injection: Since this medicine is administered in the hospital setting by a qualified healthcare professional, the likelihood of an overdose is very low. However, emergency medical treatment will be initiated by the doctor if an overdose is suspected.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.

Instructions

Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Medicine

Atropine

Ipratropium

Loxapine

Atenolol

Clozapine

Disease interactions

Retinal detachment

This medicine should be used with caution in patients with risk factors for retinal detachment such as old age, retinal degenerative changes or other retinal disorders, aphakia, prior cataract extraction, or a history of severe myopia or retinal detachment due to the increased risk of retinal detachment. Fundus examination is advised in all patients before starting therapy with this medicine. Replacement with a suitable alternative may be required based on the clinical condition of the patient.

Uveitis

This medicine is not recommended for use in patients with uveitis due to the increased risk of worsening of the patient's condition. Replacement with a suitable alternative should be considered under your doctor's supervision.

Cataract

This medicine should be used with caution in patients with or predisposed to cataracts due to the increased risk of worsening of the patient's condition. Replacement with a suitable alternative may be required based on the clinical condition of the patient.
Food interactions
Information not available.
Lab interactions
Information not available.
Oral form: Take this medicine with or without food. Do not consume in larger amounts than advised. Consult the doctor if you experience any undesirable side effects. Ensure that the treatment course is completed. Do not stop the use of this medicine without consulting your doctor. Eye drops: Use this medicine exactly as prescribed. Do not administer in larger or smaller amounts than advised/prescribed. Consult the doctor if you experience any undesirable side effects. Ensure that the treatment course is completed. Do not stop the use of this medicine without consulting your doctor. Injection: This medicine is administered by a qualified healthcare professional in the hospital setting. Inform the doctor if you have a known allergy to this medicine. Report to the doctor all your current medicines including herbs and supplements as well as all your medical conditions before receiving this medicine.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

Does not cause sleepiness

How it works
The oral form of this medicine works by increasing the secretion of saliva in the mouth. The ophthalmic form of this medicine works by reducing the fluid pressure inside the eyes as well as reducing the size of the pupil.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Cholinergic agonists, Ophthalmic glaucoma agents, Salivery stimulants, Miotics

Schedule

Schedule H

Pilocarpine: MedlinePlus Drug Information [Internet]. Medlineplus.gov. 2018 [cited 26 March 2018]. Available from:

https://medlineplus.gov/druginfo/meds/a608039.html

Pilocarpine - DrugBank [Internet]. Drugbank.ca. 2018 [cited 26 March 2018]. Available from:

https://www.drugbank.ca/drugs/DB01085

Pilocarpine Eye Drops BP 1.0% w/v - Summary of Product Characteristics (SmPC) - (eMC) [Internet]. Medicines.org.uk. 2018 [cited 26 March 2018]. Available from:

https://www.medicines.org.uk/emc/product/3398

Minims Pilocarpine Nitrate 2% w/v, Eye drops solution - Summary of Product Characteristics (SmPC) - (eMC) [Internet]. Medicines.org.uk. 2018 [cited 26 March 2018]. Available from:

https://www.medicines.org.uk/emc/product/1375

Salagen 5 mg Film Coated Tablets - Summary of Product Characteristics (SmPC) - (eMC) [Internet]. Medicines.org.uk. 2018 [cited 26 March 2018]. Available from:

https://www.medicines.org.uk/emc/product/1370

[Internet]. Davisplus.fadavis.com. 2018 [cited 26 March 2018]. Available from:

https://davisplus.fadavis.com/3976/meddeck/pdf/pilocarpine.pdf

[Internet]. Accessdata.fda.gov. 2018 [cited 26 March 2018]. Available from:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/018796s014lbl.pdf

[Internet]. Pfizer.ca. 2018 [cited 26 March 2018]. Available from:

https://www.pfizer.ca/sites/g/files/g10037206/f/201710/SALAGEN_PM_E_25Sept2014_175412.pdf

DailyMed - pilocarpine hyrochloride tablet, film coated [Internet]. Dailymed.nlm.nih.gov. 2018 [cited 27 March 2018]. Available from:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fb4810ec-d26f-429d-b87c-5898a7870169

Carpinol Ophthalmic Solutions | Leading Eyecare Specialists in India | Sunways India Pvt Ltd. [Internet]. Sunways.com. 2018 [cited 28 March 2018]. Available from:

http://www.sunways.com/Products/SunwaysProducts/Carpinol.html

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Information on this page was last updated on 28 Mar 2018

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