Resight

Indications

Pilocarpine eye drops are used to lower raised pressure inside the eye in some types of glaucoma, including emergency treatment of angle-closure glaucoma, and to make the pupil smaller after certain eye tests or surgery. Pilocarpine tablets are used to relieve dry mouth caused by radiotherapy for head and neck cancer or by Sjogren's syndrome.

How It Works

Pilocarpine acts like acetylcholine, a natural nerve messenger. In the eye it tightens the muscle that narrows the pupil and opens the drainage channels, so fluid leaves the eye more easily and pressure falls. Taken by mouth, it stimulates the glands that make saliva.

Dosage and Administration

• Eye drops: the strength and number of drops each day are as prescribed by the eye doctor.
• Tablets for dry mouth: usually 5 mg three times a day with or after meals, which the doctor may adjust; benefit may take several weeks.

To use eye drops, wash your hands, tilt your head back, pull down the lower lid and put one drop in. Close the eye and press gently on the inner corner for 1 to 2 minutes. Do not let the dropper touch the eye. Leave at least 5 minutes between different eye drops. Remove soft contact lenses before use.

Interactions

Beta blockers (such as Propranolol) taken by mouth can add to effects on heart rate. Medicines with anticholinergic effects (such as Atropine, some antihistamines and some antidepressants) can reduce its effect. Other eye drops may be used with it if spaced apart. Tell your doctor about all your medicines.

Contraindications

• Allergy to pilocarpine.
• Eye conditions where a small pupil is harmful, such as acute iritis (inflammation in the front of the eye).
• Tablets: uncontrolled asthma, and some other conditions the doctor will check.

Side Effects

Eye drops: stinging, eye redness, blurred or dim vision (especially at night or in poor light), brow ache and headache, often in the first weeks. Tablets: sweating (very common), flushing, need to pass urine more often, runny nose, nausea and dizziness.

Get urgent medical help for sudden flashes of light, new floaters or a shadow across your vision (possible retinal detachment), severe eye pain, wheezing or breathing difficulty, fainting, a very slow heartbeat, or signs of an allergic reaction such as swelling of the face.

Pregnancy and Lactation

Use only if the doctor decides the benefit is greater than the risk. Ask your doctor before using it while breastfeeding, especially the tablets.

Precautions and Warnings

Vision may be blurred and night vision poor: do not drive at night or in poor light, or use machines, until your vision is clear. Use with caution in people with asthma or lung disease, heart disease, high myopia (short-sightedness), past retinal detachment, stomach ulcer, gallstones or kidney stones. Drink plenty of fluids if you sweat a lot with tablets. Have regular eye pressure checks.

Overdose

Too much (for example if a child swallows the drops, or too many tablets are taken) can cause heavy sweating, drooling, vomiting, diarrhoea, slow heartbeat, low blood pressure and breathing difficulty. Seek emergency medical help.

Therapeutic Class

Cholinergic (parasympathomimetic) agent; anti-glaucoma medicine.

Storage

Store below 30°C, away from light and out of the reach of children, or as stated on the pack. Do not freeze. Discard eye drops 4 weeks after opening.