II. Indications
-
Open Angle Glaucoma second line agent (adjunctive)
- Pilocarpine is the most common Cholinergic Agent used in Open Angle Glaucoma
-
Presbyopia
- Pilocarpine (Vuity) gained Presbyopia indication in Presbyopia in 2022
III. Contraindications
- Ocular inflammation
IV. Mechanism
- Intraocular Parasympathomimetic (Intraocular Cholinergic) results in Miosis (Pupil Constriction)
- Reduces resistance to aqueous outflow (decreases IOP 20 to 30%)
V. Dosing
- Pilocarpine, as with other Intraocular Cholinergics has a green cap
- Do not insert Contact Lenses within 15 minutes of applying drops
-
Glaucoma
- Available in 1%, 2%, 4% solutions (15 ml bottles)
- Pilocarpine (Isoptocarpine, Pilopine gel, Ocusert, Pilocar) 1 drop three to four times daily
-
Presbyopia
-
Pilocarpine (Vuity) 1.25% apply 1 drop each eye once daily
- Costs $80/month for a 2.5 ml eyedropper in 2023
- Contrast with generic Pilocarpine 1% and 2% drops at $30/month
- Onset of action within 15 minutes and duration of 6 hours
- Improves near Vision by 3 lines on handheld Snellen Chart without loss of distance Vision
-
Pilocarpine (Vuity) 1.25% apply 1 drop each eye once daily
VI. Adverse Effects
- See Intraocular Parasympathomimetic
- Reduced night Vision (due to Miosis)
- Headache
- Darker Vision or blurry Vision may occur
- Caution when operating machinery or vehicles
-
Retinal Detachment (rare)
- Retinal Exam is recommended by the manufacturer before starting medication
VII. Safety
- Pregnancy Category C
- Compatible with Lactation
VIII. Resources
IX. References
Images: Related links to external sites (from Bing)
Related Studies
| pilocar (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| PILOCARPINE 1% EYE DROPS | Generic | $3.88 per ml |
| PILOCARPINE 2% EYE DROPS | Generic | $3.55 per ml |
| PILOCARPINE 4% EYE DROPS | Generic | $3.54 per ml |
| PILOCARPINE HCL 5 MG TABLET | Generic | $0.25 each |
| PILOCARPINE HCL 7.5 MG TABLET | Generic | $0.62 each |
| vuity (on 6/7/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| VUITY 1.25% EYE DROP | $28.19 per ml | |