Pilocarpine Ophthalmic

Ophthalmic pilocarpine is used to treat glaucoma, a condition in which increased pressure in the eye can lead to gradual loss of vision. Pilocarpine is in a class of medications called miotics. It works by allowing excess fluid to drain from the eye.

Ophthalmic pilocarpine comes as a solution (liquid) to instill in the eyes and as an eye gel to apply to the eyes. The eye drops are usually instilled two to four times daily. The gel is usually applied once daily at bedtime. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use pilocarpine eye drops and eye gel exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Pilocarpine eye drops and eye gel control glaucoma but do not cure it. Continue to use pilocarpine eye drops or eye gel even if you feel well. Do not stop using pilocarpine eye drops or eye gel without talking to your doctor.

To instill the eye drops, follow these steps:

1. Wash your hands thoroughly with soap and water.

2. Check the dropper tip to make sure that it is not chipped or cracked.

3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.

4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.

5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.

6. Brace the remaining fingers of that hand against your face.

7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.

8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.

9. Place a finger on the tear duct and apply gentle pressure.

10. Wipe any excess liquid from your face with a tissue.

11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.

12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.

13. Wash your hands to remove any medication.

To apply the eye gel, follow these instructions:

1. Wash your hands thoroughly with soap and water.

2. Use a mirror or have someone else apply the gel.

3. Remove the protective cap. Avoid touching the tip of the tube against your eye or anything else. The gel must be kept clean.

4. Tilt your head forward slightly.

5. Holding the tube between your thumb and index finger, place the tube as near as possible to your eyelid without touching it.

6. Brace the remaining fingers of that hand against your cheek or nose.

7. With the index finger of your other hand, pull the lower lid of your eye down to form a pocket.

8. Place a small amount of gel into the pocket made by the lower lid and the eye. A 1/2-inch (1.25-centimeter) strip of gel usually is enough unless otherwise directed by your doctor.

9. Hold your lower eyelid below the lashes and gently pull it outward. As you are pulling, look down and close your eye.

10. Keep your eye closed for 1 to 2 minutes to allow the medication to be absorbed.

11. Replace and tighten the cap right away.

12. Wipe off any excess gel from your eyelids and lashes with a clean tissue. Wash your hands again.

Before using pilocarpine eye drops or eye gel,

• tell your doctor and pharmacist if you are allergic to pilocarpine or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including vitamins.
• tell your doctor if you have or have ever had asthma, intestinal disease, ulcers, high blood pressure, heart disease, an overactive thyroid gland, seizures, Parkinson's disease, or an obstruction in the urinary tract.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using pilocarpine eye drops or eye gel, call your doctor immediately.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using pilocarpine eye drops or eye gel.
• if you are using another topical eye medication, instill it at least 10 minutes before or after you instill pilocarpine eye drops.

Instill or apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill or apply a double dose to make up for a missed one.

Pilocarpine eye drops or eye gel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• blurred or dim vision

• stinging, burning, or discomfort in the eye

• itching or redness of the eye

• tearing or swelling of the eye

• redness of the eyelids

• headache

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• sweating

• muscle tremors

• upset stomach

• vomiting

• diarrhea

• difficulty breathing

• watering of the mouth

• dizziness

• weakness

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

Keep the medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Keep all appointments with your doctor. Your doctor will order certain eye tests to check your response to pilocarpine eye drops or eye gel.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Last Revised - 03/23/2011