What is pilocarpine ophthalmic and when is it recommended?

The use of ocular pilocarpine in diseases such as glaucoma can decrease damage to the optic nerve and prevent loss of vision. It is a safe drug with few side effects.

Last update: October 25, 2021

The eyeball can be affected by a large number of different diseases. Fortunately, there are drugs such as ophthalmic pilocarpine that act locally, helping to improve the presented pathology.

Pilocarpine ophthalmic is a medicine belonging to the group of direct cholinergic agonists. The compound is very useful in glaucoma and ocular hypertension. In fact, studies show that a few drops of the drug can lower intraocular pressure by up to 1 millimeter of mercury (mm Hg).

The substance in question can be absorbed and distributed well in the body, so it has both local and systemic side effects. Do you want to know more about this drug? Keep reading!

How does pilocarpine ophthalmic work?

Pilocarpine ophthalmic binds to a group of autonomic nervous system receptors called muscarinic receptors. In this way, is capable of mimicking the functions of a neurotransmitter called acetylcholine and generate parasympathetic effects.

The drug binds to muscarinic M3 receptors in the eyeball. The receptors are located in the ciliary muscle and in the pupil constrictor muscle. Binding of the drug to the receptors will increase the concentration of calcium ions within the cells, causing muscle contraction.

Contraction of the ciliary muscle will lead to accommodation of the lens, which facilitates the flow of a liquid contained in the eye called aqueous humor. Increased flow and reabsorption of aqueous humor is what lowers intraocular pressure. M3 receptors are also found in the salivary glands, so pilocarpine will increase saliva production.

When is it recommended?

The use of pilocarpine ophthalmic is recommended in all those pathologies that involve an increase in intraocular pressure. One of the main indications is the presence of glaucoma, either open or closed angle. Lowering the intraocular pressure will help prevent damage to the retina and loss of vision.

Ocular hypertension is another pathology that can be treated with the application of pilocarpine ophthalmic. It is a disease characterized by an increase in eye pressure of unknown origin. High eye pressure can occur from a variety of factors, from long-term steroid use to surgery.

Pilocarpine ophthalmic It can also be used in certain cases in which it is necessary to contract the pupil. In addition, it can be useful in the treatment of certain conditions of the visual capacity of people.

Pilocarpine can reduce pressure in the eye, making it useful in the treatment and management of glaucoma.

How is pilocarpine ophthalmic used?

Before starting treatment with pilocarpine ophthalmic, people should discuss with their doctor all the pathologies they may have. It is also important to report allergies to medications or food to avoid any kind of cross reaction.

The substance is usually marketed in liquid or gel form to be applied directly to the eyeball. Multiple studies suggest that the recommended daily dose is 30 milligrams, divided between 3 and 4 applications. However, you must always follow the dosage given by the specialist.

The application of the drug is quite simple and anyone can do it from the comfort of their home. Patients should only follow the following recommendations:

  • Wash your hands well with soap and water.
  • Lie down or stretch your head back.
  • Pull the lower eyelid down with the index finger to form a kind of pocket between the eyelid and the eye.
  • In case of drops, bring the dropper close to the eye and pour the necessary drops into the bag formed. People should try that the dropper does not touch the ocular surface.
  • In case of gel, hold the tip of the gel close to the eye and place a strip on the inside of the lower eyelid. When finished, clean the tip of the tube with a tissue.

It is important to close the eye gently for a few minutes after applying pilocarpine ophthalmic. Then, people will have to remove the excess fluid present on the face and continue with their daily activities. The application of the gel should be done before sleeping, so the next day the possible remains of the drug are rinsed off.

Risks and considerations

Pilocarpine eye drops or gel they are safe drugs that usually have few side effects. The adverse reactions presented tend to be mild and disappear on their own within a few minutes.

Among the main side effects of the compound, the following stand out:

  • Itching, burning, or stinging in the eyes.
  • Epiphora or excessive tearing.
  • Redness of the eyes and eyelids.
  • Blurry vision.
  • Headache or headache.

There are certain conditions in which the use of ocular pilocarpine is not recommended, as it can make the situation worse. The main contraindication is allergy to the active ingredient.

Other conditions in which caution should be exercised when administering the drug are the following:

  • Iritis.
  • Uveitis
  • Some cases of congenital glaucoma.
  • Asthma or breathing problems
  • Cardiovascular diseases.
People with iritis cannot use these drops or the gel. They should seek alternatives with their treating physician.

When to see a doctor?

People should seek medical assistance immediately if they present any severe symptoms after ocular pilocarpine administration. Among the warning signs that may appear, the following stand out:

  • Dyspnea or shortness of breath
  • Skin rash or rash.
  • Swelling of the tongue, lips, or throat.
  • Severe dizziness

The appearance of systemic symptoms due to an ocular pilocarpine overdose is very rare. However, people should also seek medical attention in case of the following symptoms:

  • Profuse sweating or sweating.
  • Vomiting and diarrhea
  • Stomach ache.
  • Muscle tremors
  • Increased salivation.
  • Muscular weakness.

An effective and safe treatment for glaucoma

Ocular pilocarpine is one of the first-line drugs in the treatment of glaucoma. The compound shows great effectiveness in reducing intraocular pressure thanks to its union with muscarinic receptors.

Fortunately, the side effects generated are rare and they usually go away on their own after a few minutes. However, the drug should not be used without a prescription, as an excessive dose can trigger serious systemic effects.

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