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Pilocarpine ophthalmic is an eye drop used to lower pressure inside the eye. It is also used to improve focus for seeing close objects. The most common side effects are headache, temporary burning or stinging, and blurred vision. Do not drive at night until you know how this medicine affects you. Contact your healthcare provider right away if you have sudden vision changes, such as seeing flashes of light or loss of vision.

Uses

What is pilocarpine ophthalmic (eye) used for?

Pilocarpine ophthalmic is commonly used for the following conditions.

These uses may vary depending on the specific pilocarpine product prescribed. Pilocarpine ophthalmic may also be used for other conditions as determined by your healthcare provider.

Pilocarpine is also available in a form that is taken by mouth. See Pilocarpine for more information. 

How does pilocarpine ophthalmic work (mechanism of action)?

Pilocarpine ophthalmic works by activating muscles inside the eye and making the pupil smaller in size. This helps fluid drain out of the eye more easily, which lowers pressure inside the eye. It also improves focus for close-up vision.

How is pilocarpine ophthalmic supplied (dosage forms)?

Brands and other names

  • Isopto Carpine
  • Qlosi
  • Vuity

Dosage forms and strengths

  • 0.4% ophthalmic solution (eye drops)
  • 1% ophthalmic solution (eye drops)
  • 1.25% ophthalmic solution (eye drops)
  • 2% ophthalmic solution (eye drops)
  • 4% ophthalmic solution (eye drops)

How should I store pilocarpine ophthalmic?

Some pilocarpine ophthalmic products should be stored at room temperature, between 59 F to 77 F (15 C to 25 C). Avoid freezing. Other pilocarpine ophthalmic products are packaged in single-use containers and wrapped in foil to protect them from light. These should be stored in a refrigerator, between 36 F to 46 F (2 C to 8 C), until you open the pouch. After you open the foil pouch, the single-use containers may be stored at room temperature, up to 77 F (25 C), and should be used or discarded within 30 days. 

Ask your pharmacist if you are unsure how to store your eye drops.

Side Effects

What are the most common side effects of pilocarpine ophthalmic?

The most common side effects of pilocarpine ophthalmic are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Headache
  • Stinging or discomfort after you put the drop in your eye
  • Eye redness, irritation, or pain
  • Blurry vision when looking between close and far-away objects
  • Night vision problems (see below)

There may be other side effects of pilocarpine ophthalmic that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of pilocarpine ophthalmic?

While less common, the most serious side effects of pilocarpine ophthalmic are described below, along with what to do if they happen.

Severe Allergic Reactions. Pilocarpine ophthalmic may cause allergic reactions, which can be serious. Stop using pilocarpine ophthalmic and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Night Vision Problems. Pilocarpine ophthalmic may cause temporary dim or dark vision, especially in low light. Symptoms can include difficulty seeing in the dark, blurry vision, or trouble driving at night. Do not drive at night until you know how this medicine affects you.

Retinal Detachment. Pilocarpine ophthalmic can increase your risk of a retinal detachment, which is when the retina separates from the tissue around it. Retinal detachment can lead to permanent vision loss if not treated. Contact your healthcare provider right away if you have any of the following symptoms of a retinal detachment.

  • Seeing flashes of light
  • Floaters or shadows in your vision
  • Sudden vision loss

Warnings & Precautions

Who should not use pilocarpine ophthalmic?

Allergies to Ingredients. People who are allergic to any of the following should not use pilocarpine ophthalmic.

  • Pilocarpine 
  • Isopto Carpine
  • Qlosi
  • Vuity
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific pilocarpine ophthalmic products they stock.

What should I know about pilocarpine ophthalmic before using it?

Do not use pilocarpine ophthalmic unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share pilocarpine ophthalmic with other people, even if they have the same condition as you. It may harm them.

Keep pilocarpine ophthalmic out of the reach of children. If you use a pilocarpine ophthalmic product that is stored in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

Pilocarpine ophthalmic is an eye drop medicine. Make sure that you or a caregiver understands how to properly administer eye drops. If you have any questions, talk to your healthcare provider.

Press on the inner corner of your eye for a few minutes after putting a drop in your eye, then wash your hands. Do not let the medicine get into your mouth. These steps help limit how much of the medicine gets into your bloodstream, which reduces the chance of side effects.

If you use more than one eye medicine, separate them by at least five minutes. Ask your healthcare provider if you are unsure about when to use your eye medicines.

Eye infections may occur if your eye drops get contaminated with bacteria or other germs. In some cases, eye infections may become severe and lead to vision loss. To help prevent eye injury or infections, be careful not to let the tip of the container touch your eye, fingers, or any other surfaces. Wash your hands before each use. 

Pilocarpine ophthalmic may cause temporary blurred vision and trouble seeing in the dark. Do not drive or do other activities that require clear vision until you know how pilocarpine ophthalmic affects you.

Remove contact lenses before using pilocarpine ophthalmic. Then wait at least ten minutes before you put your contacts back in.

Some pilocarpine ophthalmic products come in single-use containers. These products are preservative-free, which means they can go bad quickly after the container is opened. Use the medicine as prescribed as soon as you open it, then throw away the container. Do not save any leftover medicine.

What should I tell my healthcare provider before using pilocarpine ophthalmic?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if pilocarpine ophthalmic is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Inflamed iris, which is the colored part of the eye
  • Problems with your retina, which is a layer of tissue at the back of the eye that senses light
  • Certain types of glaucoma in children

Pregnancy. It is not known if or how pilocarpine ophthalmic could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if pilocarpine ophthalmic passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take pilocarpine ophthalmic while breastfeeding.

Interactions

Does pilocarpine ophthalmic interact with foods or drinks?

There are no known interactions between pilocarpine ophthalmic and foods.

It is unknown if drinking alcohol will affect pilocarpine ophthalmic. 

Does pilocarpine ophthalmic interact with other medicines (drug interactions)?

There are no known interactions between pilocarpine ophthalmic and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much pilocarpine ophthalmic?

If you or someone else has used too much pilocarpine ophthalmic, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of pilocarpine ophthalmic?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses. 

Ask your pharmacist if you are unsure after missing a dose of pilocarpine ophthalmic.