physostigmine ophthalmic

Generic Name: physostigmine ophthalmic (fye zoe STIG meen)
Brand Name: Eserine Sulfate Ophthalmic

What is physostigmine ophthalmic?

Physostigmine ophthalmic reduces pressure in the eye by increasing the amount of fluid that drains from the eye. Physostigmine ophthalmic also causes the pupil to become smaller and reduces its response to light or dark conditions.

Physostigmine ophthalmic is used to treat glaucoma by lowering pressure inside the eye.

Physostigmine ophthalmic is not commercially available in the United States.

Physostigmine ophthalmic may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about physostigmine ophthalmic?

Contact your doctor immediately if you notice any decrease in vision or an increase in "floaters" in your visual field. Rarely, physostigmine ophthalmic may cause retinal detachment . Retinal detachment can lead to blind spots, floaters in your visual field, and even blindness. Your doctor will want to check your retina before you use this medication to determine if you have an increased risk of retinal detachment.

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Do not touch the tube opening to any surface, including the eyes or hands. The tube opening is sterile. If it becomes contaminated, it could cause an infection in the eye.

Apply light pressure to the inside corner of the eye (near the nose) after each application to prevent the medicine from draining down the tear duct.

Use caution when driving, operating machinery, or performing other hazardous activities. Physostigmine ophthalmic may cause decreased vision at night. If you experience decreased vision, avoid these activities.

What should I discuss with my healthcare provider before using physostigmine ophthalmic?

Rarely, physostigmine ophthalmic may cause retinal detachment. Tell your doctor if you have any type of retinal disease, if you have had a retinal tear, if you are nearsighted, or if you have had cataract surgery. These conditions may increase the risk of retinal detachment.

Before using this medication, tell your doctor if you have

  • heart failure;

  • high or low blood pressure;

  • ever had a heart attack;

  • asthma;

  • a stomach ulcer or stomach spasms;

  • epilepsy;

  • hyperthyroidism (an overactive thyroid);

  • blockage of your urinary tract or difficulty urinating; or

  • Parkinson's disease.

You may not be able to use physostigmine ophthalmic, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Physostigmine ophthalmic is in the FDA pregnancy category C. This means that it is not known whether physostigmine ophthalmic will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether physostigmine passes into breast milk. Do not use physostigmine ophthalmic without first talking to your doctor if you are breast-feeding a baby.

How should I use physostigmine ophthalmic?

Use physostigmine ophthalmic ointment exactly as directed by your doctor. If you do not understand the instructions, ask your doctor, pharmacist, or nurse to explain them to you.

Wash your hands before and after using the ointment.

If you wear contact lenses, remove them before applying physostigmine ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication.

To apply the ointment:

  • Hold the tube in your hand for a few minutes to warm it up so that the ointment comes out easily. Tilt your head back slightly and pull down gently on your lower eyelid. Apply a thin film of ointment into your lower eyelid. Close your eye and roll your eyeball around in all directions for 1 to 2 minutes. If you are applying another eye medication, allow at least 10 minutes before applying.

Do not touch the tube opening to any surface, including the eyes or hands. The tube opening is sterile. If it becomes contaminated, it could cause an infection in the eye.

Store physostigmine ophthalmic at room temperature away from moisture and heat. Keep the tube properly capped. Discard any unused medication on the expiration date.

What happens if I miss a dose?

Apply the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and apply the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

Flush the eye with water and seek emergency medical attention if an overdose is suspected.

Symptoms of a physostigmine ophthalmic overdose may include sweating, nausea, vomiting, diarrhea, watering mouth, tearing eyes, fainting, difficulty breathing, and an irregular heartbeat.

What should I avoid while using physostigmine ophthalmic?

Use caution when driving, operating machinery, or performing other hazardous activities. Physostigmine ophthalmic may cause decreased vision at night. If you experience decreased vision, avoid these activities.

Do not touch the tube opening to any surface, including the eyes or hands. The tube opening is sterile. If it becomes contaminated, it could cause an infection in the eye.

If you wear contact lenses, remove them before applying physostigmine ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication.

Do not use other eye medications during treatment with physostigmine ophthalmic except under the direction of your doctor.

Physostigmine ophthalmic side effects

Contact your doctor immediately if you notice any decrease in vision or an increase in "floaters" in your visual field. Rarely, physostigmine ophthalmic may cause retinal detachment . Retinal detachment can lead to blind spots, floaters in your visual field, and even blindness. Your doctor will want to check your retina before you use this medication to determine if you have an increased risk of retinal detachment.

If you experience any of the following serious side effects, stop using physostigmine ophthalmic and seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (difficulty breathing; shortness of breath; swelling of the lips, face, or tongue; or hives);

  • abdominal cramps or diarrhea;

  • watering mouth;

  • excessive sweating;

  • urinary incontinence;

  • muscle weakness;

  • difficulty breathing; or

  • an irregular heart beat.

Other, less serious side effects may be more likely to occur. Continue to use physostigmine ophthalmic and talk to your doctor if you experience

  • burning, stinging, red, or tearing eyes;

  • eyelid muscle twitches;

  • headache or brow ache; or

  • decreased vision in poor light.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

See also: Side effects (in more detail)

Physostigmine ophthalmic dosing information

Usual Adult Dose for Glaucoma:

Apply a small quantity to the lower eye lid up to 3 times a day.

What other drugs will affect physostigmine ophthalmic?

Do not use other eye medications during treatment with physostigmine ophthalmic except under the direction of your doctor.

Organophosphates may increase the effects of physostigmine ophthalmic. If you are a gardener, an organophosphate plant or warehouse worker, or a farmer, you may be exposed to organophosphates. Follow the directions of your doctor and workplace safety guides regarding respiratory masks and the washing and changing of clothes.

Drugs other than those listed here may also interact with physostigmine ophthalmic. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist has additional information about physostigmine ophthalmic written for health professionals that you may read.

What does my medication look like?

Physostigmine ophthalmic is not commercially available in the United States.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.01. Revision Date: 2/6/04 4:27:45 PM.

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