Acetylcholine Chloride

Pronunciation: a-SEET-il-KOE-leen
Class: Ophthalmic agent, direct-acting miotic

Trade Names

Miochol-E
- Powder for solution, intraocular 20 mg

Pharmacology

Decreases IOP by constricting pupil and stimulating ciliary muscles to open trabecular meshwork spaces and facilitate outflow of aqueous humor.

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Pharmacokinetics

Onset

Seconds.

Duration

10 min.

Special Populations

Renal Function Impairment

No data available.

Hepatic Function Impairment

No data available.

Indications and Usage

To obtain miosis of the iris in seconds after delivery of the lens in cataract surgery, in penetrating keratoplasty, iridectomy, and other anterior segment surgery where rapid miosis may be required.

Contraindications

Standard considerations.

Dosage and Administration

Miosis
Adults

Intraocular Instill 0.5 to 2 mL into the anterior chamber before or after securing 1 or more sutures. In cataract surgery, use only after delivery of the lens.

General Advice

  • Follow manufacturer's instructions for reconstitution of powder with supplied diluent.
  • Prepare solution immediately before use.
  • Do not use solution that is not clear and colorless.
  • Do not aspirate and inject through the same filter.
  • Instillation should be gentle and parallel to the iris face and tangential to pupil border.
  • Any anatomical hindrance to miosis must be released to permit the desired effect.
  • Note: The syringe filter supplied has a priming volume of approximately 0.6 mL.

Storage/Stability

Store at 39° to 77°F. Discard any unused solution. Do not reuse the syringe filter and discard appropriately after use. Do not gas sterilize. If blister or peelable backing is damaged or broken, sterility of the enclosed vial and ampoule cannot be assured. Open under aseptic conditions only.

Drug Interactions

Topical NSAIDs

There have been reports that acetylcholine has been ineffective during coadministration.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Bradycardia, flushing, hypotension (rare).

EENT

Corneal edema, clouding, and decompensation (infrequent).

Miscellaneous

Breathing difficulties, sweating (rare).

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Overdosage

Symptoms

Cardiovascular or bronchoconstrictor responses.

Patient Information

  • Advise patient, family, or caregiver that medication will be prepared and administered by a health care provider in a health care setting.

Copyright © 2009 Wolters Kluwer Health.

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