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Isopto Carpine Side Effects

Generic Name: pilocarpine ophthalmic

Note: This page contains information about the side effects of pilocarpine ophthalmic. Some of the dosage forms included on this document may not apply to the brand name Isopto Carpine.

Not all side effects for Isopto Carpine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to pilocarpine ophthalmic: ophthalmic device, ophthalmic gel/jelly, ophthalmic solution, ophthalmic suspension

In addition to its needed effects, some unwanted effects may be caused by pilocarpine ophthalmic (the active ingredient contained in Isopto Carpine). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking pilocarpine ophthalmic, check with your doctor or nurse as soon as possible:

Symptoms of too much medicine being absorbed into the body
  • Increased sweating
  • muscle tremors
  • nausea, vomiting, or diarrhea
  • troubled breathing or wheezing
  • watering of mouth
Less common or rare
  • Eye pain

Some of the side effects that can occur with pilocarpine ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Blurred vision or change in near or far vision
  • decrease in night vision
Less common
  • Eye irritation
  • headache or browache

For Healthcare Professionals

Applies to pilocarpine ophthalmic: compounding powder, ophthalmic gel, ophthalmic insert, ophthalmic solution


The results of small studies have suggested that patients with depression or Alzheimer's disease may have greater sensitivity to the muscarinic effects of pilocarpine.[Ref]

Ocular side effects with the ophthalmic gel or solution have included lacrimation, burning, local discomfort, temporal or supraorbital headache, ciliary spasm, conjunctival vascular congestion, superficial keratitis, and induced myopia. Reduced visual acuity in poor illumination is frequently experienced in older individuals and in those with lens opacity. A subtle corneal granularity was observed in approximately 10% of patients. Cases of retinal detachment have been associated with the use of miotic agents, especially in young myopic patients. Lens opacity may occur after prolonged use of this drug. Ocular reactions usually occur during initiation of therapy and often will not persist with continued use.

Ocular side effects with pilocarpine ocular inserts have included ciliary spasm (often resulting in transient myopia), local irritation, corneal abrasions, and visual impairment. In some cases, local irritation, allergic reactions, or induced myopia necessitates cessation of therapy. Cases of retinal detachment have been associated with the use of miotic agents, especially in young myopic patients. Some patients may experience conjunctival irritation, including mild erythema with or without increased mucous secretion near the initiation of therapy that tends to subside with continued use. Although rare, increased pilocarpine effect has been observed during therapy.[Ref]


General side effects have included sweating and gastrointestinal overactivity in rare circumstances.[Ref]


1. "Product Information. Pilopine HS (pilocarpine ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.

2. Sokolski KN, Demet EM "Increased pupillary sensitivity to pilocarpine in depression." Prog Neuropsychopharmacol Biol Psychiatry 20 (1996): 253-62

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