Pilocarpine ophthalmic Side Effects

It is possible that some side effects of pilocarpine ophthalmic may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

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

Along with its needed effects, pilocarpine ophthalmic may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur while taking pilocarpine ophthalmic:

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 side effects of pilocarpine ophthalmic may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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.

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.


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

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