Miochol-E System Pak (acetylcholine ophthalmic) Disease Interactions
There is 1 disease interaction with Miochol-E System Pak (acetylcholine ophthalmic):
Miotics (Includes Miochol-E System Pak) ↔ Systemic Vagotonic Effects
Moderate Potential Hazard, Low plausibility
Applies to: Asthma, Chronic Obstructive Pulmonary Disease, Dyspepsia, Heart Block, Hypotension, Irritable Bowel Syndrome, Myocardial Infarction, Parkinsonism, Peptic Ulcer, Post MI Syndrome, Seizures, Sinus Node Dysfunction, Corneal Abrasion, Urinary Tract Obstruction, Hypertension, Congestive Heart Failure
Topically applied cholinergic agents are systemically absorbed, with the potential for producing rare but clinically significant systemic effects, including urinary incontinence, tightness of the bladder, increased gastric contractility and acid secretion, bradycardia, severe hypotension, bronchospasm, seizures, and coma. Increases in blood pressure may occur rarely due to a nicotinic effect on sympathetic ganglia. Therapy with ophthalmic cholinergic agents, particularly the long-acting cholinesterase inhibitors (e.g., demecarium and echothiophate), should be administered cautiously in patients with corneal abrasion (which may increase drug penetration), bronchospastic diseases, spastic gastrointestinal disturbances, urinary tract obstruction, peptic ulcer, pronounced bradycardia and hypotension, vascular hypertension, acute cardiac failure, recent myocardial infarction, epilepsy, parkinsonism, and other conditions that may respond adversely to vagotonic effects. The usual precautions should be followed to minimize the risk of systemic toxicity, including digital compression of the nasolacrimal ducts (1 to 2 minutes) following instillation to limit drainage into the nasal chamber, where extensive absorption may occur, and washing hands after use to prevent skin absorption. Excessive cholinergic effects may be reversed with parenterally administered atropine.
- Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
- American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
- Babinski M, Smith B, Wickerham EP "Hypotension and bradycardia following intraocular acetylcholine injection. Report of a case." Arch Ophthalmol 94 (1976): 675-6
- Rongey KA, Weisman H "Hypotension following intraocular acetylcholine." Anesthesiology 36 (1972): 412
- Gombos DS "Acetylcholine in ophthalmology: a revisit." Ann Ophthalmol 20 (1988): 455,462
- Marmion VJ "Vascular hypotension and bradycardia following intraocular injection of acetylcholine during cataract surgery." Am J Ophthalmol 97 (1984): 799-80
- Zimmerman TJ, Wheeler TM "Miotics: side effects and ways to avoid them." Ophthalmology 89 (1982): 76-80
- Rasch D, Holt J, Wilson M, Smith RB "Bronchospasm following intraocular injection of acetylcholine in a patient taking metoprolol." Anesthesiology 59 (1983): 583-5
- Sekiya M, Okayama H, Suzuki M, Kobayashi T, Matsuoka H, Sumimoto T, Hamada M, Hiwada K "Acetylcholine-induced myocardial ischemia without epicardial coronary artery spasm: a possible vasospasm of small coronary arteries--a case report." Angiology 44 (1993): 811-5
- Brinkley JR Jr, Henrick A "Vascular hypotension and bradycardia following intraocular injection of acetylcholine during cataract surgery." Am J Ophthalmol 97 (1984): 40-2
- "Product Information. Isopto Carpine (pilocarpine ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
- "Product Information. Eserine (physostigmine ophthalmic)." Ciba Vision Ophthalmics, Duluth, GA.
- Treasure CB, Vita JA, Cox DA, Fish RD, Selwyn AP, Alexander RW, Ganz P "Acute myocardial infarction with normal coronary arteries associated with acetylcholine-induced vasoconstriction in the absence of a positive ergonovine test." Am J Cardiol 65 (1990): 255-7
- "Product Information. Isopto Carbachol (carbachol ophthalmic)" Alcon Laboratories Inc, Ft Worth, TX.
- "Product Information. Miochol (acetylcholine chloride, intraocular)." Ciba Vision Ophthalmics, Duluth, GA.
- "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
- Gombos GM "Systemic reactions following intraocular acetylcholine instillation." Ann Ophthalmol 14 (1982): 529-30
- Taytard A, Vergeret J, Auzerie J, Freour P "Acetylcholine-induced bronchospasm in asthma patients: dose/response curves." Eur J Respir Dis Suppl 128(Pt 2) (1983): 513-4
- Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
- "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Miochol-E System Pak (acetylcholine ophthalmic) drug Interactions
There are 372 drug interactions with Miochol-E System Pak (acetylcholine ophthalmic)
Miochol-E System Pak (acetylcholine ophthalmic) alcohol/food Interactions
There is 1 alcohol/food interaction with Miochol-E System Pak (acetylcholine ophthalmic)
Drug Interaction Classification
|Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
|No information available.|
Do not stop taking any medications without consulting your healthcare provider.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.