Skip to Content
Get key facts and figures about chronic dry eye

Phospholine Iodide (echothiophate iodide ophthalmic) Disease Interactions

There are 6 disease interactions with Phospholine Iodide (echothiophate iodide ophthalmic):

Major

Miotics (Includes Phospholine Iodide) ↔ Retinal Detachment

Severe Potential Hazard, High plausibility

Applies to: Aphakia, Myopia, Retinal Disorder

The use of miotic agents may occasionally cause retinal detachment due to drug-induced ciliary or accommodative spasm, which causes the lens and vitreous to move forward and create a retinal tear. Therapy with miotic agents should be administered with extreme caution, if at all, in patients with risk factors for retinal detachment, such as old age, retinal degenerative changes or other retinal disorders, aphakia, prior cataract extraction, or a history of severe myopia or retinal detachment.

References

  1. "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 9 references
Major

Miotics (Includes Phospholine Iodide) ↔ Uveitis

Severe Potential Hazard, High plausibility

Applies to: Uveitis (Anterior)

The use of miotic agents is contraindicated in patients with active anterior uveitis and/or glaucoma associated with iridocyclitis. Pupillary constriction produced by these agents may aggravate the inflammation and predispose these patients to the development of posterior synechiae.

References

  1. "Product Information. Phospholine iodide (echothiophate iodide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Humorsol Ophthalmic Solution (demecarium bromide ophthalmic)." Merck & Co, Inc, West Point, PA.
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 7 references
Major

Miotics (Long-Acting) (Includes Phospholine Iodide) ↔ Narrow-Angle/Pupillary Block Glaucoma

Severe Potential Hazard, High plausibility

Applies to: Glaucoma (Narrow Angle)

Miotic agents may cause a paradoxical transient increase in intraocular pressure, which can precipitate an acute attack in patients with angle-closure (narrow-angle) glaucoma or anatomically narrow angles. The risk is much higher with long-acting cholinesterase inhibitors (e.g., demecarium and echothiophate), since these agents can cause pupillary block and increase angle closure. Therapy with long-acting cholinesterase inhibitors should be administered cautiously, or avoided, in patients with chronic angle-closure glaucoma or in patients with anatomically narrow angles. The use of echothiophate iodide is specifically contraindicated in most cases of angle-closure glaucoma. Because chronic use of long-acting cholinesterase inhibitors may cause dilation of blood vessels and increased permeability, these agents should be avoided for at least 2 weeks prior to ophthalmic surgery so as to minimize the risk of hyphema. Miotic agents in general should not be used in patients with glaucoma secondary to unrelieved pupillary block.

References

  1. Zimmerman TJ, Wheeler TM "Miotics: side effects and ways to avoid them." Ophthalmology 89 (1982): 76-80
  2. "Product Information. Isopto Carpine (pilocarpine ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  3. "Product Information. Eserine (physostigmine ophthalmic)." Ciba Vision Ophthalmics, Duluth, GA.
View all 7 references
Moderate

Miotics (Includes Phospholine Iodide) ↔ Cataracts

Moderate Potential Hazard, Moderate plausibility

Applies to: Cataracts

The use of miotic agents has been associated with the development of lens opacities characterized by the appearance of anterior subcapsular vacuoles. The incidence of cataracts appears to be highest in patients treated with long-acting cholinesterase inhibitors (e.g., demecarium and echothiophate) and may also be related to age (higher in patients > 60 years of age), drug concentration, frequency of use, and duration of therapy (>= 6 months). Lens opacities usually regress if miotic therapy is withdrawn early in their development but often become progressive once they are established. Therapy with miotic agents should be administered cautiously in patients with or predisposed to cataracts. Slit-lamp examinations should be performed regularly, and miotic therapy discontinued if necessary.

References

  1. Zimmerman TJ, Wheeler TM "Miotics: side effects and ways to avoid them." Ophthalmology 89 (1982): 76-80
  2. "Product Information. Isopto Carpine (pilocarpine ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  3. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
View all 7 references
Moderate

Miotics (Includes Phospholine Iodide) ↔ Systemic Vagotonic Effects

Moderate Potential Hazard, Moderate 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.

References

  1. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
  2. Babinski M, Smith B, Wickerham EP "Hypotension and bradycardia following intraocular acetylcholine injection. Report of a case." Arch Ophthalmol 94 (1976): 675-6
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 20 references
Moderate

Ophthalmic Anticholinesterases (Includes Phospholine Iodide) ↔ Down's Syndrome

Moderate Potential Hazard, Moderate plausibility

Applies to: Down's Syndrome

Topically applied cholinesterase inhibitors are systemically absorbed, with the potential for producing rare but clinically significant systemic effects, including central nervous system disturbances such as confusion and seizures. Children with Down's syndrome may be particularly susceptible to the CNS effects of these drugs. Echothiophate, specifically, has also been reported to cause hyperactivity in these children. Therapy with ophthalmic cholinesterase inhibitors, particularly the long-acting ones (e.g., demecarium and echothiophate), should be administered cautiously in children with Down's syndrome.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):

Phospholine Iodide (echothiophate iodide ophthalmic) drug Interactions

There are 368 drug interactions with Phospholine Iodide (echothiophate iodide ophthalmic)

Phospholine Iodide (echothiophate iodide ophthalmic) alcohol/food Interactions

There is 1 alcohol/food interaction with Phospholine Iodide (echothiophate iodide ophthalmic)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. 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.

Hide