Pilocarpine Ophthalmic Dosage

Medically reviewed by Drugs.com. Last updated on Jan 21, 2025.

Usual Adult Dose for Intraocular Hypertension

Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension: One drop of 1%, 2%, or 4% solution applied in the eye(s) up to four times a day

Comments:

• Patients who are naive to this drug should be started on the 1% concentration.
• The frequency of instillation and concentration of this drug is determined by the severity of the elevated intraocular pressure and miotic response of the patient.
• Patients may be instructed to perform punctal occlusion for 2 minutes after instillation to limit systemic exposure to this drug.
• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics, or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.

Prevention of Postoperative Elevated IOP Associated with Laser Surgery: One drop of the 1%, 2%, or 4% solution (or two drops administered five minutes apart) should be applied in the eye(s) 15 to 60 minutes prior to surgery

Comments:

• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.

Usual Adult Dose for Glaucoma (Open Angle)

Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension: One drop of 1%, 2%, or 4% solution applied in the eye(s) up to four times a day

Comments:

• Patients who are naive to this drug should be started on the 1% concentration.
• The frequency of instillation and concentration of this drug is determined by the severity of the elevated intraocular pressure and miotic response of the patient.
• Patients may be instructed to perform punctal occlusion for 2 minutes after instillation to limit systemic exposure to this drug.
• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics, or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.

Prevention of Postoperative Elevated IOP Associated with Laser Surgery: One drop of the 1%, 2%, or 4% solution (or two drops administered five minutes apart) should be applied in the eye(s) 15 to 60 minutes prior to surgery

Comments:

• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.

Usual Adult Dose for Glaucoma (Narrow Angle)

One drop of the 1% or 2% solution applied in the eye(s) up to three times over a 30-minute period

Comments:

• Prior to use, treatment with secretory suppressants and hyperosmotic agents may be needed to lower IOP below 50 mmHg and relieve iris ischemia.
• If laser iridoplasty or iridomy is used to break the attack, one drop of the 4% solution should be administered prior to the procedure.
• Following laser iridoplasty, one drop of the 1% solution should be administered four times daily until an iridotomy can be performed.
• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.

Use: Management of Acute Angle-Closure Glaucoma

Usual Adult Dose for Production of Miosis

One drop of 1%, 2%, or 4% solution (or two drops administered five minutes apart) should be applied in the eye(s)

Comments:

• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.

Use: Induction of Miosis

Usual Pediatric Dose for Glaucoma

Under 2 years:
One drop of 1% solution should be applied in the eye(s) three times a day

2 years or older:
Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension: One drop of 1%, 2% or 4% solution applied in the eye(s) up to four times a day
Management of Acute Angle-Closure Glaucoma: One drop of the 1% or 2% solution applied in the eye(s) up to three times over a 30-minute period
Prevention of Postoperative Elevated IOP Associated with Laser Surgery: One drop of the 1%, 2% or 4% solution (or two drops administered five minutes apart) should be applied in the eye(s) 15 to 60 minutes prior to surgery

Comments:

• Patients who are naive to this drug should be started on the 1% concentration.
• The frequency of instillation and concentration of this drug is determined by the severity of the elevated intraocular pressure and miotic response of the patient.
• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.
• Prior to use, treatment with secretory suppressants and hyperosmotic agents may be needed to lower IOP below 50 mmHg and relieve iris ischemia.
• If laser iridoplasty or iridomy is used to break the attack, one drop of the 4% solution should be administered prior to the procedure.
• Following laser iridoplasty, one drop of the 1% solution should be administered four times daily until an iridotomy can be performed.

Uses:

• Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension
• Management of acute angle-closure glaucoma
• Prevention of postoperative elevated IOP associated with laser surgery
• Induction of miosis

Usual Pediatric Dose for Intraocular Hypertension

Under 2 years:
One drop of 1% solution should be applied in the eye(s) three times a day

2 years or older:
Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension: One drop of 1%, 2% or 4% solution applied in the eye(s) up to four times a day
Management of Acute Angle-Closure Glaucoma: One drop of the 1% or 2% solution applied in the eye(s) up to three times over a 30-minute period
Prevention of Postoperative Elevated IOP Associated with Laser Surgery: One drop of the 1%, 2% or 4% solution (or two drops administered five minutes apart) should be applied in the eye(s) 15 to 60 minutes prior to surgery

Comments:

• Patients who are naive to this drug should be started on the 1% concentration.
• The frequency of instillation and concentration of this drug is determined by the severity of the elevated intraocular pressure and miotic response of the patient.
• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.
• Prior to use, treatment with secretory suppressants and hyperosmotic agents may be needed to lower IOP below 50 mmHg and relieve iris ischemia.
• If laser iridoplasty or iridomy is used to break the attack, one drop of the 4% solution should be administered prior to the procedure.
• Following laser iridoplasty, one drop of the 1% solution should be administered four times daily until an iridotomy can be performed.

Uses:

• Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension
• Management of acute angle-closure glaucoma
• Prevention of postoperative elevated IOP associated with laser surgery
• Induction of miosis

Usual Pediatric Dose for Production of Miosis

Under 2 years:
One drop of 1% solution should be applied in the eye(s) three times a day

2 years or older:
Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension: One drop of 1%, 2% or 4% solution applied in the eye(s) up to four times a day
Management of Acute Angle-Closure Glaucoma: One drop of the 1% or 2% solution applied in the eye(s) up to three times over a 30-minute period
Prevention of Postoperative Elevated IOP Associated with Laser Surgery: One drop of the 1%, 2% or 4% solution (or two drops administered five minutes apart) should be applied in the eye(s) 15 to 60 minutes prior to surgery

Comments:

• Patients who are naive to this drug should be started on the 1% concentration.
• The frequency of instillation and concentration of this drug is determined by the severity of the elevated intraocular pressure and miotic response of the patient.
• This drug may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents.
• If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 minutes apart.
• Prior to use, treatment with secretory suppressants and hyperosmotic agents may be needed to lower IOP below 50 mmHg and relieve iris ischemia.
• If laser iridoplasty or iridomy is used to break the attack, one drop of the 4% solution should be administered prior to the procedure.
• Following laser iridoplasty, one drop of the 1% solution should be administered four times daily until an iridotomy can be performed.

Uses:

• Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension
• Management of acute angle-closure glaucoma
• Prevention of postoperative elevated IOP associated with laser surgery
• Induction of miosis

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dialysis

Data not available

Other Comments

Patient advice:

• Patients should be instructed to wash their hands before use and avoid allowing the tip of the bottle to come into contact with the eye or surrounding structures.
• Systemic absorption of drugs from ophthalmic solutions may be minimized by

pressure on the tear-duct immediately after application.

Storage requirements:

• Do not freeze
• Protect from light
• Pilocarpine nitrate: Store between 2 C to 8 C ( 36 F to 46 F)

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer