Medically reviewed by Drugs.com. Last updated on Apr 26, 2020.
(a se teel KOE leen)
- Acetylcholine Chloride
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Intraocular, as chloride:
Miochol-E: 20 mg (1 ea) [contains mannitol]
Brand Names: U.S.
- Cholinergic Agonist
- Ophthalmic Agent, Miotic
Causes contraction of the sphincter muscles of the iris, resulting in miosis and contraction of the ciliary muscle, leading to accommodation spasm
Onset of Action
Duration of Action
~20 minutes (Kanski 1968); duration as long as 6 hours has been reported (Roszkowska 1998)
Use: Labeled Indications
Ophthalmic surgery: To obtain miosis of the iris in seconds after delivery of the lens in cataract surgery, in penetrating keratoplasty, iridectomy, and other anterior segment surgery where rapid miosis may be required
Hypersensitivity to acetylcholine chloride or any component of the formulation
Ophthalmic surgery: Intraocular: Usual dosage: 0.5 to 2 mL
Refer to adult dosing.
Reconstitute in an aseptic environment immediately before use.
Ophthalmic: Open under aseptic conditions only. Attach filter before irrigating eye. Instill into anterior chamber before or after securing one or more sutures; instillation should be gentle and parallel to the iris face and tangential to the pupil border; in cataract surgery, acetylcholine should be used only after delivery of the lens.
Store unopened vial at 4°C to 25°C (39°F to 77°F); prevent from freezing. Prepare solution immediately before use and discard unused portion. Acetylcholine solutions are unstable. Only use if solution is clear and colorless.
Acetylcholinesterase Inhibitors: May enhance the adverse/toxic effect of Cholinergic Agonists. Monitor therapy
Beta-Blockers: May enhance the adverse/toxic effect of Cholinergic Agonists. Of particular concern are the potential for cardiac conduction abnormalities and bronchoconstriction. Monitor therapy
Sincalide: Drugs that Affect Gallbladder Function may diminish the therapeutic effect of Sincalide. Management: Consider discontinuing drugs that may affect gallbladder motility prior to the use of sincalide to stimulate gallbladder contraction. Consider therapy modification
Frequency not defined.
Cardiovascular: Bradycardia, flushing, hypotension
Ophthalmic: Cloudy vision, corneal decompensation, corneal edema
• Diseases affected by systemic effects: Systemic effects rarely occur but can cause problems for patients with asthma, GI spasm, acute heart failure, hyperthyroidism, Parkinson's disease, peptic ulcer disease, and or urinary tract obstruction. In a scientific statement from the American Heart Association, ophthalmic cholinergic agents have been determined to be agents that may exacerbate underlying myocardial dysfunction (magnitude: minor) (AHA [Page 2016]).
• Aseptic conditions: Open under aseptic conditions only; do not gas sterilize.
• Cataract surgery: During cataract surgery, use only after lens is in place.
What is this drug used for?
• It is used during eye surgery.
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
• Sudden vision changes
• Severe eye irritation
• Eye pain
• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.
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