Pilocarpine Ophthalmic

(pye loe kar' peen)

Brand Name(s): Qlosi^®, Isopto Carpine^®, Pilopine^® HS¶, Betoptic^® Pilo (as a combination product containing Betaxolol, Pilocarpine)¶, Vuity^®; also available generically

WHY is this medicine prescribed?

Pilocarpine ophthalmic is used to treat glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision) and ocular hypertension (a condition which causes increased pressure in the eye). Pilocarpine ophthalmic is also used to prevent or reduce increased pressure in the eye during and after certain types of laser eye surgery. It is also used during an eye exam to constrict (close) the pupil (the black part of the eye through which you see). Pilocarpine ophthalmic (Vuity, Qlosi) is used to treat presbyopia (a condition in which the lens of the eye loses its ability to focus making hard to see objects up close) in adults. Pilocarpine is in a class of medications called miotics. Pilocarpine ophthalmic treats glaucoma and ocular hypertension by allowing excess fluid to drain from the eye. Pilocarpine ophthalmic treats presbyopia by reducing the size of the pupils which helps to see objects up close.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Pilocarpine ophthalmic comes as a 0.4, 1, 1.25, 2, and 4% solution (liquid) to instill in the eyes. For the treatment of glaucoma or ocular hypertension, one drop of the 1, 2, or 4% solution is usually into the affected eye(s) up to four times daily. To prevent or reduce increased pressure in the eye during and after certain types of laser eye surgery, one or two drops of the 1, 2, or 4% solution are usually instilled into the affected eye(s) 15 to 60 minutes before surgery. For the treatment of presbyopia, one drop of the 1.25% solution (Vuity) is usually instilled into the affected eyes once a day or one drop of the 0.4% solution (Qlosi) into the affected eyes up to twice a day (eye drop can be repeated after 2 to 3 hours for an effect of 8 hours) as needed to control symptoms. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use pilocarpine eye drops exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Pilocarpine eye drops control your condition, but will not cure it. Continue to use pilocarpine eye drops even if you feel well. Do not stop using pilocarpine eye drops without talking to your doctor.

If you are using another topical eye medication, instill it at least 5 minutes before or after you instill pilocarpine eye drops.

Be careful not to let the tip of the bottle touch your eye, fingers, face, or any surface. If the tip does touch another surface, bacteria may get into the eye drops.

To instill the eye drops, follow these steps:

1. Wash your hands thoroughly with soap and water.
2. Check the dropper tip to make sure that it is not chipped or cracked.
3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
6. Brace the remaining fingers of that hand against your face.
7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
9. Place a finger on the tear duct and apply gentle pressure for 2 minutes.
10. Wipe any excess liquid from your face with a tissue.
11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
13. Wash your hands to remove any medication.

What SPECIAL PRECAUTIONS should I follow?

Before using pilocarpine eye drops,

• tell your doctor and pharmacist if you are allergic to pilocarpine, any other medications, or any of the ingredients in pilocarpine eye drops. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while you are using pilocarpine ophthalmic. Your doctor may need to change the doses of your medications or monitor you carefully for side effects..

• tell your doctor if you have or have ever had acute iritis (uveitis; swelling and irritation inside the eye) or retinal detachment.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using pilocarpine eye drops, call your doctor.

• you should know that pilocarpine eye drops should not be instilled while you are wearing contact lenses. If you wear contact lenses, remove them before instilling pilocarpine eye drops; you may put them back in 10 minutes later.

• you should know that pilocarpine eye drops may cause changes in vision, especially at night, or when there is not enough light. Be careful when driving at night, or when performing dangerous activities in low lighting. Pilocarpine may also cause blurred vision. If blurred vision occurs, do not drive or operate heavy machinery until vision clears.

What should I do IF I FORGET to take a dose?

Instill or apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill or apply a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Pilocarpine eye drops or eye gel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• blurred or dim vision
• stinging, burning, or discomfort in the eye
• itching or redness of the eye
• tearing or swelling of the eye
• headache

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• sudden onset of flashing lights, floaters or loss of vision
• sweating
• nausea
• vomiting
• diarrhea

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep the medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Pilocarpine 0.4% ophthalmic solution (Qlosi) comes in single dose vials that should be stored in the refrigerator. Once the vial is removed from its foil packet, it can be stored at room temperature for 30 days.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• sweating
• nausea
• muscle tremors
• watering of the mouth
• slow heart rate

What OTHER INFORMATION should I know?

Keep all appointments with your doctor. Your doctor will order certain eye tests to check your response to pilocarpine eye drops.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

^¶ This branded product is no longer on the market. Generic alternatives may be available.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: January 15, 2024.