Carbachol

DEA Class;  Rx

Common Brand Names; Miostat

  • Direct-Acting; 
  • Antiglaucoma, Miotics
 

Direct-acting ophthalmic miotic agent.
Used to lower intraocular pressure (IOP) in glaucoma, induce miosis during surgery, and reduce IOP after cataract surgery.
Eye preparations can produce systemic cholinergic side effects, even with intact epithelium.

Used for intraocular miosis induction during surgery and to reduce increased intraocular pressure during the first 24 hours after cataract surgery.

For lowering intraocular pressure in the treatment of glaucoma.

Hypersensitivity

Acute iritis

Acute inflammatory disease of the anterior chamber

Ocular

  • Corneal clouding
  • Stinging (transient)
  • Ciliary spasm
  • Bullous keratopathy
  • Persistent bullous keratopathy
  • Postoperative iritis following cataract extraction
  • Retinal detachment (rare)
  • Corneal edema, drug effect prolonged miosis, eye inflammation, eye pain, intraocular pressure increased, ocular hyperemia, vision blurred, and visual impairment

Systemic

  • Abdominal cramps
  • Epigastric distress
  • Flushing
  • Arrhythmia
  • Hypotension
  • Syncope
  • Epigastric stress
  • Salivation
  • Vomiting

Use caution in asthma, acute heart failure, corneal abrasion, hyperthyroidism, urinary tract obstruction, Parkinson’s disease, active peptic ulcer, GI spasm

Does not penetrate cornea readily, benzalkonium chloride is added in some formulations to enhance corneal penetration (Isopto-Carbachol)

Topical ophthalmic solution produces transient ocular & frontal headache

Use with caution in patients undergoing general anesthesia

The vial stopper contains natural rubber (latex) which may cause severe allergic reactions

Pregnancy Category: C

Lactation: Excretion in milk unknown; use with caution

Adults

Intraocular injection (Miostat): 0.5 mL/dose intraocularly for induction of miosis.
Ophthalmic solution: 6 drops/day per affected eye.

Geriatric

Intraocular injection (Miostat): 0.5 mL/dose intraocularly for induction of miosis.
Ophthalmic solution: 6 drops/day per affected eye.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Intraocular solution

  • 0.01%

Topical solution

  • 1.5%
  • 3%

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