Included in the formulation
АТХ:S.01.E.B.02 Carbachol
Pharmacodynamics:M- and n-cholinomimetic; ether choline. Stimulates cholinergic receptors, activates the release of acetylcholine, has a weak anticholinesterase effect.
Reduces intraocular pressure: the maximum antihypertensive effect develops after 4 hours, the duration of action is 8 hours. Causes narrowing of the pupil (miosis): the beginning of myotonic effect in 10-20 minutes, the duration of the action is 4-8 hours.
Pharmacokinetics:For carbachol, pharmacokinetics has not been studied.
Indications:Closed-angle glaucoma.
Contraindications:Hypersensitivity, age under 18 years (efficacy and safety not established).
Carefully:Cicatricial changes in the iris, obliteration of the vessels of the fundus, bronchial asthma, chronic heart failure, hyperthyroidism, urinary tract obstruction, gastric or duodenal ulcer (in the anamnesis), Parkinson's disease, pregnancy, lactation.
Pregnancy and lactation:Sufficient experience in the use of the drug during pregnancy and during lactation there.The use of the drug during pregnancy is possible only if the expected benefit for the mother exceeds the potential risk to the fetus and the baby. There is no evidence that the drug can be excreted into breast milk, and therefore breast-feeding for the period of drug use should be discontinued.
Dosing and Administration:Closed-angle glaucoma - 1-2 drops 3-4 times a day in the conjunctival sac.
Induction of miosis during the operation, postoperative increase in intraocular pressure (in the first 24 hours) - a single intraocular injection into the anterior chamber of the eye through an atraumatic cannula. A single dose is not more than 0.5 ml of a 0.05% solution. When intraoperative use can be administered before or after the application of fixing sutures.
Side effects:With systemic suction: bronchial asthma, arrhythmias, diarrhea, cramps or abdominal pain, nausea, redness of the face, frequent urination, hypotension, excessive sweating, syncopal conditions, drooling. Local side effect: blurring of vision, change of vision when focusing at close range (spasm of accommodation).
Pain, burning in the eyes, headache, irritation or redness of the eyes, eyelid twitching, retinal detachment (when using intraocular solution).
Overdose:Symptoms: increased blood pressure, bradycardia, arrhythmias, nausea, increased intestinal peristalsis, increased sweating. Treatment: injections of atropine. The use of hemodialysis is impractical.
Interaction:The alkaloids of belladonna, cyclopentolate - joint application with carbachol may interfere with mydriatic action of these drugs. Flurbiprofen (eye form) - when combined carbachole may be ineffective.
Special instructions:To achieve an effective reduction in intraocular pressure in patients with dark iris, more frequent instillation may be required than in patients with light eyes. To prevent excessive systemic absorption, the patient should press a finger on the lacrimal bag during instillation and hold for 1-2 minutes.
With prolonged use, tolerance to the drug may develop. Efficiency is restored through a temporary transition to another drug with a similar effect, followed by a return to treatment with carbachol.
The prolonged miosis induced by carbachol slows the restoration of the hemo-ophthalmic barrier and promotes the development of inflammation.