Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
ONLS
Minimal chemist's assortment
АТХ:S.01.E.B.01 Pilocarpine
Pharmacodynamics:Stimulation of m-holinoretseptorov: reduction of the sphincter of the iris (miosis), the ciliary body (spasm of accommodation, the intraocular pressure decreases). Decrease in intraocular pressure due to improvement of outflow (number of participants - 5) and decrease of watery moisture intake: maximum hypotensive effect develops within 75 minutes (depending on the concentration of solution), duration - 4-14 hours.
Pharmacokinetics:For eye forms: penetrates well into the cornea. In the conjunctival sac, it is practically not absorbed and does not have a resorptive effect. The maximum concentration in the aqueous humor is reached after 30 minutes. Retained in the tissues of the eye. Half-life is 1.5-2.5 hours.It is excreted unchanged with intraocular fluid. For the tablet form: when ingested quickly absorbed (simultaneous intake of food with a high content of fat reduces the degree of absorption). Plasma does not bind to proteins. Metabolized in synapses of neurons and in plasma. Half-life - 0.76 hours (after taking 5 mg), increases in proportion to the dose: after taking 10 mg, the elimination half-life is 1.35 hours. It is excreted by the kidneys: 30% in unchanged form (within 12 hours), 14% in the form of pilocarpic acid.
Indications:Glaucoma, including acute attacks.Disturbance of trophism of the eye with thrombosis of the central vein of the retina or acute obstruction of its arteries, atrophy of the optic nerve, hemorrhage into the vitreous.
Elimination of mydriatic action of atropine, gomatropin, scopolamine.
VII.H30-H36.H34 Vascular occlusion of the retina
VII.H40-H42 Glaucoma
VII.H43-H45.H43.1 Hemorrhage in the vitreous body
VII.H46-H48.H47.2 Atrophy of the optic nerve
Contraindications:Iritis, iridocyclitis and other conditions in which the pupil narrowing is not recommended (for example, after ophthalmic operations, except when it is necessary to narrow the pupil directly after the operation to prevent the formation of synechia).Anamnestic indications of retinal detachment, high degree of myopia with the risk of detachment of the retina.
Individual intolerance.
Children under 18 years.
Carefully:In patients with retinal detachment in history and in young patients with high degree of myopia; severe cardiovascular failure.
Pregnancy and lactation:The action category for the fetus is FDA-C. The drug is contraindicated during pregnancy. For the period of treatment, it is desirable to refuse breastfeeding.
Dosing and Administration:Instillations in the conjunctival sac. The dosage regimen is set depending on the indications and the dosage form used.
Side effects:Signs of systemic absorption: increased sweating (15%), muscle trembling, nausea (20%), vomiting, diarrhea, dyspnea, drooling (5%). Pain in the eyes.
Blurred vision (5%), changes in vision when focusing at close and far distance.
Deterioration of night vision.
Eye irritation.
Headache and migraine.
Overdose:In case of overdose, it is recommended to wash the eyes with water or an isotonic solution of sodium chloride; if the droplets get inside, induce vomiting or perform gastric lavage.Patients should be examined to determine signs of pilocarpine toxicity (unusual salivation, sweating, nausea, vomiting and diarrhea), and when detected, therapy with anticholinergic drugs may be required.
Interaction:Belladonna alkaloids and cyclopentolate: simultaneous use may interfere with the mydriatic action of these drugs and the anti-glaucoma effect of pilocarpine. Timolol and phenylephrine increase the decrease in intraocular pressure (reduce the production of intraocular fluid).
It can be used in combination with sympathomimetics, β-adrenoblockers, inhibitors of carbonic anhydrase.
M-cholinostimulating activity is reduced by tricyclic antidepressants, phenothiazine derivatives, chloroproticsen, clozapine, enhanced by anticholinesterase drugs.
Bradycardia may develop and blood pressure may decrease during general anesthesia with halothane (in patients who use pilocarpine in the eye drops).
Special instructions:To prevent excessive systemic absorption,the patient should, at the time of instillation, press a finger on the lacrimal sac and hold it in this position for 1-2 minutes.