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Pilocarpine - Uses - Dosages - Side Effects - Precautions

Pilocarpine: Frequently Asked Questions Answered

What is Pilocarpine?

Pilocarpine is a drug that belongs to a class of medications called cholinergic agonists. They stimulate muscarinic receptors in the nervous system. It results in the secretion of acetylcholine, a chemical released from nerve cells. It stimulates receptors that increase the secretion of saliva, sweat, and mucus. It can also decrease eye pressure (intraocular pressure) by constricting the pupil and ciliary muscle. It leads to drainage of excess fluid from the eyes. It is available in eye drops and oral tablet form.

What are the uses of Pilocarpine?

The following are a few of the uses of Pilocarpine.

  • Treats conditions like Sjogren’s syndrome, which causes dry eyes and dry mouth.
  • Reduces open-angle glaucoma and eye pressure
  • Constricts pupil
  • Dry mouth in head and neck cancer patients who had radiotherapy
  • Sometimes it is used before eye surgeries like cataract surgery, corneal graft, etc.
  • Used in sweat test, which is a diagnostic test of cystic fibrosis
  • Used in the treatment of Presbyopia, which is an age-related difficulty in reading small letters.
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What are the side effects of Pilocarpine?

The following are a few side effects of Pilocarpine

  • Excessive salivation
  • Excessive sweating
  • Excessive mucus secretion
  • Diarrhoea
  • Reduced heart rate
  • Increased tears
  • Blurred vision
  • Lung related side effects like difficulty in breathing, cough, phlegm, wheezing.
  • Confusion 
  • Stomach pain
  • Tremors and shaking
  • More frequent urination
  • Headache

Allergic reactions to this drug are infrequent. But if you are experiencing itching, redness, shortness of breath, and other symptoms, stop the medication and consult the doctor immediately.

 

Frequently Asked Questions about Pilocarpine

1. How to dilute Pilocarpine eye drops?

Diluting Pilocarpine can diagnose conditions like Adie's pupil when correct strength Pilocarpine is not available. The solution should be in the ratio of one drop of Pilocarpine to 15 drops of saline. One drop of 2% Pilocarpine is added to 15 drops of normal saline and mixed well.

2. Does Pilocarpine cause weight gain?

If you already have heart conditions, then Pilocarpine may cause some changes to blood pressure, heart rhythm, etc. Some may experience chest discomfort, shortness of breath, palpitations, including abnormal weight gain. If you do, stop Pilocarpine immediately and consult a doctor.

3. Why is Pilocarpine used to treat glaucoma?

Glaucoma is a condition that can lead to loss of vision due to an increase in pressure inside the eye. Pilocarpine can treat this condition by draining the excess fluid and decreasing the intraocular pressure. It also reduces the symptoms of glaucoma.

4. Can cycloplegic be used along with Pilocarpine?

Cycloplegic drugs have the opposite effect of Pilocarpine. The cycloplegic drugs can dilate the pupil in several eye conditions and diagnose. Pilocarpine constricts the pupil. Pilocarpine eye drops are used to reverse the effects of cycloplegic eye drops.

5. Can Pilocarpine cause artificial myopia?

Myopia is a condition where far-away objects are blurry. Some people can experience temporary myopia after using Pilocarpine eye drops. But these visual disturbances will usually correct themselves in a few hours.

6. Can Pilocarpine cause cataracts?

There is a moderate chance that Pilocarpine can cause cataracts. The chances increase in long-term usage, dosage levels, and the age of the patient. Discontinuing Pilocarpine can reverse its effects. Therefore, it is necessary to monitor patients on Pilocarpine who already have cataracts.

7. Is Pilocarpine an anticholinergic?

No, Pilocarpine is a cholinergic drug. It mimics the properties of acetylcholine, which is produced by nerves.

8. When should I take Pilocarpine?

It is recommended to take Pilocarpine during or after meals. The oral tablet dose is usually 3-4 times a day.

9. What is the difference between Pilocarpine and Cevimeline?

Both are cholinergic drugs, which stimulates muscarinic (M1, M2, M3) receptors, which release acetylcholine from nerve endings. Pilocarpine is non-selective and stimulates all receptors, whereas cevimeline is specific to M1/M3 receptors.

10. What is the antidote for Pilocarpine?

In conditions with severe poisoning due to Pilocarpine, atropine is used as an antidote to reverse its effects.

11. Can you use Pilocarpine long-term?

This study suggests that Pilocarpine as an oral tablet is safe to use in long-term administration.

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Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.