pilocarpine nitrate at a glance
Medicine class
Miotic and direct-acting parasympathomimetic
Main roles
Pupil constriction, reversal of weaker mydriatics and emergency glaucoma treatment
Presentation
Sterile, preservative-free, single-use eye-drop unit
Vision effects
May temporarily blur vision and make seeing in dim light more difficult
What is pilocarpine nitrate used for?
The selected UK product is licensed as an eye-drop miotic for:
Making the pupil smaller
Reversing the effects of weaker medicines that dilate the pupil
Emergency treatment of glaucoma
How does pilocarpine nitrate work?
Pilocarpine directly stimulates muscarinic acetylcholine receptors. In the eye, this contracts the iris and ciliary muscles, making the pupil smaller and helping aqueous fluid drain from the eye, which can reduce intraocular pressure.
pilocarpine nitrate preparations and strengths
Eye drops
Route: Ophthalmic
Strengths: 2% w/v
How to take pilocarpine nitrate
Use only as directed by the eye-care professional. The selected product is for ophthalmic use and each unit is single-use.
Wash and dry your hands before use.
Pull down the lower eyelid to form a pocket, without letting the container tip touch the eye, eyelid or eyelashes.
After application, close the eye and gently press its inner corner for about one minute to reduce drainage into the nose and systemic absorption.
Use the opened unit immediately and discard it afterwards, even if liquid remains.
Do not use this preparation while wearing soft contact lenses. Do not reinsert lenses until the effects have completely worn off and your clinician says it is appropriate.
If using another eye drop, allow separation between products as directed by the eye-care team.
pilocarpine nitrate side effects
Common or expected effects
- Local effects can include burning, stinging, itching, watering, redness or eye discomfort; their frequency is not known.
- Blurred vision, difficulty focusing, reduced vision in dim light, brow ache or headache can occur, particularly when treatment is started.
Get urgent medical advice
- Sudden flashes, floaters, a curtain-like shadow or sudden visual deterioration, which may indicate retinal detachment or bleeding inside the eye
- Wheezing, bronchospasm or severe shortness of breath
- Marked slowing of the heartbeat, low blood pressure or fainting
- Pronounced sweating, salivation, vomiting or diarrhoea suggesting systemic cholinergic effects
- Severe swelling or other signs of an allergic reaction
pilocarpine nitrate in pregnancy
Evidence for individual glaucoma medicines in pregnancy is limited, although eye drops generally produce low systemic exposure. The selected SmPC says safety has not been established and pilocarpine nitrate should be used only when clearly indicated. Anyone pregnant or planning pregnancy should discuss treatment with their eye specialist rather than stopping necessary glaucoma treatment independently.
pilocarpine nitrate while breastfeeding
Safety during breastfeeding has not been established for the selected product. A prescriber should assess whether treatment is clearly needed; pressing the inner corner of the eye after administration can reduce systemic absorption.
pilocarpine nitrate interactions
These interactions are mainly pharmacodynamic; some are theoretical rather than clinically proven.
Topical or systemic corticosteroids
Long-term use may oppose pilocarpine's pupil-constricting effect.
Systemic anticholinergic medicines
Their opposing action may reduce pilocarpine's miotic effect.
Antihistamines, sympathomimetics, pethidine or tricyclic antidepressants
These medicines may antagonise the intended pupil-constricting response.
Common questions about pilocarpine nitrate
Answers are fully visible for fast scanning and source review.
What is pilocarpine nitrate used for in the eye?
It constricts the pupil and is licensed to reverse weaker pupil-dilating drops and for emergency glaucoma treatment.
Why can pilocarpine nitrate make vision seem darker or blurred?
Constriction of the pupil reduces the light entering the eye, while contraction of the focusing muscle can temporarily alter focus.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.