Adult Dosing

Miosis during ocular Surgery

• 0.5-2 mL intraocular injection x 1

• Use solution only after lens delivery
• Instill the solution into the anterior chamber before or after securing one or more sutures and should be gentle and parallel to the iris face and tangential to pupil border
• In cataract surgery, use only after delivery of the lens

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• For obtaining miosis of the iris following delivery of the lens in cataract surgery
• In penetrating keratoplasty, iridectomy and anterior segment surgery where rapid miosis is required

• Hypersensitivity to any of the ingredients of the product
• Acute iritis
• Anterior or acute uveitis
• Acute anterior chamber inflammation

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Avoid gas sterlization. If blister or peelable backing is damaged or broken, sterility of the enclosed vial and ampoule cannot be assured. Open under aseptic conditions only
• Release anatomical hindrances to miosis, such as anterior or posterior synechiae prior to administration if miosis is to be obtained quickly. Anatomical hindrances to miosis bust be released prior to administration
• During cataract surgery, use therapy only after delivery of the lens
• Topical NSAIDS may diminish effectiveness

Pregnancy Category:C

Breastfeeding: No information is available on the use of acetylcholine ophthalmic drops during breastfeeding. Because of its short half-life, it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 28 June 2011).

• CV: Bradycardia, hypotension
• EENT: Corneal edema, corneal clouding, corneal decompensation, cataract, transient corneal decompensation, corneal edema, endophthalmitis, optic atrophy
• DERM: Flushing, sweating
• RESP: Breathing difficulties

• Cholinergics/Miotics; stimulates cholinergic receptors resulting in constriction of the iris and ciliary body thus produces miosis and reduces IOP
• Metabolism: Rapid hydrolysis via acetylcholinesterase
• Excretion: Unknown
• Half-life: Unknown

US Trade Name(s)

• Miochol-E

US Availability

Miochol-E

• PWDR for INJ: 20 mg/vial

Canadian Trade Name(s)

• Miochol-E
• Miogan PWS

Canadian Availability

Miochol-E

• PWDR for INJ: 10 mg/mL

Miogan PWS

• PWDR for INJ: 20 mg/mL

UK Trade Name(s)

• Miochol-E

UK Availability

Miochol-E

• PWDR for INJ: 20 mg/mL

Australian Trade Name(s)

• Miochol-E

Australian Availability

Miochol-E

• PWDR for INJ: 20 mg/2mL

Ophthalmic

Ophthalmic Surgical Agents