Rarely, pilocarpine ophthalmic may cause retinal detachment. Tell your doctor if you have any type of retinal disease, if you have had a retinal tear, if you are nearsighted, or if you have had cataract surgery. These conditions may increase the risk of retinal detachment.
Before using this medication, tell your doctor if you
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have heart failure,
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have high or low blood pressure,
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have ever had a heart attack,
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have asthma,
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have a stomach ulcer or stomach spasms,
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have epilepsy,
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have hyperthyroidism (an overactive thyroid),
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have blockage of your urinary tract or difficulty urinating, or
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have Parkinson’s disease.
You may not be able to use pilocarpine ophthalmic, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.
Pilocarpine ophthalmic is in the FDA pregnancy category C. This means that it is not known whether pilocarpine ophthalmic will harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant.
It is not known whether pilocarpine passes into breast milk. Do not use pilocarpine ophthalmic without first talking to your doctor if you are breast-feeding a baby.
Use pilocarpine ophthalmic eyedrops or gel exactly as directed by your doctor. If you do not understand these instructions, ask your doctor, pharmacist, or nurse to explain them to you.
To apply the eyedrops:
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Tilt your head back slightly and pull down on your lower eyelid. Position the dropper above your eye. Look up and away from the dropper. Squeeze out a drop and close your eye. Apply gentle pressure to the inside corner of your eye (near your nose) for about 1 minute to prevent the liquid from draining down your tear duct. If you are using drops in both eyes, repeat the process. If you are using more than one drop in the same eye, repeat the process with about 5 minutes between drops.
To apply the gel:
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Tilt your head back slightly and pull down gently on your lower eyelid. Apply a thin film, about an inch long, into your lower eyelid. Close your eye and roll your eyeball around in all directions for 1 to 2 minutes. If you are also using eyedrops, apply them at least 5 full minutes before using the gel.
Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper or tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye.
Do not use any eyedrop that is discolored or has particles in it.
Store pilocarpine ophthalmic at room temperature away from moisture and heat. Keep the bottle or tube properly capped. Discard any unused medication on the expiration date.
Apply the missed dose as soon as you remember. However, if it is almost time for your next
regularly scheduled dose, skip the missed dose and apply the next one as directed.
Call your doctor immediately if you notice any decrease in vision or an increase in "floaters” in your visual field. Rarely, pilocarpine ophthalmic may cause retinal detachment. Retinal detachment can lead to blind spots, floaters in your visual field, and even blindness. Your doctor will want to check your retina before you use this medicine to determine if you have an increased risk of retinal detachment.
If you experience any of the following serious side effects, stop using pilocarpine ophthalmic and seek emergency medical attention:
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an allergic reaction (difficulty breathing; shortness of breath; swelling of your lips, face, or tongue; or hives);
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abdominal cramps or diarrhea;
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watering mouth;
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excessive sweating;
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urinary incontinence;
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muscle weakness;
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difficulty breathing; or
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an irregular heartbeat
Other, less serious side effects may be more likely to occur. Continue to use pilocarpine ophthalmic and talk to your doctor if you experience
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burning, stinging, red, or tearing eyes;
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eyelid muscle twitches;
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headache or brow ache; or
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decreased vision in poor light.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper or tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye.
Apply light pressure to the inside corner of your eye (near your nose) after each drop to prevent the fluid from draining down your tear duct.
Use caution when driving, operating machinery, or performing other hazardous activities at night or in poor light. Pilocarpine ophthalmic may cause decreased vision in poor light. If you experience decreased vision, avoid these activities.
Use caution when driving, operating machinery, or performing other hazardous activities at night or in poor light. Pilocarpine ophthalmic may cause decreased vision in poor light. If you experience decreased vision, avoid these activities.
Do not touch the dropper or tube opening to any surface, including your eyes or hands. The dropper or tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye.
The pilocarpine ophthalmic eyedrops contain a preservative (benzalkonium chloride), so do not wear soft contact lenses when applying this medication. Contact lenses can be inserted 15 minutes after you have applied the drops.
Avoid other eye medications unless your doctor approves.
Before using this medication, tell your doctor if you are using another eye medication, especially if it is a nonsteroidal anti-inflammatory drug (NSAID) such as flurbiprofen (Ocufen), suprofen (Profenal), diclofenac (Voltaren), or ketorolac (Acular).
Drugs other than those listed here may also interact with pilocarpine ophthalmic. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.
Flush the eye with water and seek emergency medical attention.
Symptoms of a pilocarpine ophthalmic overdose include sweating, nausea, vomiting, diarrhea, watering mouth, and tearing eyes.