Abilene Premier Eye Care Logo

Patient Portal

Local (325) 701-9885
Toll Free (885) 813-1446
2959 Buffalo Gap Road • Abilene, TX 79605


Cholinergic (Miotic)

Medication Company Brand Name Generic Name
Carpine Alcon, Inc. Isopto® Carpine Pilocarpine HCl 1%, 2%, 4%
Carbachol Alcon, Inc. Isopto® Carbachol Carbachol 0.75%, 1.5%, 3%
Pilopine Alcon, Inc. Pilopine HS® Gel Pilocarpine HCl gel 4%
Pilocarpine Bausch & Lomb Inc. Pilocarpine HCl Ophthalmic Solution USP Pilocarpine HCI 1%, 2%, 4%

These medications reduce eye pressure by increasing the drainage of intraocular fluid through the trabecular meshwork. Cholinergics can be used alone or combined with other glaucoma medications. A combination of medications can help control how much fluid is produced in the eye and increase the amount of fluid that drains out of the eye.

Side Effects

Many people who use these medications complain of dim vision, especially at night or in darkened areas such as movie theaters. This is due to constriction of the pupil. Miotics increase drainage of intraocular fluid by making the pupil size smaller, thereby increasing the flow of intraocular fluid from the eye.

Additional Side Effects:


  • Transient symptoms of stinging and burning may occur.
  • Ciliary spasm, conjunctival vascular congestion, temporal or supraorbital headache, lacrimation, and induced myopia may occur. This is especially true in younger individuals who have recently started administration.
  • Reduced visual acuity in poor illumination is frequently experienced by older individuals and individuals with lens opacity.

Miotic agents may also cause retinal detachment; thus, care should be exercised with all miotic therapy especially in young myopic patients. Lens opacity (cataracts) may occur with a prolonged use of pilocarpine. Systemic reactions following topical administration, although extremely rare, have included hypertension, tachycardia, bronchitis spasm, pulmonary edema, salivation, sweating, nausea, vomiting, and diarrhea.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.