Pilocarpine: its uses, side effects, and FAQs

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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.

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

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.

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.

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.

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.

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.

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.

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

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

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.

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

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

For a free second opinion, consult our medical experts.