Carbachol

What is Carbachol?

• Carbachol (Miostat; carbastat) is a potent cholinergic (parasympathomimetic) agent, a sterile balanced salt solution of carbachol for intraocular injection.
• It is also known as carbamylcholine.

File:Carbachol chloride.svg

Carbachol chloride

What are the uses of this medicine?

• Carbachol (Miostat; carbastat) is used for obtaining miosis during surgery.
• In addition it reduces the intensity of intraocular pressure elevation in the first 24 hours after cataract surgery.

How does this medicine work?

• Carbachol is a potent cholinergic (parasympathomimetic) agent which produces constriction of the iris and ciliary body resulting in reduction in intraocular pressure.
• The exact mechanism by which carbachol lowers intraocular pressure is not precisely known.
• In topical ocular and intraocular administration its principal effects are miosis and increased aqueous humour outflow.

Who Should Not Use this medicine ?

This medicine have cannot be used in patients:

• showing hypersensitivity to any of the components of this preparation.

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Is this medicine FDA approved?

• Yes, it was FDA approved.
• In most countries carbachol is only available by prescription.
• Outside the United States, it is also indicated for urinary retention as an oral (2 mg) tablet.

How should this medicine be used?

Recommended dosage:

• No more than one-half milliliter should be gently instilled into the anterior chamber for the production of satisfactory miosis.
• It may be instilled before or after securing sutures.
• Miosis is usually maximal within two to five minutes after application.

Administration:

• Aseptically remove the sterile vial from the blister package by peeling the backing paper and dropping the vial onto a sterile tray.
• Withdraw the contents into a dry sterile syringe, and replace the needle with an atraumatic cannula prior to intraocular instillation.
• Miostat should be gently instilled into the anterior chamber of eye.
• For single-dose intraocular use only.
• Discard unused portion.
• The vial stopper contains natural rubber (latex) which may cause severe allergic reactions.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As carbachol intraocular solution, USP 0.01%, a sterile balanced salt solution of carbachol for intraocular injection.

This medicine is available in fallowing brand namesː Miostat; carbastat

What side effects can this medication cause?

The most common side effects of this medicine include:

• Corneal clouding, persistent bullous keratopathy, retinal detachment and postoperative iritis

• Side effects such as flushing, sweating, epigastric distress, abdominal cramps, tightness in urinary bladder, and headache have been reported with topical or systemic application of carbachol.

The most serious adverse reactions may include:

• corneal edema, drug effect prolonged (miosis), eye inflammation, eye pain, intraocular pressure increased, ocular hyperemia, vision blurred, visual impairment, and vomiting.

What special precautions should I follow?

• For single-dose intraocular use only.
• Discard unused portion.
• Intraocular carbachol 0.01% should be used with caution in patients with acute cardiac failure, bronchial asthma, peptic ulcer, hyperthyroidism, G.I. spasm, urinary tract obstruction and Parkinson's disease.
• The vial stopper contains natural rubber (latex) which may cause severe allergic reactions.
• Use only if the container is undamaged.
• It is not known if this medication is excreted in breast milk. Exercise caution when administering to a nursing woman.

What to do in case of emergency/overdose?

Symptoms of overdosage may include: The effects of a systemic overdose will probably be as fallows:

• corneal edema, drug effect prolonged (miosis), eye inflammation, eye pain, intraocular pressure increased, ocular hyperemia, vision blurred, visual impairment, and vomiting.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Can this medicine be used in pregnancy?

• Category C.
• There are no adequate and well controlled studies in pregnant women.
• carbachol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Can this medicine be used in children?

• Safety and efficacy in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• Carbachol

Inactive ingredients:

• calcium chloride dihydrate
• hydrochloric acid
• magnesium chloride hexahydrate
• potassium chloride
• sodium acetate trihydrate
• Sodium chloride
• sodium citrate dihydrate
• sodium hydroxide
• water

Who manufactures and distributes this medicine?

Carbastat Manufactured by:

• OMJ Pharmaceuticals, Inc.,
• San Germán
• for Novartis Ophthalmics
• Duluth, GA

Miostat:

• Distributed by:
• Alcon Laboratories, Inc.
• Fort Worth, Texas

What should I know about storage and disposal of this medication?

• Store at 15° - 30°C (59° - 86°F).

• Dailymed label info on Carbachol
• FDA Carbachol