Dosing & Uses
Dosage Forms & Strengths
Open Angle or Secondary Glaucoma
Initial: 0.03% solution instilled in affected eye(s) twice daily (AM & HS); may use higher dose (>0.06%) if unsatisfactory response
Maintenance: 1 dose every other day
Advanced Chronic Simple Glaucoma/Glaucoma Following Cataract Surgery
Initial 0.03% instilled in affected eye(s) twice daily
Higher strengths usu necessary if transferred after unsatisfactory response with other drugs
Dosage Forms & Strengths
Initial (Dx): 0.125% solution instilled in both eyes qHS for 2-3 weeks
Maintenance (if Dx+)
- 0.125% solution qOTHERday
- May be gradually lowered
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Iris cyst formation
Increased intraocular pressure
Lid muscle twitching
Angle clossure glaucoma
Relative: history of retinal detachment; quiescent/history of uveitis
Caution in marked vagotonia, bronchial asthma, spastic GI disturbances, peptic ulcer, pronounced bradycardia & hypotension, recent MI, epilepsy, parkinsonism
Concomitant cholinergic drugs (succinylcholine, systemic myasthenia gravis drugs)
Potential for conjunctival thickening, retinal detachment, lens opacity
Discontinue if cholinergic side-effects occur (hyperhidrosis, sialorrhea, urinary incontience, diarrhea etc) or cardiac irregularities
Do not use more frequently than q12hr
Few weeks of therapy may depress plasma and erythrocyte cholinesterase levels
Perform baseline measurement of anterior chamber angle and perform routine lenss examination; do not use for tonometric glaucoma, or with active history of uveitis
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Discontinue drug or do not nurse
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Cholinesterase inhibitor; enhances activity of endogenous acetylcholine, which leads to continuous stimulation of the ciliary muscle producing miosis and fascilitation of humor outflow that may reduce intraocular pressure
Onset of action: 10-30 min (miosis); 4-8hr (IOP); 24 hr (peak effects IOP)
Duration: 1-4 weeks (miosis)
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.