carbachol (Rx)

Brand and Other Names:Miostat
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

intraocular solution

  • 0.01%

topical solution

  • 1.5%
  • 3%

Glaucoma

1-2 gtt instilled into conjunctival sac three times daily

Inhibition of Perioperative Intraocular Pressure

0.5 mL instilled into the anterior chamber before or after securing sutures

As in adults

Next:

Interactions

Interaction Checker

and carbachol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (67)

                • aclidinium

                  carbachol increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • amifampridine

                  amifampridine and carbachol both increase cholinergic effects/transmission. Use Caution/Monitor.

                • amitriptyline

                  carbachol increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

                • amoxapine

                  carbachol increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • anticholinergic/sedative combos

                  carbachol increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atracurium

                  carbachol increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atropine

                  carbachol increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atropine IV/IM

                  carbachol increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                • belladonna alkaloids

                  carbachol increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • belladonna and opium

                  carbachol increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • bethanechol

                  bethanechol and carbachol both increase cholinergic effects/transmission. Use Caution/Monitor.

                • cevimeline

                  carbachol and cevimeline both increase cholinergic effects/transmission. Use Caution/Monitor.

                • cisatracurium

                  carbachol increases and cisatracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • clomipramine

                  carbachol increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • cyclizine

                  carbachol increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • cyclobenzaprine

                  carbachol increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • darifenacin

                  carbachol increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dicyclomine

                  carbachol increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • diphenhydramine

                  carbachol increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • donepezil

                  carbachol and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.

                • dosulepin

                  carbachol increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • doxepin

                  carbachol increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • echothiophate iodide

                  carbachol and echothiophate iodide both increase cholinergic effects/transmission. Use Caution/Monitor.

                • fesoterodine

                  carbachol increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • flavoxate

                  carbachol increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • galantamine

                  carbachol and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • glycopyrrolate

                  carbachol increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • glycopyrrolate inhaled

                  carbachol increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • henbane

                  carbachol increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • homatropine

                  carbachol increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • huperzine A

                  carbachol and huperzine A both increase cholinergic effects/transmission. Use Caution/Monitor.

                • hyoscyamine

                  carbachol increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • hyoscyamine spray

                  carbachol increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                • imipramine

                  carbachol increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • ipratropium

                  carbachol increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • lofepramine

                  carbachol increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • maprotiline

                  carbachol increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • meclizine

                  carbachol increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • methscopolamine

                  carbachol increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • neostigmine

                  carbachol and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • nortriptyline

                  carbachol increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • onabotulinumtoxinA

                  carbachol increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • orphenadrine

                  carbachol increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin

                  carbachol increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin topical

                  carbachol increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin transdermal

                  carbachol increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pancuronium

                  carbachol increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • physostigmine

                  carbachol and physostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pilocarpine

                  carbachol and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pilocarpine ophthalmic

                  carbachol and pilocarpine ophthalmic both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pralidoxime

                  carbachol increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • propantheline

                  carbachol increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • protriptyline

                  carbachol increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pyridostigmine

                  carbachol and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • rapacuronium

                  carbachol increases and rapacuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • rimabotulinumtoxinB

                  carbachol increases and rimabotulinumtoxinB decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • rivastigmine

                  carbachol and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • rocuronium

                  carbachol increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • scopolamine

                  carbachol increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • solifenacin

                  carbachol increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • succinylcholine

                  carbachol and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • tiotropium

                  carbachol increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • tolterodine

                  carbachol increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • trimipramine

                  carbachol increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • trospium chloride

                  carbachol increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • umeclidinium bromide

                  carbachol increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.

                • vecuronium

                  carbachol increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                Minor (6)

                • desipramine

                  carbachol increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

                • donepezil

                  donepezil increases effects of carbachol by pharmacodynamic synergism. Minor/Significance Unknown.

                • galantamine

                  galantamine increases effects of carbachol by pharmacodynamic synergism. Minor/Significance Unknown.

                • pantothenic acid

                  pantothenic acid, carbachol. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.

                • procainamide

                  procainamide decreases effects of carbachol by pharmacodynamic antagonism. Minor/Significance Unknown.

                • trazodone

                  carbachol increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

                Previous
                Next:

                Adverse Effects

                Frequency Not Defined

                Ocular

                • Corneal clouding
                • Stinging (transient)
                • Ciliary spasm
                • Bullous keratopathy
                • Persistent bullous keratopathy
                • Postoperative iritis following cataract extraction
                • Retinal detachment (rare)
                • Corneal edema, drug effect prolonged miosis, eye inflammation, eye pain, intraocular pressure increased, ocular hyperemia, vision blurred, and visual impairment

                Systemic

                • Abdominal cramps
                • Epigastric distress
                • Flushing
                • Arrhythmia
                • Hypotension
                • Syncope
                • Epigastric stress
                • Salivation
                • Vomiting
                • Asthma
                • Diaphoresis
                • Headache
                • Sweating
                • Tightness in urinary bladder
                Previous
                Next:

                Warnings

                Contraindications

                Hypersensitivity

                Acute iritis

                Acute inflammatory disease of the anterior chamber

                Cautions

                Use caution in asthma, acute heart failure, corneal abrasion, hyperthyroidism, urinary tract obstruction, Parkinson's disease, active peptic ulcer, GI spasm

                Does not penetrate cornea readily, benzalkonium chloride is added in some formulations to enhance corneal penetration (Isopto-Carbachol)

                Topical ophthalmic solution produces transient ocular & frontal headache

                Use with caution in patients undergoing general anesthesia

                The vial stopper contains natural rubber (latex) which may cause severe allergic reactions

                Previous
                Next:

                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: Excretion in milk unknown; use with caution

                Pregnancy Categories

                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.

                Previous
                Next:

                Pharmacology

                Mechanism of Action

                Stimulates cholinergic receptors in the eye and in turn causes miosis

                Pharmacokinetics

                Duration:4-8 hr (reduction in intraocular pressure with ophthalmic instillation); 24hr (intraocular administration)

                Onset: miosis: 2-3 min ((intraocular inj); ; 10-20 min (ophthalmic instillation)

                Previous
                Next:

                Administration

                Administration

                Topical solution: to reduce drainage to nose & throat, apply finger pressure to lacrimal sac following administration, remove excess solution from eye & hand

                Intraocular Injection: Withdraw appropriate amount into a sterile disposable syringe through a 0.45-micron filter provided by manufacturer using a 21-gauge needle. Prior to administration, remove attached needle & filter from syringe & replace with a suitable atraumatic cannula for intraocular irrigation. Instillation should be gentle & parallel to the iris face & tangential to the pupil border. Discard unused portions.

                Previous
                Next:

                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Miostat intraocular
                -
                0.01 % vial

                Copyright © 2010 First DataBank, Inc.

                Previous
                Next:

                Patient Handout

                Patient Education
                carbachol intraocular

                NO MONOGRAPH AVAILABLE AT THIS TIME

                USES: Consult your pharmacist.

                HOW TO USE: Consult your pharmacist.

                SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Consult your pharmacist.

                DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: No monograph available at this time.

                MISSED DOSE: Consult your pharmacist.

                STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

                Previous
                Next:

                Formulary

                FormularyPatient Discounts

                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.
                • Access your plan list on any device – mobile or desktop.

                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.

                Tier Description
                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.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
                Additional Offers
                Email to Patient

                From:

                To:

                The recipient will receive more details and instructions to access this offer.

                By clicking send, you acknowledge that you have permission to email the recipient with this information.

                Email Forms to Patient

                From:

                To:

                The recipient will receive more details and instructions to access this offer.

                By clicking send, you acknowledge that you have permission to email the recipient with this information.

                Previous
                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.