Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (66)
- 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.
- 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.
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
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
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.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)
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.
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Miostat intraocular - | 0.01 % vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
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) 2023 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.
Formulary
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