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    Drugs & Diseases

    echothiophate iodide (Rx)

    Brand and Other Names:Phospholine Iodide
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    Dosing & Uses

    AdultPediatric

    Dosage Forms & Strengths

    ophthalmic solution

    • 0.125%

    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

    ophthalmic solution

    • 0.125%

    Accommodative Esotropia

    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
    Next:

    Interactions

    Interaction Checker

    and echothiophate iodide

    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 (1)

                • succinylcholine

                  echothiophate iodide increases levels of succinylcholine by decreasing metabolism. Avoid or Use Alternate Drug.

                Monitor Closely (66)

                • aclidinium

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

                • amifampridine

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

                • amitriptyline

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

                • amoxapine

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

                • anticholinergic/sedative combos

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

                • atracurium

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

                • atropine

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

                • atropine IV/IM

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

                • belladonna alkaloids

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

                • belladonna and opium

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

                • benztropine

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

                • bethanechol

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

                • carbachol

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

                • cevimeline

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

                • cisatracurium

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

                • clomipramine

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

                • cyclizine

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

                • cyclobenzaprine

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

                • darifenacin

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

                • dicyclomine

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

                • diphenhydramine

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

                • donepezil

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

                • dosulepin

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

                • doxepin

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

                • fesoterodine

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

                • flavoxate

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

                • galantamine

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

                • glycopyrrolate

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

                • glycopyrrolate inhaled

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

                • henbane

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

                • homatropine

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

                • huperzine A

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

                • hyoscyamine

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

                • hyoscyamine spray

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

                • imipramine

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

                • ipratropium

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

                • lofepramine

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

                • maprotiline

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

                • meclizine

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

                • methscopolamine

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

                • neostigmine

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

                • nortriptyline

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

                • onabotulinumtoxinA

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

                • orphenadrine

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

                • oxybutynin

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

                • oxybutynin topical

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

                • oxybutynin transdermal

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

                • pancuronium

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

                • physostigmine

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

                • pilocarpine

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

                • pralidoxime

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

                • propantheline

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

                • protriptyline

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

                • pyridostigmine

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

                • rapacuronium

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

                • rivastigmine

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

                • rocuronium

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

                • scopolamine

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

                • solifenacin

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

                • succinylcholine

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

                • tiotropium

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

                • tolterodine

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

                • trimipramine

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

                • trospium chloride

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

                • umeclidinium bromide

                  echothiophate iodide 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

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

                Minor (6)

                • desipramine

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

                • donepezil

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

                • galantamine

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

                • pantothenic acid

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

                • procainamide

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

                • trazodone

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

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                Adverse Effects

                Frequency Not Defined

                Burning

                Bradycardia

                Flushing

                Hypotension

                Stinging

                Lacrimation

                Iris cyst formation

                Diarrhea

                Nausea

                Vomiting

                Blurred vision

                Ciliary redness

                Increased intraocular pressure

                Miosis

                Myopia

                Uveitis activation

                Lens opacities

                Retinal detachment

                Lid muscle twitching

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                Warnings

                Contraindications

                Hypersensitivity

                Active uveitis

                Angle-closure glaucoma without iridectomy

                Relative: history of retinal detachment; quiescent/history of uveitis

                Cautions

                Use with caution, if at all, in patients with marked vagotonia, bronchial asthma, spastic gastrointestinal disturbances, peptic ulcer, pronounced bradycardia and hypotension, recent myocardial infarction, epilepsy, parkinsonism, and other disorders that may respond adversely to vagotonic effects

                Concomitant cholinergic drugs (succinylcholine, systemic myasthenia gravis drugs)

                Potential for conjunctival thickening, retinal detachment, lens opacity; use with caution, where there is prior history of retinal detachment

                Temporary discontinuance of medication necessary if cholinergic side-effects, including hyperhidrosis, sialorrhea, urinary incontinence, diarrhea, muscle weakness, cardiac irregularities, or respiratory difficulties occur

                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

                Because of possible adverse effects, observe caution in treating elevated IOP with echothiophate iodide for ophthalmic solution in patients who are at same time undergoing treatment with systemic anticholinesterase medications

                Digital compression of nasolacrimal ducts for a minute or two following instillation to minimize drainage into nasal chamber recommended; to prevent possible skin absorption, hands should be washed following instillation

                Patients receiving echothiophate iodide for ophthalmic solution exposed to carbamate- or organophosphate-type insecticides and pesticides should be warned of additive systemic effects possible from absorption of pesticide through respiratory tract or skin; during periods of exposure to such pesticides, the wearing of respiratory masks, and frequent washing and clothing changes may be advisable

                Administer succinylcholine only with great caution, if at all, prior to or during general anesthesia to patients receiving anticholinesterase medication because of possible respiratory or cardiovascular collapse

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: Discontinue drug or do not nurse

                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.

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                Pharmacology

                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

                Pharmacokinetics

                Onset of action: 10-30 min (miosis); 4-8hr (IOP); 24 hr (peak effects IOP)

                Duration: 1-4 weeks (miosis)

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                Images

                No images available for this drug.
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                Patient Handout

                A Patient Handout is not currently available for this monograph.
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                Formulary

                FormularyPatient Discounts

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                • 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.

                View explanations for tiers and restrictions
                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.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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