Ophthalmic surgery: Intraocular: Usual dosage: 0.5 to 2 mL.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Cardiovascular: Bradycardia, flushing, hypotension
Dermatologic: Diaphoresis
Ophthalmic: Cloudy vision, corneal decompensation, corneal edema
Respiratory: Dyspnea
Hypersensitivity to acetylcholine chloride or any component of the formulation
Disease-related concerns:
• Diseases affected by systemic effects: Systemic effects rarely occur but can cause problems for patients with asthma, GI spasm, acute heart failure, hyperthyroidism, Parkinson's disease, peptic ulcer disease, and or urinary tract obstruction. In a scientific statement from the American Heart Association, ophthalmic cholinergic agents have been determined to be agents that may exacerbate underlying myocardial dysfunction (magnitude: minor) (AHA [Page 2016]).
Other warnings/precautions:
• Aseptic conditions: Open under aseptic conditions only; do not gas sterilize.
• Cataract surgery: During cataract surgery, use only after lens is in place.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Intraocular, as chloride:
Miochol-E: 20 mg (1 ea) [contains mannitol]
No
Solution (reconstituted) (Miochol-E Intraocular)
20 mg (per each): $154.37
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Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Intraocular, as chloride:
Miochol-E: 20 mg (2 mL)
Ophthalmic: Open under aseptic conditions only. Attach filter before irrigating eye. Instill into anterior chamber before or after securing one or more sutures; instillation should be gentle and parallel to the iris face and tangential to the pupil border; in cataract surgery, acetylcholine should be used only after delivery of the lens.
Ophthalmic surgery: To obtain miosis of the iris in seconds after delivery of the lens in cataract surgery, in penetrating keratoplasty, iridectomy, and other anterior segment surgery where rapid miosis may be required
Acetylcholine may be confused with acetylcysteine
None known.
There are no known significant interactions.
Causes contraction of the sphincter muscles of the iris, resulting in miosis and contraction of the ciliary muscle, leading to accommodation spasm
Onset of action: Rapid
Duration: ~20 minutes (Kanski 1968); duration as long as 6 hours has been reported (Roszkowska 1998)
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