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Isopto® Carpine (pilocarpine hydrochloride ophthalmic solution) is a cholinergic agonist prepared as a sterile topical ophthalmic solution. The active ingredient is represented by the chemical structure:

Established name: pilocarpine hydrochloride Chemical name: 2(3)-furanone, 3-ethyldihydro-4-[(1-methyl-1-imidazol-5-yl)-methyl]- monohydrochloride, (3S-)-. Molecular Formula: CHNO • HCl Molecular Weight: 244.72. Each mL of Isopto® Carpine (pilocarpine hydrochloride ophthalmic solution) contains: pilocarpine hydrochloride 1% (10 mg/mL), 2% (20 mg/mL), or 4% (40 mg/mL).  benzalkonium chloride 0.01%.  hypromellose 2910, boric acid, sodium citrate, sodium chloride (present in 1% only); hydrochloric acid and/or sodium hydroxide (to adjust pH); purified water. Isopto® Carpine has a pH of 3.5 to 5.5 and an osmolality of 290 to 350 mOsm/kg (1% and 2% products) and 550 to 600 mOsm/kg (4% product).

What does ISOPTO CARPINE look like?

What are the available doses of ISOPTO CARPINE?

Bottle filled with 15 mL of 1% (10 mg/mL), 2% (20 mg/mL) or 4% (40 mg/mL) pilocarpine hydrochloride sterile ophthalmic solution.

What should I talk to my health care provider before I take ISOPTO CARPINE?

How should I use ISOPTO CARPINE?

Isopto® Carpine is indicated for the:

One drop of Isopto® Carpine 1%, 2% or 4% should be applied topically in the eye(s) up to four times daily. Pilocarpine-naïve patients should be started on the 1% concentration as higher concentrations are often not tolerated initially. The frequency of instillation and concentration of Isopto® Carpine are determined by the severity of the elevated intraocular pressure and miotic response of the patient. To limit systemic exposure to pilocarpine, patients may be instructed to perform punctal occlusion for 2 minutes after instillation of Isopto® Carpine ophthalmic solution.

What interacts with ISOPTO CARPINE?

Sorry No Records found

What are the warnings of ISOPTO CARPINE?

Sorry No Records found

What are the precautions of ISOPTO CARPINE?

Sorry No Records found

What are the side effects of ISOPTO CARPINE?

Sorry No records found

What should I look out for while using ISOPTO CARPINE?


What might happen if I take too much ISOPTO CARPINE?

Systemic toxicity following topical ocular administration of pilocarpine is rare, but occasionally patients who are sensitive may develop sweating and gastrointestinal overactivity following the suggested dosage and administration. Overdosage can produce sweating, salivation, nausea, tremors and slowing of the pulse and a decrease in blood pressure. In moderate overdosage, spontaneous recovery is to be expected and is aided by intravenous fluids to compensate for dehydration. For patients demonstrating severe poisoning, atropine, the pharmacologic antagonist to pilocarpine, should be used.

How should I store and handle ISOPTO CARPINE?

Isopto® Carpine (pilocarpine hydrochloride ophthalmic solution) 1%, 2% and 4% is supplied sterile in natural low density polyethylene plastic ophthalmic DROP-TAINER® dispensers and green low density polyethylene tips with green polypropylene caps.15 mL in 15 mL bottles1%: 0998-0203-152%: 0998-0204-154%: 0998-0206-15 Store at 15°- 25°C (59° - 77°F) and protect from freezing.


Clinical Information

Chemical Structure

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Clinical Pharmacology

Pilocarpine hydrochloride is a direct acting cholinergic parasympathomimetic agent which acts through direct stimulation of muscarinic receptors and smooth muscle such as the iris and secretory glands. Pilocarpine contracts the ciliary muscle, causing increased tension on the scleral spur and opening of the trabecular meshwork spaces to facilitate outflow of aqueous humor. Outflow resistance is reduced, lowering intraocular pressure (IOP). Pilocarpine also produces miosis through contraction of the iris sphincter muscle. Miosis relieves appositional angle narrowing and closure, which lowers IOP in certain types of angle-closure glaucoma.

Non-Clinical Toxicology

Fexmid may have life-threatening interactions with MAO inhibitors (see ).  Postmarketing cases of serotonin syndrome have been reported during combined use of Cyclobenzaprine Hydrochloride and other drugs, such as SSRIs, SNRIs, TCAs, tramadol, bupropion, meperidine, verapamil, or MAO inhibitors. If concomitant treatment with Fexmid and other serotonergic drugs is clinically warranted, careful observation is advised, particularly during treatment initiation or dose increases (see ).

Fexmid may enhance the effects of alcohol, barbiturates, and other CNS depressants.

Tricyclic antidepressants may block the antihypertensive action of guanethidine and similarly acting compounds.

Tricyclic antidepressants may enhance the seizure risk in patients taking tramadol.

____________________________________________________________________ ULTRAM (tramadol HCl tablets, PriCar, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.) ULTRACET (tramadol HCl and acetaminophen tablets, Ortho-McNeil-Janssen Pharmaceuticals, Inc.)_____________________________________________________________________

Patients should be advised to exercise caution in night driving and other hazardous occupations in poor illumination. In addition, miotics may cause accommodative spasm. Patients should be advised not to drive or use machinery if vision is not clear.

Clinical Studies Experience



This information is obtained from the National Institute of Health's Standard Packaging Label drug database.

While we update our database periodically, we cannot guarantee it is always updated to the latest version.



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