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echothiophate iodide

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Overview

What is Phospholine Iodide?

Chemical name: (2-mercaptoethyl) trimethylammonium iodide O,O-diethyl phosphorothioate

Structural formula

Echothiophate iodide for ophthalmic solution occurs as a white, crystalline, water-soluble, hygroscopic solid having a slight mercaptan-like odor. When freeze-dried in the presence of potassium acetate, the mixture appears as a white amorphous deposit on the walls of the bottle.

Each package contains materials for dispensing 5 mL of eyedrops: (1) bottle containing sterile echothiophate iodide for ophthalmic solution in one of four potencies [1.5 mg (0.03%), 3 mg (0.06%), 6.25 mg (0.125%), or 12.5 mg (0.25%)] as indicated on the label, with 40 mg potassium acetate in each case. Sodium hydroxide or acetic acid may have been incorporated to adjust pH during manufacturing. (2) a 5 mL bottle of sterile diluent containing chlorobutanol (chloral derivative), 0.55%; mannitol, 1.2%; boric acid, 0.06%; and sodium phosphate, 0.026%. (3) sterilized dropper.



What does Phospholine Iodide look like?



What are the available doses of Phospholine Iodide?

Sorry No records found.

What should I talk to my health care provider before I take Phospholine Iodide?

Sorry No records found

How should I use Phospholine Iodide?

Chronic open-angle glaucoma. Subacute or chronic angle-closure glaucoma after iridectomy or where surgery is refused or contraindicated. Certain non-uveitic secondary types of glaucoma, especially glaucoma following cataract surgery.

1. Use aseptic technique.

2. Tear off aluminum seals, and remove and discard rubber plugs from both drug and diluent containers.

3. Pour diluent into drug container.

4. Remove dropper assembly from its sterile wrapping. Holding dropper assembly by the screw cap and, WITHOUT COMPRESSING RUBBER BULB, insert into drug container and screw down tightly.

5. Shake for several seconds to ensure mixing.

6. Do not cover nor obliterate instructions to patient regarding storage of eyedrops.


What interacts with Phospholine Iodide?

Sorry No Records found


What are the warnings of Phospholine Iodide?

Sorry No Records found


What are the precautions of Phospholine Iodide?

Sorry No Records found


What are the side effects of Phospholine Iodide?

Sorry No records found


What should I look out for while using Phospholine Iodide?

1. Succinylcholine should be administered 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.

2. Caution should be observed in treating glaucoma with echothiophate iodide for ophthalmic solution in patients who are at the same time undergoing treatment with systemic anticholinesterase medications for myasthenia gravis, because of possible adverse additive effects.

(See “” for further information.)


What might happen if I take too much Phospholine Iodide?

Sorry No Records found


How should I store and handle Phospholine Iodide?

Store at 20° to 25ºC (68° to 77°F).[See USP Controlled Room Temperature]Dispense in a tight container as defined in the USP.Store at 20° to 25ºC (68° to 77°F).[See USP Controlled Room Temperature]Dispense in a tight container as defined in the USP.Store at 20° to 25ºC (68° to 77°F).[See USP Controlled Room Temperature]Dispense in a tight container as defined in the USP.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:NDC 0046-1062-05 . . . . . . . . . . . . . . . . . 1.5 mg package for 0.03%White amorphous deposit on bottle walls. Aluminum crimp seal is blue.NDC 0046-1064-05 . . . . . . . . . . . . . . . . . 3 mg package for 0.06%White amorphous deposit on bottle walls. Aluminum crimp seal is red.NDC 0046-1065-05 . . . . . . . . . . . . . . . . . 6.25 mg package for 0.125% White amorphous deposit on bottle walls. Aluminum crimp seal is green.NDC 0046-1066-05 . . . . . . . . . . . . . . . . . 12.5 mg package for 0.25%White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.


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Clinical Information

Chemical Structure

No Image found
Clinical Pharmacology

Echothiophate iodide for ophthalmic solution is a long-acting cholinesterase inhibitor for topical use which enhances the effect of endogenously liberated acetylcholine in iris, ciliary muscle, and other parasympathetically innervated structures of the eye. It thereby causes miosis, increase in facility of outflow of aqueous humor, fall in intraocular pressure, and potentiation of accommodation.

Echothiophate iodide for ophthalmic solution will depress both plasma and erythrocyte cholinesterase levels in most patients after a few weeks of eyedrop therapy.

Non-Clinical Toxicology
1. Succinylcholine should be administered 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.

2. Caution should be observed in treating glaucoma with echothiophate iodide for ophthalmic solution in patients who are at the same time undergoing treatment with systemic anticholinesterase medications for myasthenia gravis, because of possible adverse additive effects.

(See “” for further information.)

Echothiophate iodide for ophthalmic solution potentiates other cholinesterase inhibitors such as succinylcholine or organophosphate and carbamate insecticides. Patients undergoing systemic anticholinesterase treatment should be warned of the possible additive effects of echothiophate iodide for ophthalmic solution.

1. Gonioscopy is recommended prior to initiation of therapy. Routine examination to detect lens opacity should accompany clinical use of echothiophate iodide for ophthalmic solution.

2. Where there is a quiescent uveitis or a history of this condition, anticholinesterase therapy should be avoided or used cautiously because of the intense and persistent miosis and ciliary muscle contraction that may occur.

3. While systemic effects are infrequent, proper use of the drug requires digital compression of the nasolacrimal ducts for a minute or two following instillation to minimize drainage into the nasal chamber with its extensive absorption area. To prevent possible skin absorption, hands should be washed following instillation.

4. Temporary or permanent discontinuance of medication is necessary if cardiac irregularities occur.

5. Anticholinesterase drugs should be used with extreme 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.

6. Anticholinesterase drugs should be employed prior to ophthalmic surgery only as a considered risk because of the possible occurrence of hyphema.

7. Echothiophate iodide for ophthalmic solution should be used with great caution, if at all, where there is a prior history of retinal detachment.

8. Temporary discontinuance of medication is necessary if salivation, urinary incontinence, diarrhea, profuse sweating, muscle weakness, or respiratory difficulties occur.

9. Patients receiving echothiophate iodide for ophthalmic solution who are exposed to carbamate- or organophosphate-type insecticides and pesticides (professional gardeners, farmers, workers in plants manufacturing or formulating such products, etc.) should be warned of the additive systemic effects possible from absorption of the pesticide through the 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.

1. Although the relationship, if any, of retinal detachment to the administration of echothiophate iodide for ophthalmic solution has not been established, retinal detachment has been reported in a few cases during the use of echothiophate iodide for ophthalmic solution in adult patients without a previous history of this disorder.

2. Stinging, burning, lacrimation, lid muscle twitching, conjunctival and ciliary redness, browache, induced myopia with visual blurring may occur.

3. Activation of latent iritis or uveitis may occur.

4. Iris cysts may form, and if treatment is continued, may enlarge and obscure vision. This occurrence is more frequent in children. The cysts usually shrink upon discontinuance of the medication, reduction in strength of the drops or frequency of instillation. Rarely, they may rupture or break free into the aqueous. Regular examinations are advisable when the drug is being prescribed for the treatment of accommodative esotropia.

5. Prolonged use may cause conjunctival thickening, obstruction of nasolacrimal canals.

6. Lens opacities occurring in patients under treatment for glaucoma with echothiophate iodide for ophthalmic solution have been reported and similar changes have been produced experimentally in normal monkeys. Routine examinations should accompany clinical use of the drug.

7. Paradoxical increase in intraocular pressure may follow anticholinesterase instillation. This may be alleviated by prescribing a sympathomimetic mydriatic such as phenylephrine.

8. Cardiac irregularities.

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

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

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Interactions

Interactions

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