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Pronunciation(KAR ba kole)
U.S. Brand NamesCarbastat® [DSC]; Isopto® Carbachol; Miostat®
SynonymsCarbacholine; Carbamylcholine Chloride
Generic AvailableNo
Canadian Brand NamesCarbastat®; Isopto® Carbachol; Miostat®
UseLowers intraocular pressure in the treatment of glaucoma; cause miosis during surgery
Pregnancy Risk FactorC
Pregnancy ImplicationsReproduction studies have not been conducted.
LactationExcretion in breast milk unknown/use caution
ContraindicationsHypersensitivity to carbachol or any component of the formulation; acute iritis, acute inflammatory disease of the anterior chamber
Warnings/PrecautionsUse with caution in patients undergoing general anesthesia and in presence of corneal abrasion. Use caution with acute cardiac failure, asthma, peptic ulcer, hyperthyroidism, gastrointestinal spasm, urinary tract obstruction, and Parkinson's disease.
Adverse ReactionsFrequency not defined. Cardiovascular: Arrhythmia, flushing, hypotension, syncope
Central nervous system: Headache
Gastrointestinal: Abdominal cramps, diarrhea, epigastric distress, salivation, vomiting
Genitourinary: Urinary bladder tightness
Ocular: Bullous keratopathy, burning (transient), ciliary spasm, conjunctival injection, corneal clouding, irritation, postoperative iritis (following cataract extraction), retinal detachment, stinging (transient)
Respiratory: Asthma
Miscellaneous: Diaphoresis
Overdosage/ToxicologySymptoms of overdose include miosis, flushing, vomiting, bradycardia, bronchospasm, involuntary urination Atropine is the treatment of choice for intoxications manifesting with significant muscarinic symptoms. Atropine I.V. 1-2 mg every 5-60 minutes (or 0.04-0.08 mg/kg I.V. every 5-60 minutes if needed for children) should be repeated to control symptoms and then continued as needed for 1-2 days following the acute ingestion. Epinephrine 0.1-1 mg SubQ may be useful in reversing severe cardiovascular or pulmonary sequelae.
Drug InteractionsDecreased effect of carbachol possible with topical NSAIDs
StabilityIntraocular: Store at room temperature of 15°C to 30°C (59°F to 86°F)
Topical: Store at 8°C to 27°C (46°F to 80°F)
Mechanism of ActionSynthetic direct-acting cholinergic agent that causes miosis by stimulating muscarinic receptors in the eye
Pharmacodynamics/KineticsOphthalmic instillation:
Onset of action: Miosis: 10-20 minutes
Duration: Reduction in intraocular pressure: 4-8 hours
Intraocular administration:
Onset of action: Miosis: 2-5 minutes
Duration: 24 hours
DosageAdults: Ophthalmic: Instill 1-2 drops up to 3 times/day
Intraocular: 0.5 mL instilled into anterior chamber before or after securing sutures
AdministrationOphthalmic: Finger pressure should be applied on the lacrimal sac for 1-2 minutes following topical instillation; remove excess around the eye with a tissue.
Intraocular: Instillation for miosis prior to eye surgery should be gentle and parallel to the iris face and tangential to the pupil border; discard unused portion. Not >0.5 mL should be injected into the anterior chamber. Instillation may occur before or after securing sutures. Sterile technique must be used.
Patient EducationMay sting on instillation. May cause headache, altered distance vision, and decreased night vision. Pregnancy precaution: Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.
Dental Health: Effects on Dental TreatmentKey adverse event(s) related to dental treatment: Increased salivation.
Dental Health: Vasoconstrictor/Local Anesthetic PrecautionsNo information available to require special precautions
Mental Health: Effects on Mental StatusNone reported
Mental Health: Effects on Psychiatric TreatmentNone reported
Dosage Forms[DSC] = Discontinued product Solution, intraocular (Carbastat® [DSC], Miostat®): 0.01% (1.5 mL)
Solution, ophthalmic (Isopto® Carbachol): 1.5% (15 mL); 3% (30 mL) [contains benzalkonium chloride]
International Brand NamesCarbachol® (GB, PL); Carbacolo Alfa INTES® (IT); Carbamann® (DE); Carbastat® (CA); Doryl® (DE); Isopto Carbachol® (AU, BE); Isopto® Carbachol (CA); Isopto Carbachol® (CZ, DE, FI, GB, HR, IE, IL, LU, NL, NO, NZ, PL, SI, ZA); Isopto-Karbakolin® (SE); Jestryl® (CZ, DE); Miostat® (AU, BE, BR, CA, CH, CZ, IL, LU, NL, NZ, PL, RO, SG, SI, TH, TR); Mioticol® (IT)
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-
A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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