Headache can be a troublesome side-effect when you first start using pilocarpine. Ask your doctor or pharmacist to recommend a suitable painkiller.
Keep your regular appointments with your doctor and clinic so that your progress can be checked.
About pilocarpine eye drops
|Type of medicine||A miotic (makes the pupil of your eye smaller)|
|Also called||Minims® Pilocarpine|
|Available as||Eye drops in bottles and single-dose units (Minims®)|
Pilocarpine eye drops are used for glaucoma. They are most commonly used for acute angle-closure glaucoma (AACG). This occurs when the pressure inside your eye gets too high very quickly. AACG is sometimes referred to as acute closed-angle glaucoma, or simply, acute glaucoma. It must be treated straightaway.
This type of glaucoma is caused by a sudden blockage in your eye, which prevents fluid from draining out of your eye. As more fluid is still being made in your eye, the pressure inside your eye starts to rise quickly. This causes pain and redness and your vision may be affected. Pilocarpine works by causing your pupil to constrict which opens up the drainage channels in your eye. This allows the fluid to leave your eye and relieves the pressure.
There are other types of glaucoma which occur more gradually but pilocarpine is not commonly used for the treatment of these.
Before using pilocarpine eye drops
To make sure that this is the right treatment for you, before you start using pilocarpine drops it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have a heart condition, or if you have been told your blood pressure is higher or lower than normal.
- If you have any of the following conditions: asthma, epilepsy, or Parkinson's disease.
- If you have a problem with your digestive system, such as an ulcer or spasms.
- If you have an overactive thyroid gland.
- If you have been experiencing difficulty passing urine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to use pilocarpine eye drops
- Wash your hands well before you use the drops.
- Remove the cap (or open the single-dose unit by twisting off the tip).
- Tilt your head back a little and pull the lower lid of your eye downwards to form a pocket.
- Hold the bottle/unit upside down near to your eye. Try not to touch your eye as you do this.
- Apply enough pressure to release one drop into your eye.
- Close your eye for a minute or two and press gently on the side of your nose where the corner of your eye meets your nose. This helps to stop the drop from draining away and keeps it in your eye.
- Repeat the process in your other eye if you have been told to use the drops in both eyes.
- Replace the cap on the bottle (or throw away the single-dose unit).
Getting the most from your treatment
- Before you start using the drops, read the manufacturer's printed information leaflet from the pack. It will give you more information about pilocarpine and will provide you with a full list of side-effects which you could experience from using the drops.
- Your doctor will tell you how often to put the drops in. Use the drops exactly as your doctor tells you to. They are commonly used up to four times a day, although you may need to use them more regularly to begin with.
- Take care not to touch the tip of the dropper or opened unit with your eye, fingers, or any other surface. This is to prevent the drops from becoming contaminated.
- When first put in, eye drops can cause blurred vision. This should quickly clear, but it can become troublesome at night or in reduced lighting. Make sure you can see clearly before you drive, or before using tools or machines.
- If you usually wear contact lenses, please speak with your doctor for advice. Your eye is likely to be too painful for lenses, but even if not, do not wear contact lenses while you are using pilocarpine eye drops unless your doctor has advised you otherwise. This is because there is a preservative in bottles of eye drops which can affect soft contact lenses.
Can pilocarpine eye drops cause problems?
Along with their useful effects, eye drops can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with pilocarpine. You will find a full list in the manufacturer's information leaflet supplied with the drops. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist for further advice if any of the following continue or become troublesome.
|Pilocarpine eye drop side-effects||What can I do if I experience this?|
|Headache or brow ache||This can be troublesome during the first few weeks. Ask your doctor or pharmacist to recommend a suitable painkiller|
|Blurred vision and difficulty seeing in poor lighting||Do not drive and do not use tools or machines if you cannot see clearly|
|A feeling of burning, itching, or smarting when the drops are put in||This should not last long|
Bottles of eye drops contain preservatives which some people can develop an allergic reaction to. If your eye becomes more red or inflamed after using the drops, contact your doctor for advice.
How to store pilocarpine eye drops
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Eye drops in bottles only keep for four weeks once the bottle has been opened. Do not use pilocarpine drops if the bottle has been open for longer than this, even if there is some solution remaining.
- Single-dose units (Minims®) should be used immediately the unit is opened. Do not store or re-use opened units for subsequent doses. This is because the units do not contain any preservative.
Important information about all medicines
If you are due to have an operation or any dental treatment, please tell the person carrying out the treatment which medicines you are taking/using.
Never use more than the prescribed dose. If you suspect that someone might have swallowed some of the drops, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about the medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Pilocarpine eye drops BP 1.0% w/v; Martindale Pharma, an Ethypharm Group Company, The electronic Medicines Compendium. Dated April 2016.
British National Formulary, 82nd Edition (Sep 2021); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.