Pilocarpine adverse effects

The adverse effects of pilocarpine are caused by the induction of miosis. The contraction of the ciliary muscle causes the lens to displace forward, which can lead to accommodation spasm, myopia, and brow ache. Pupillary constriction can also affect night vision. Pilocarpine should be avoided in patients with severe myopia, as it increases the risk of developing retinal detachment. Systemic effects may occur at higher concentrations and include, nausea, vomiting, diarrhea, and bradycardia. 

Potentially severe adverse effects can result from systemic administration of cholinomimetic drugs, and none should be administered by intramuscular or intravenous injection. If significant amounts of these drugs enter the circulation, nausea, abdominal cramps, diarrhea, salivation, hypotension with reflex tachycardia, cutaneous vasodilation, sweating, and bronchoconstric-tion can result. Pilocarpine can cross the blood-brain barrier and affect cognitive function. Even the topical application of cholinomimetics to the eyes can present... 

Symptomatic adverse effects Topical pilocarpine therapy produces blurred vision or myopia, poor vision in dim light or sometime painful spasm. Many patients on pilocarpine may experience ciliary or conjunctival congestion, headache, photophobia. Some patient may develop pupillary dilatation following use of pilocarpine. 

Adverse effects Pilocarpine can enter the brain and cause CNS disturbances. It stimulates profuse sweating and salivation. 

Carbachol is a potent direct-acting miotic agent its duration of action is longer than that of pilocarpine (8 to 10 hours) because of resistance to hydrolysis by cholinesterases. This drug also may act as a weak inhibitor of cholinesterase. Patients with an inadequate response to or intolerance of pilocarpine as a result of ocular hritation or allergy frequently do well on carbachol. The ocular and systemic adverse effects of carbachol are similar to butmore frequent, constant, and severe than those of pilocarpine. " ... 

An early study reported that the compound pilocarpine was associated with adverse effects on fetal development... 

Laundauer 1956). Pilocarpine is listed in FDA pregnancy category C, which states, "Animal reproduction studies have shown an adverse effect on the fetus, and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks."... 

The most frequent adverse experiences associated with pilocarpine were a consequence of the expected pharmacologic effects. Adverse reactions occurring in at least 3% of patients include the following Sweating, nausea, rhinitis, chills, flushing, urinary frequency, dizziness, asthenia, headache, dyspepsia, lacrimation, diarrhea, edema, abdominal pain, amblyopia, vomiting, pharyngitis, and hypertension. 

---