Isopto Carpine (Pilocarpine 2%)

Isopto Carpine general information

What is Isopto Carpine used for?

Isopto Carpine Eye Drops 2% are used to lower pressure within the eye caused by a build-up of eye fluid (aqueous humour).  This increased pressure, known as intraocular pressure (IOP), can cause glaucoma, which defines a group of eye disorders that affects the optic nerve, causing damage to the optic nerve fibres leading out of the back of the eye to the brain.  Damage to the optic nerve may lead to gradual loss of sight, starting with peripheral vision and eventually leading to total blindness in that eye.  Isopto Carpine Eye Drops 2% are used to treat chronic simple (open angle) glaucoma, the most common form of glaucoma; also acute (closed angle) glaucoma to decrease intra-ocular pressure prior to surgical treatment.  Isopto Carpine Eye Drops 2% either can either be used alone or in combination with other medications that reduce IOP. 

How does Isopto Carpine work?

Isopto Carpine Eye Drops 2% contain pilocarpine hydrochloride, a cholinergic parasympathomimetic agent with miotic activity that is used to treat glaucoma, caused by a build-up of intraocular pressure (IOP) in the eye.  This is caused by a blockage in the draining system for the eye fluid called aqueous humour, which is produced continually by the ciliary process of the eye, as a result of filtration from the capillaries (small blood vessels) to maintain normal eye pressure.  Normally the eye fluid drains out of the eye through the spongy tissue called the trabecular network between the cornea and the iris, which is the conventional drainage route.  If this drainage system becomes blocked, fluid is produced at a faster rate that it is drained away and this causes an increase in intraocular pressure (IOP) that can cause glaucoma.  Pilocarpine in Isopto Carpine Eye Drops 2% acts through direct stimulation of muscarinic receptors that are found in the central nervous system and in several tissues of the body, including smooth muscle of the iris that controls the amount of light entering the eye, and ciliary muscle which controls the shape of the lens of the eye and forms part of the ciliary process, which where the aqueous humour is produced.  Stimulation by pilocarpine in Isopto Carpine Eye Drops 2% of the muscarinic receptors in smooth muscle of the ciliary process and the iris causes them to contract.  Since the ciliary muscle is connected to the trabecular network by the scleral spur, this contraction increased tension on the scleral spur and opens up the trabecular meshwork, which increases the outflow of aqueous humour, reducing IOP; also causing miosis, which is contraction of the iris sphincter.  Isopto Carpine Eye Drops 2% restore the balance in the flow of fluid into and out of the eye and this reduces IOP and the risk of damage to the optic nerve, which helps prevent loss of sight that can happen if glaucoma continues untreated.

What does Isopto Carpine contain?

Isopto Carpine Eye Drops contain the active ingredient pilocarpine hydrochloride 2% in 15ml solution.  They also contain benzalkonium chloride, hydroxypropyl methycellulose, boric acid, sodium citrate, hydrochloric acid and/or sodium hydroxide (to adjust pH); purified water

Treating glaucome with Isopto Carpine

Isopto Carpine Eye Drops 2% contain pilocarpine, a cholinergic parasympathomimetic agent with miotic (contraction of the iris) activity that is used to treat glaucoma, to lower pressure within the eye caused by a build-up of fluid (aqueous humour).  This increased pressure, known as intraocular pressure (IOP) and can cause damage to the optic nerve fibres leading out of the back of the eye to the brain, which may lead to gradual loss of sight, starting with peripheral vision and eventually leading to total blindness in that eye.  IOP is caused by a blockage in the draining system for the aqueous humour, which is produced continually by ciliary process of the eye, by filtration from the capillaries (small blood vessels) to maintain normal eye pressure.  Normally aqueous humour drains out of the eye through the spongy tissue called the trabecular network between the cornea and the iris, but if blocked, fluid is produced at a faster rate that it is drained away causing an increase in IOP.  Pilocarpine in Isopto Carpine Eye Drops 2% acts by stimulation of muscarinic receptors in the smooth muscle of the iris and the ciliary process, which both contract opening up the trabecular meshwork, increasing the outflow of aqueous humour and reducing IOP.  Isopto Carpine Eye Drops 2% restore the balance in the flow of fluid into and out of the eye and this reduces IOP and the risk of damage to the optic nerve, which helps prevent loss of sight that can happen if glaucoma continues untreated.

What are the side effects of Isopto Carpine?

The most commonly reported side effects when taking Isopto Carpine Eye Drops 2% include headache, dizziness, blurred vision, visual impairment, reduced visual acuity, eye pain, photopsia (flashing lights), floaters (myodesopsia), eye irritation, ocular hyperaemia (red eye), nausea, transient symptoms of stinging and burning may occur.  A more serious side effect is retinal detachment but this is very rare.

When should Isopto Carpine not be used?

You should not use Isopto Carpine Eye Drops 2% if you:

• are allergic to pilocarpine or any ingredients in Isopto Carpine
• are pregnant or are breastfeeding, without discussion with your doctor
• have iritis (inflammation of the iris) or anterior uveitis (inflammation of the iris, choroid and the ciliary body) or acute inflammatory diseases of the anterior chamber as this will increase risk of retinal detachment
• have corneal or conjunctival damage
• have pupillary block glaucoma, a condition that prevents normal flow of fluid through the pupil
• wear soft contact lenses, you should remove your contacts and replace them after using Isopto Carpine
• have acute cardiac failure, bronchial asthma, peptic ulcer, hyperthyroidism, gastro-intestinal spasms, Parkinson’s Disease, urinary tract obstruction, recent myocardial infarction, hypertension and hypotension due to the risk of exacerbating these conditions.

How should Isopto Carpine be used?

You should take your Isopto Carpine Eye Drops 2% by applying one to two drops in the affected eye(s) three to four times a day, according to the instructions provided and you should apply your Isopto Carpine Eye Drops 2% at the same time each day.  You should continue to use your Isopto Carpine Eye Drops 2% for as long as recommended by your doctor, which may be long term, as they will treat your condition but will not cure it.  If you are wearing contact lenses, you should remove them before applying your Isopto Carpine Eye Drops 2% and then replace them at least 15 minutes after applying your drops.

How long should you use Isopto Carpine?

You should continue to use your Isopto Carpine Eye Drops 2% for as long as recommended by your doctor, which may be long term, as they will treat your condition but will not cure it.

Missed dose of Isopto Carpine

If you miss a dose of Isopto Carpine Eye Drops 2% apply it as soon as you remember, unless it is time to apply the next dose, then skip the missed dose.  Do not apply a double dose.

How should Isopto Carpine be stored?

You should store your Isopto Carpine Eye Drops 2% below 25°C in a cool dry place but do not freeze.