Open-Angle Glaucoma or Ocular Hypertension

Isopto® Carpine (pilocarpine) ophthalmic solution is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.

Acute Angle-Closure Glaucoma

Isopto® Carpine (pilocarpine) is indicated for the management of acute angle-closure glaucoma.

Prevention of Postoperative Elevated IOP

Isopto® Carpine (pilocarpine) is indicated for the prevention of postoperative elevated IOP associated with laser surgery.

Induction of Miosis

Isopto® Carpine (pilocarpine) is indi cated for the induction of miosis.

Open-Angle Glaucoma or Ocular Hypertension

One drop of Isopto® Carpine (pilocarpine) 1%, 2% or 4% should be applied topically in the eye(s) up to four times daily. Pilocarpine-naïve patients should be started on the 1% concentration as higher concentrations are often not tolerated initially. The frequency of instillation and concentration of Isopto® Carpine (pilocarpine) are determined by the severity of the elevated intraocular pressure and miotic response of the patient.

To limit systemic exposure to pilocarpine, patients may be instructed to perform punctal occlusion for 2 minutes after instillation of Isopto® Carpine (pilocarpine) ophthalmic solution.

Acute Angle-Closure Glaucoma

Prior to Isopto® Carpine (pilocarpine) use, treatment with secretory suppressants and hyperosmotic agents may be needed to lower IOP below 50 mmHg and relieve iris ischemia.

For initial management of acute angle-closure glaucoma, one drop of Isopto® Carpine 1% or 2% may be applied topically in the eye(s) up to three times over a 30-minute period.

If laser iridoplasty or iridomy is used to break the attack, one drop of Isopto® Carpine 4% should be administered prior to the procedure. Following laser iridoplasty, one drop of Isopto® Carpine (pilocarpine) 1% should be administered four times daily until an iridotomy can be performed.

Prevention of Postoperative Elevated IOP

One drop of Isopto® Carpine (pilocarpine) 1%, 2% or 4% (or two drops administered five minutes apart) should be applied topically in the eye(s) 15 to 60 minutes prior to surgery.

Induction of Miosis

One drop of Isopto® Carpine (pilocarpine) 1%, 2% or 4% (or two drops administered five minutes apart) should be applied topically in the eye(s).

Use with Other Topical Ophthalmic Medications

Isopto® Carpine (pilocarpine) may be used in combination with beta-blockers, carbonic anhydrase inhibitors, sympathomimetics or hyperosmotic agents. If more than one topical ophthalmic drug is being used, the drugs should be administered at least five (5) minutes apart.

Use in Pediatric Patients

In children under 2 years of age, one drop of Isopto® Carpine (pilocarpine) 1% should be applied topically in the eye(s) three times daily. Children 2 years of age and over should be dosed as for adults.

For the induction of miosis prior to goniotomy or trabeculotomy in children, one drop of Isopto® Carpine (pilocarpine) 1% or 2% should be applied topically in the eye 15 to 60 minutes prior to surgery.

Dosage Forms And Strengths

Bottle filled with 15 mL of 1% (10 mg/mL), 2% (20 mg/mL) or 4% (40 mg/mL) pilocarpine hydrochloride sterile ophthalmic solution.

Storage And Handling

Isopto® Carpine (pilocarpine hydrochloride ophthalmic solution) 1%, 2% and 4% is supplied sterile in natural low density polyethylene plastic ophthalmic DROP­TAINER® dispensers and green low density polyethylene tips with green polypropylene caps.

15 mL in 15 mL bottles

1%: NDC 0998-0203-15
2%: NDC 0998-0204-15
4%: NDC 0998-0206-15

Storage

Store at 15°- 25°C (59° - 77°F) and protect from freezing.

ALCON LABORATORIES, INC. 6201 South Freeway, Fort Worth, Texas 76134 USA. 1-800-757-9195. Revised: 6/2010.

Last reviewed on RxList: 7/21/2010
This monograph has been modified to include the generic and brand name in many instances.