[7] However, if used appropriately, pilocarpine is known to reduce intraocular pressure in glaucoma by 20 to 25% and increase salivation in those with xerostomia.

Pilocarpine may have paradoxical effects on the cardiovascular system. The expected effect of a muscarinic agonist is vasodepression, but administration of Pilocarpine may produce hypertension after a brief episode of hypotension. Bradycardia and tachycardia have both been reported with use of Pilocarpine.

Pilocarpine is a drug that acts as a muscarinic receptor agonist. It acts on a subtype of muscarinic receptor (M3) found on the iris sphincter muscle, causing the muscle to contract – resulting in pupil constriction (miosis). Pilocarpine also acts on the ciliary muscle and causes it to contract.

Injection of pilocarpine directly in the central nervous system (CNS) induces an intense vasoconstriction in the mesenteric vascular bed and an increase in arterial pressure (Moreira et al., 2003).

Topical pilocarpine and pilocarpine lozenges don’t work as well as pilocarpine tablets—but they work just as well as the many saliva substitutes available over the counter and online (Oasis mouth spray, Roxane, and so on).

Miosis usually persists for 4-8 hours, rarely, up to 20 hours. Reduction of intra-ocular pressure is evident within 60 minutes, peaks within 75 minutes and, depending on the concentration of pilocarpine used, persists for 4-14 hours.

Take your doses during (or straight after) a meal, and make sure you take your last dose of the day with your evening meal. If you are taking pilocarpine because you have Sjögren’s syndrome, the usual dose is one tablet four times daily. Take a tablet with each of your three main meals, and also one at bedtime.

Ophthalmic pilocarpine is used to treat glaucoma, a condition in which increased pressure in the eye can lead to gradual loss of vision. Pilocarpine is in a class of medications called miotics. It works by allowing excess fluid to drain from the eye.

This medicine may cause blurred vision, especially at night or in low light. Be careful if you drive or do anything that requires you to be able to see clearly. Avoid becoming overheated during exercise and in hot weather. Pilocarpine can increase sweating and you may be more prone to dehydration.

Thus the miotic effects of pilocarpine are prolonged in the pigmented rabbit eyes compared to albino eyes (Fig. 1). Pigmentation of the anterior uvea may form a reservoir of pilocarpine from which the drug is released during the elimination phase of the drug action, resulting in prolonged duration of action.

Pilocarpine can be associated with retinal tears and detachments. The mechanism for this is thought to be related to drug-induced forward displacement of the lens which causes anterior movement of the vitreous and results in traction to areas of the retina that have significant vitreous adherence.

This medication may also be used during certain eye surgeries and to reverse the effects of drugs used to enlarge the pupil (e.g., during an eye exam). Pilocarpine works by causing the pupil of the eye to shrink and decreasing the amount of fluid within the eye.

Pilocarpine is also contraindicated in uveitis and secondary glaucoma because its miotic effect may predispose to posterior synechiae and pupillary occlusion.

Common side effects

• constipation.
• dizziness.
• dry mouth.
• feeling sleepy.
• difficulty peeing.
• headache.

If you want to stop taking amitriptyline, go to the doctor and they will help you to bring the dose down gradually. This will take a few weeks. You may still get some withdrawal effects, especially during the first two weeks as you reduce the dose. These effects will go away as you carry on reducing the dose.