Pilocar Eye drop 5 ml with Pilocarpine Nitrate

Pilocar 2% Eye Drops is a sterile ophthalmic solution available in a 5 ml bottle. Each ml of the solution contains Pilocarpine IP 2% w/v as the active ingredient, along with a preservative and sterile aqueous vehicle. The product is strictly for external ophthalmic use only and must not be injected or ingested. It is a miotic (pupil-constricting) agent used primarily for the management of glaucoma and other conditions involving elevated intraocular pressure. The product is packaged in a clean white box with the brand name “PILOCAR” displayed in white text on a black rectangular block, with the product description “Pilocarpine Eye Drops IP 2% w/v” and a dark blue triangle in the bottom right corner. The box also features text in Bengali script, indicating its availability in West Bengal and Bangladesh markets.

Pilocarpine is a direct-acting cholinergic parasympathomimetic agent that acts through direct stimulation of muscarinic receptors on the smooth muscles of the eye. Its mechanism of action involves two key actions: first, it contracts the ciliary muscle, which causes increased tension on the scleral spur and opens the trabecular meshwork spaces, facilitating the outflow of aqueous humor (the fluid inside the eye) through the canal of Schlemm, thereby reducing intraocular pressure. Second, it contracts the iris sphincter muscle (the circular muscle of the iris), causing miosis (pupil constriction). The miosis effect is particularly important in angle-closure glaucoma, where it pulls the iris away from the trabecular meshwork, relieving the appositional narrowing and closure of the drainage angle. This dual mechanism makes pilocarpine uniquely effective in both open-angle and angle-closure glaucoma.

The primary indications for Pilocar 2% Eye Drops are the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension, the management of acute angle-closure glaucoma, the prevention of postoperative elevated intraocular pressure associated with laser surgery, and the induction of miosis (pupil constriction). It is also used to reverse the effect of medications that cause the pupil to enlarge (mydriatic drugs). The product may be used alone or in combination with other intraocular pressure-lowering medications such as beta-blockers, prostaglandin analogues, or carbonic anhydrase inhibitors for better pressure control. The product is intended for use in adults and should be used under the supervision of a qualified ophthalmologist.

The recommended dosage is 1 drop instilled into the affected eye(s) up to 4 times daily, or as directed by the ophthalmologist. For acute angle-closure glaucoma, a more intensive regimen may be used initially. The IOP-lowering effect begins within approximately 10 to 30 minutes after instillation, with maximum effect reached at around 1 to 2 hours. The effect typically lasts for 4 to 8 hours, though in some cases it may last up to 20 hours. Patients should use the drops at the same times each day for consistent pressure control. It is critical that the medication is not stopped abruptly without consulting a doctor, as intraocular pressure may rise again, potentially causing permanent damage to the optic nerve.

The most common side effects (occurring in 5% or more of patients) include headache or brow ache, accommodative change (difficulty focusing when looking at objects at different distances), blurred vision, eye irritation, visual impairment (dim, dark, or “jumping” vision), and eye pain. Other common side effects include decreased night vision, temporary burning or stinging upon instillation, increased tearing, eye redness, and mild eye discomfort. These effects are generally temporary and related to the expected pharmacologic action of the drug. The blurred vision typically resolves within 2 to 3 hours after instillation.

Serious but less common side effects include retinal detachment (particularly in patients with pre-existing retinal problems or high myopia), hyphema (bleeding into the anterior chamber of the eye), and paradoxical increase in intraocular pressure in patients with certain types of glaucoma. Systemic cholinergic effects from absorption may include sweating, nausea, vomiting, diarrhea, and bradycardia (slow heartbeat). Patients should seek immediate medical attention if they experience sudden onset of flashing lights, floaters, loss of vision, severe eye pain, or signs of a severe allergic reaction.

Important precautions include not wearing soft contact lenses during use, as the preservative (benzalkonium chloride) can be absorbed by the lenses and cause damage. The product is contraindicated in patients with a known hypersensitivity to pilocarpine or any of its components. It should not be used in patients with iritis (inflammation of the iris) or uveitis, as the miosis effect can worsen these conditions. Caution is advised in patients with a history of retinal detachment or high myopia, as the drug can rarely precipitate retinal detachment. In children with primary congenital glaucoma, a paradoxical increase in intraocular pressure has been reported, so it should be used with caution. Patients should avoid driving or operating heavy machinery until their vision is clear, as blurred vision and decreased night vision are expected effects. The product is not recommended during pregnancy or breastfeeding unless the potential benefit clearly outweighs the risk.

The product should be stored in a cool and dry place away from direct sunlight and kept out of reach of children. The dropper tip should not be touched to the eye or any surface to maintain sterility. The product should not be used if the solution changes color or becomes cloudy. The product is available in India at a price range of approximately 50 to 87 rupees per 5 ml bottle and is available through major online pharmacy platforms and offline pharmacies with a valid prescription.