Chemical Diagram
ISOPTO(r) Carbachol (carbachol ophthalmic solution) is a cholinergic prepared as a sterile topical ophthalmic solution. The active ingredient is represented by the chemical structure:
Established name: CarbacholChemical name: 2-[(Aminocarbonyl)oxy]-N,N,Ntrimethylethanaminium chloride. Each mL contains: Active: carbachol, 1.5% or 3.0%. Preservative: benzalkonium chloride 0.005%. Vehicle: hypromellose 1.0%. Inactives: boric acid, sodium chloride, sodium borate, purified water.
A cholinergic (parasympathomimetic) agent. Carbachol acts directly to stimulate muscarinic (smooth muscle) and nicotinic (autonomic ganglia) receptors and indirectly to inhibit cholinesterase enzyme activity. Carbachol is resistant to hydrolysis by cholinesterases.
For lowering intraocular pressure in the treatment of glaucoma.
Miotics are contraindicated where pupillary constriction is undesirable such as acute iritis. Contraindicated in those persons showing hypersensitivity to any component of this preparation.
FOR TOPICAL OPHTHALMIC USE ONLY. NOT FOR INJECTION. Carbachol should be used with caution in the presence of corneal abrasion to avoid excessive penetration which can produce systemic toxicity; and in patients with acute cardiac failure, bronchial asthma, active peptic ulcer, hyperthyroidism, gastrointestinal spasm, urinary tract obstruction, Parkinson's disease, recent myocardial infarct, systemic hypertension or hypotension. As with all miotics, retinal detachment has been reported when used in certain susceptible individuals. Remove contact lenses before using.
Avoid overdosage.
The miosis usually causes difficulty in dark adaptation. Patient should be advised to exercise caution in night driving and other hazardous occupations in poor light. Do not touch dropper tip to any surface, as this may contaminate the solution.
No long-term animal studies have been conducted to evaluate the carcinogenic potential of carbachol.
Pregnancy Category C. Animal reproduction studies have not been conducted with carbachol. It is also not known whether carbachol can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Carbachol should be given to a pregnant woman only if clearly needed.
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when carbachol is administered to a nursing woman.
Safety and effectiveness in pediatric patients have not been established.
No overall differences in safety or effectiveness have been observed between elderly and younger patients.
Transient symptoms of stinging and burning may occur. This preparation is capable of producing systemic symptoms of a cholinesterase inhibitor, even when the epithelium is intact. Transient ciliary and conjunctival injection, headache, and ciliary spasm with resultant temporary decrease of visual acuity may occur. Salivation, syncope, cardiac arrhythmia, gastrointestinal cramping, vomiting, asthma, hypotension, diarrhea, frequent urge to urinate, increased sweating, and irritation of eyes may occur.
Atropine should be administered parenterally (for dosage refer to Goodman & Gilman or other pharmacology reference).
Instill two drops topically in the eye(s) up to three times daily or as indicated by physician.
15 mL in plastic DROP-TAINER(r) Dispensers. 1.5%: 15 mL NDC 0998-0223-15 3%: 15 mL NDC 0998-0225-15
Store at 8deg - 27degC (46deg - 80degF).
Rx Only ALCON LABORATORIES, INC. Fort Worth, Texas 76134 USARevised: June 2007Printed in USA(c)2002, 2003, 2007 Alcon, Inc. 9002666-0607
NDC 0998-0223-15 Alcon(r) Isopto(r) Carbachol 1.5% (carbachol ophthalmic solution) 15 mL Sterile