Acetylcholine chloride: Uses, Dosage, Side Effects...

This information is not country-specific. Please refer to the Hong Kong prescribing information.

Generic Medicine Info

Indications and Dosage

Intraocular
Miosis during surgery

Adult: To obtain rapid and complete miosis of the iris after delivery of the lens in cataract surgery, in penetrating keratoplasty, iridectomy, and other anterior segment surgery: As 20 mg/2 mL intraocular solution: Instil 0.5-2 mL into the anterior chamber of the eye. A 2nd dose may be administered if prolonged miosis is necessary.

Reconstitution

Reconstitute the powder using the entire diluent provided to make a 20 mg/2 mL solution. Shake gently to dissolve.

Special Precautions

Patient with bronchial asthma, gastrointestinal spasm, acute heart failure, hyperthyroidism, Parkinson's disease, peptic ulcer disease, urinary tract obstruction. Pregnancy and lactation.

Adverse Reactions

Significant: Rarely, systemic effects (e.g. bradycardia, hypotension, flushing, breathing difficulties, sweating).
Eye disorders: Corneal clouding, decompensation, and oedema.

Overdosage

Symptoms: Flushing, breathing difficulties, sweating, hypotension, and bradycardia. Management: Symptomatic and supportive treatment. May administer 0.5-1 mg atropine (IV or IM). In case of severe CV or bronchoconstrictor responses, 0.1-1 mg epinephrine (SC) may be beneficial.

Drug Interactions

May cause bronchospasm with β-blockers.

Action

Description:
Mechanism of Action: Acetylcholine is a direct-acting parasympathomimetic agent. It induces contraction of the iris sphincter muscles, causing miosis and ciliary muscle contraction, thereby resulting in accommodation spasm.
Onset: Rapid.
Duration: Approx 20 minutes.

Chemical Structure

Storage

Store between 4-25°C. Do not freeze.

MIMS Class

Miotic Drugs

ATC Classification

S01EB09 - acetylcholine ; Belongs to the class of parasympathomimetics. Used in the treatment of glaucoma and miosis.

References

Acetylcholine Chloride. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/08/2025.

Acetylcholine. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/08/2025.

Bausch & Lomb (NZ) Ltd. Miochol-E 20 mg/2 mL Intraocular Injection data sheet 30 Nov 2018. Medsafe. http://www.medsafe.govt.nz. Accessed 01/08/2025.

Brayfield A, Cadart C (eds). Acetylcholine Chloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/08/2025.

Joint Formulary Committee. Acetylcholine Chloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/08/2025.

Miochol-E Intraocular Solution (Bausch & Lomb Incorporated). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/08/2025.

Miphtel 20 mg Powder and Solvent for Solution for Intraocular Irrigation (Farmigea S.p.A.). MHRA. https://products.mhra.gov.uk. Accessed 01/08/2025.

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