Other Brands/Names

Miochol-E.

How It Works

Acetylcholine is a medication commonly used during ophthalmic surgeries, such as cataract surgery, keratoplasty, iridectomy, and anterior segment surgery. It functions by stimulating the peripheral nervous system to constrict the pupil (a process called miosis), which helps facilitate the surgery, especially after certain layers of the eye are sutured.

Indications

Acetylcholine is primarily used in various ophthalmic surgeries, including cataracts, keratoplasty, iridectomy, and anterior segment surgery, where pupil constriction (miosis) is required during the procedure.

Contraindications

Acetylcholine should not be used by individuals with a history of hypersensitivity or allergies to the drug.

Side Effects

Side effects are generally rare, but some people may experience:

• Nausea

• Vomiting

• Stomach pain

• Diarrhea

• Headache

• Palpitations

• Facial flushing

• Excessive sweating

• Shortness of breath

• Increased salivation

• Frequent urination

• Excessive nasal discharge

• Swelling or cloudiness of the eyelids

Types

Acetylcholine is available in the following form:

• Sterile powder injection 20 mg/2 mL

Dosage

For inducing miosis (pupil constriction) during eye surgery:

• Adult dosage

Instill 0.5–2 mL (5–20 mg) directly into the anterior chamber of the eye before or after suturing the eyelids.

Safety

Pregnancy:

Acetylcholine is classified as FDA Category N (the risk to the fetus is not clearly known). It is important to consult with a doctor before using this medication to ensure proper monitoring during pregnancy.

Drug Interactions

Beta-Blocker Drugs (e.g., metoprolol):

The concurrent use of acetylcholine and metoprolol may result in drug interactions that increase the risk of the narrowing of bronchial airways and cardiac electrical conduction disorders. Therefore, when the patient is taking acetylcholine alongside beta-blockers, medical supervision is essential to avoid adverse effects.

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