Drug information of Acetylcholine


Used to obtain miosis of the iris in seconds after delivery of the lens in cataract surgery, in penetrating keratoplasty, iridectomy and other anterior segment surgery where rapid miosis may be required.

Mechanism of effect

Direct-acting parasympathomimetic neurotransmitter; causes contraction of sphincter muscles of the iris, which results in miosis and contraction of ciliary muscle and leads to accomodation spasm


Onset of action: Rapid

Duration: 20 minutes to 6 hr

Drug indications

Miosis During Ocular Surgery


0.5-2 mL of 1% solution intraocular instillation during surgery

Miosis occurs promptly and persists for approximately 10 minutes

Drug contraindications


Hypersensitivity to acetylcholine chloride or any component of the formulation

Side effects

sweating , corneal changes , Corneal edema


Corneal edema

Corneal clouding

Corneal decompensation

Systemic (Rare)




Breathing difficulty



-Systemic effects (rare) can cause problems for patients with asthma, acute heart failure, GI spasm, peptic ulcer disease, urinary tract obstruction and hyperthyroidism.

-Instill gently; forceful jet may rupture the hyaloid, cause vitreous loss, or traumatize/perforate iris.


Points of recommendation

-Use reconstituted solution immediately; aqueous solution unstable

-Reconstitute vial with 2 mL supplied diluent to obtain 1% solution; use immediately

-Instill gently into anterior chamber of eye with suitable atraumatic cannula

-May use 2% pilocarpine or 0.25% physostigmine topically immediately after surgery before application of dressing to maintain miosis

-For cataract surgery, instill only after delivery of lens

- Aseptic conditions: Open under aseptic conditions only;

Pregnancy level


-It is unknown whether this drug can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Use is not recommended.

Breast feeding warning

Excretion in milk unknown; use with caution

Drug forms

Miochol E

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