One drop in each eye, wait 2 minutes, then a second drop in each eye, once daily
Contraindications
None.
Available Forms
Ophthalmic solution, aceclidine 1.44% preservative-free single-dose vials, carton of 25 vials of 0.4 mL, carton of 25 vials of 0.25 mL
Mechanism of Action
Cholinergic muscarinic agonist and predominantly pupil selective miotic that contracts the iris sphincter with minimal ciliary muscle stimulation. The resulting small pupil creates a pinhole effect that extends depth of focus.
Warnings & Precautions
Dim or dark vision: Temporary after instillation; caution with night driving and other hazardous activity in poor illumination.
Accommodative spasm: Miotics may cause it; no driving or machinery while vision is not clear.
Retinal tear and detachment: Rare reports with miotics in susceptible individuals and those with pre-existing retinal disease. Retinal examination advised in all patients before initiation, and immediate care for sudden flashing lights, floaters, or vision loss.
History of iritis: Miotic use may exacerbate sequelae of ocular inflammation, including synechiae between iris and lens.
Hypersensitivity: Not recommended with known hypersensitivity to aceclidine or any component of the solution.
Vial contamination and eye injury: Avoid touching the single-dose vial to the eye or any other surface, and discard it after use.
Common Side Effects
Ocular: Instillation site irritation 20%, dim vision 16%, conjunctival hyperemia 8%, ocular hyperemia 7%.
Systemic: Headache 13%.
Severity: Majority of reactions mild, transient, and self-resolving.
Pregnancy & Lactation
Pregnancy: No adequate and well-controlled studies in pregnant women. Oral dosing of pregnant rats and rabbits throughout organogenesis and lactation produced no maternal, fetal, or neonatal effects at clinically relevant doses.
Lactation: No information on presence in human or animal milk, effects on the breastfed infant, or effects on milk production; systemic levels after topical ocular dosing are low.
Pediatric Use
Presbyopia does not occur in the pediatric population.