Pairs a cholinergic agonist with an alpha agonist, so miosis comes with a whitening effect
Contraindications
Known hypersensitivity to the active ingredients or to any of the excipients.
Available Forms
Carbachol and brimonidine tartrate ophthalmic solution 2.75% / 0.1%.
Mechanism of Action
The proposed mechanism of action of this fixed-dose combination of carbachol and brimonidine in presbyopia is pupillary constriction and the creation of a pinhole effect that improves near visual acuity and depth of focus.
Warnings & Precautions
Blurred vision: advise patients not to drive or operate machinery when vision is not clear, and to take care with night driving.
Retinal detachment has been reported with miotics; advise patients to report a sudden loss of vision at once.
Iritis: not recommended in active iritis.
Remove contact lenses before instillation.
Common Side Effects
Most common adverse reactions (incidence >5%) are eye pain upon instillation, visual impairment, eye irritation upon instillation, and headache.
Pregnancy & Lactation
Pregnancy: No adequate and well-controlled studies in pregnant women.
Lactation: No data on presence in human milk.
Pediatric Use
Presbyopia does not occur in the pediatric population.