Antiglaucoma Agents, Cholinergic, Long-acting (Ophthalmic)

Proper Use of This Medicine

To use the ophthalmic solution (eye drops) form of this medicine:

• First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
• Remove any excess solution around the eye with a clean tissue, being careful not to touch the eye.
• Immediately after using the eye drops, wash your hands to remove any medicine that may be on them.
• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.
• The preservative in the eye drops containing the medicine, demecarium, may be absorbed by soft contact lenses. If you wear soft contact lenses, and your doctor has informed you that you can wear them while taking this medication, you should wait at least 15 minutes after applying the eye drops before inserting your lenses.

To use the ophthalmic ointment (eye ointment) form of this medicine:

• First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Squeeze a thin strip of ointment into this space. A 1/2-cm (approximately 1/4-inch) strip of ointment is usually enough, unless you have been told by your doctor to use a different amount. Let go of the eyelid and gently close the eyes. Keep the eyes closed for 1 to 2 minutes to allow the medicine to be absorbed by the eye.
• Immediately after using the eye ointment, wash your hands to remove any medicine that may be on them.
• Since isoflurophate loses its effectiveness when exposed to moisture, do not wash the tip of the ointment tube or allow it to touch any moist surface (including the eye).
• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). After using this eye ointment, wipe the tip of the ointment tube with a clean tissue and keep the tube tightly closed.

It is very important that you use this medicine only as directed . Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of too much medicine being absorbed into the body and the chance of side effects.

If the applicator tip touches any surface (including the eye), it may become contaminated with bacteria, which may increase the chance of developing an eye infection. If you think the applicator has become contaminated, notify your doctor immediately.

Eye ointment usually causes blurred vision for a short time after you use it, and eye drops containing these medicines may affect your vision for several hours after you use them. Therefore, ask your doctor if the dose (or one of the doses if you use more than 1 dose a day) can be used at bedtime.

Dosing - The doses of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

For demecarium
• For ophthalmic solution (eye drops) dosage form:
  • For glaucoma:
    • Adults and older children - Use one drop in the eye one or two times a day.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For treatment of accommodative esotropia:
    • Adults and older children - Use one drop in the eye once a day for two to three weeks, then one drop in the eye once every two days for three to four weeks, then use as determined by the doctor.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For diagnosis of accommodative esotropia:
    • Adults and older children - Use one drop in the eye once a day for two weeks, then one drop in the eye once every two days for two to three weeks.
    • Infants and young children - Use and dose must be determined by your doctor.

For echothiophate
• For ophthalmic solution (eye drops) dosage form:
  • For glaucoma:
    • Adults and older children - Use one drop in the eye one or two times a day.
    • Infants and younger children - Use and dose must be determined by your doctor.
  • For treatment of accommodative esotropia:
    • Adults and older children - Use one drop in the eye once a day or one drop in the eye once every two days.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For diagnosis of accommodative esotropia:
    • Adults and older children - Use one drop in the eye once a day at bedtime for two to three weeks.
    • Infants and young children - Use and dose must be determined by your doctor.

For isoflurophate
• For ophthalmic ointment dosage form:
  • For glaucoma:
    • Adults and older children - Use the ointment in the eyes once every three days or as often as three times a day as directed by the doctor.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For treatment of accommodative esotropia:
    • Adults and older children - Use the ointment in the eyes once a day at bedtime for two weeks, then once a week or as often as once every two days as directed by the doctor.
    • Infants and young children - Use and dose must be determined by your doctor.
  • For diagnosis of accommodative esotropia:
    • Adults and older children - Use the ointment in the eyes once a day at bedtime for two weeks.
    • Infants and young children - Use and dose must be determined by your doctor.

Missed dose - If you miss a dose of this medicine and your dosing schedule is:

• One dose every other day - Use the missed dose as soon as possible if you remember it on the day it should be used. However, if you do not remember the missed dose until the next day, use it at that time. Then skip a day and start your dosing schedule again. Do not double doses.
• One dose a day - Use the missed dose as soon as possible. However, if you do not remember the missed dose until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
• More than one dose a day - Use the missed dose as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If your dosing schedule is different from all of the above and you miss a dose of this medicine, or if you have any questions about this, check with your doctor.

Storage - To store this medicine:

• Keep out of the reach of children. Overdose of demecarium, echothiophate, or isoflurophate is very dangerous in young children.
• Store away from heat and direct light.
• Keep this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.