Echothiophate Iodide for Ophthalmic Solution (Phospholine Iodide)
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Echothiophate Iodide for Ophthalmic Solution (Phospholine Iodide)

Phospholine Iodide®
(echothiophate iodide) for Ophthalmic Solution

DRUG DESCRIPTION

Chemical name: (2-mercaptoethyl) trimethylammonium iodide O,O-diethyl phosphorothioate

Structural formula

Phospholine Iodide®
  (echothiophate iodide for ophthalmic solution)  Structural Formula Illustration

C9H23INO3PS           M.W 383.23

Echothiophate iodide for ophthalmic solution occurs as a white, crystalline, water-soluble, hygroscopic solid having a slight mercaptan-like odor. When freeze-dried in the presence of potassium acetate, the mixture appears as a white amorphous deposit on the walls of the bottle.

Each package contains materials for dispensing 5 mL of eyedrops: (1) bottle containing sterile echothiophate iodide for ophthalmic solution in one of four potencies [1.5 mg (0.03%), 3 mg (0.06%), 6.25 mg (0.125%), or 12.5 mg (0.25%)] as indicated on the label, with 40 mg potassium acetate in each case. Sodium hydroxide or acetic acid may have been incorporated to adjust pH during manufacturing. (2) a 5 mL bottle of sterile diluent containing chlorobutanol (chloral derivative), 0.55%; mannitol, 1.2%; boric acid, 0.06%; and sodium phosphate, 0.026%. (3) sterilized dropper.

What are the possible side effects of echothiophate iodide ophthalmic (Phospholine Iodide)?

Contact your doctor immediately if you notice any decrease in vision or an increase in "floaters" in your visual field. Rarely, echothiophate iodide ophthalmic may cause retinal detachment. Retinal detachment can lead to blind spots, floaters in your visual field, and even blindness. Your doctor will want to check your retina before you use this medicine to determine if you have an increased risk of retinal detachment.

If you experience any of the following serious side effects, stop using echothiophate iodide ophthalmic and seek emergency medical...

Read All Potential Side Effects and See Pictures of Phospholine Iodide »

What are the precautions when taking echothiophate iodide for ophthalmic solution (Phospholine Iodide)?

Before using echothiophate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, epilepsy, other eye problems (e.g., iritis, uveitis, detached retina), heart disease (e.g., heart failure, recent heart attack), low or high blood pressure, myasthenia gravis, overactive thyroid (hyperthyroidism), Parkinsonism, stomach/intestinal problems (e.g., ulcers, spasms), certain urinary problems (e.g., blockage).

After you apply echothiophate, your vision may become temporarily blurred or unstable....

Read All Potential Precautions of Phospholine Iodide »

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

INDICATIONS

Glaucoma

Chronic open-angle glaucoma. Subacute or chronic angle-closure glaucoma after iridectomy or where surgery is refused or contraindicated. Certain non-uveitic secondary types of glaucoma, especially glaucoma following cataract surgery.

Accommodative Esotropia

Concomitant esotropias with a significant accommodative component.

DOSAGE AND ADMINISTRATION

DIRECTIONS FOR PREPARING EYEDROPS

  1. Use aseptic technique.
  2. Tear off aluminum seals, and remove and discard rubber plugs from both drug and diluent containers.
  3. Pour diluent into drug container.
  4. Remove dropper assembly from its sterile wrapping. Holding dropper assembly by the screw cap and, WITHOUT COMPRESSING RUBBER BULB, insert into drug container and screw down tightly.
  5. Shake for several seconds to ensure mixing.
  6. Do not cover nor obliterate instructions to patient regarding storage of eyedrops.

Glaucoma

Selection of TherapyThe medication prescribed should be that which will control the intraocular pressure around-the-clock with the least risk of side effects or adverse reactions. "Tonometric glaucoma" (ocular hypertension without other evidence of the disease) is frequently not treated with any medication, and echothiophate iodide for ophthalmic solution is certainly not recommended for this condition. In early chronic simple glaucoma with field loss or disc changes, pilocarpine is generally used for initial therapy and can be recommended so long as control is thereby maintained over the 24 hours of the day.

When this is not the case, echothiophate iodide for ophthalmic solution 0.03% may be effective and probably has no greater potential for side effects. If this dosage is inadequate, epinephrine and a carbonic anhydrase inhibitor may be added to the regimen. When still more effective medication is required, the higher strengths of echothiophate iodide for ophthalmic solution may be prescribed with the recognition that the control of the intraocular pressure should have priority regardless of potential side effects. In secondary glaucoma following cataract surgery, the higher strengths of the drug are frequently needed and are ordinarily very well tolerated.

The dosage regimen prescribed should call for the lowest concentration that will control the intraocular pressure around-the-clock. Where tonometry around-the-clock is not feasible, it is suggested that appointments for tension-taking be made at different times of the day so that inadequate control may be more readily detected. Two doses a day are preferred to one in order to maintain as smooth a diurnal tension curve as possible, although a single dose per day or every other day has been used with satisfactory results. Because of the long duration of action of the drug, it is never necessary or desirable to exceed a schedule of twice a day. The daily dose or one of the two daily doses should always be instilled just before retiring to avoid inconvenience due to the miosis.

Early Chronic Simple Glaucoma – Echothiophate iodide for ophthalmic solution 0.03% instilled twice a day, just before retiring and in the morning, may be prescribed advantageously for cases of early chronic simple glaucoma that are not controlled around-the-clock with other less potent agents. Because of prolonged action, control during the night and early morning hours may then sometimes be obtained. A change in therapy is indicated if, at any time, the tension fails to remain at an acceptable level on this regimen.

Advanced Chronic Simple Glaucoma and Glaucoma Secondary to Cataract Surgery – These cases may respond satisfactorily to echothiophate iodide for ophthalmic solution 0.03% twice a day as above. When the patient is being transferred to echothiophate iodide for ophthalmic solution because of unsatisfactory control with pilocarpine, carbachol, epinephrine, etc., one of the higher strengths, 0.06%, 0.125%, or 0.25% will usually be needed. In this case, a brief trial with the 0.03% eyedrops will be advantageous in that the higher strengths will then be more easily tolerated.

Concomitant Therapy – Echothiophate iodide for ophthalmic solution may be used concomitantly with epinephrine, a carbonic anhydrase inhibitor, or both.

Technique – Good technique in the administration of echothiophate iodide for ophthalmic solution requires that finger pressure at the inner canthus should be exerted for a minute or two following instillation of the eyedrops, to minimize drainage into the nose and throat. Excess solution around the eye should be removed with tissue and any medication on the hands should be rinsed off.

Accommodative Esotropia (Pediatric Use)

In Diagnosis – One drop of 0.125% may be instilled once a day in both eyes on retiring, for a period of two or three weeks. If the esotropia is accommodative, a favorable response will usually be noted which may begin within a few hours.

In Treatment – Echothiophate iodide for ophthalmic solution is prescribed at the lowest concentration and frequency which gives satisfactory results. After the initial period of treatment for diagnostic purposes, the schedule may be reduced to 0.125% every other day or 0.06% every day. These dosages can often be gradually lowered as treatment progresses. The 0.03% strength has proven to be effective in some cases. The maximum usually recommended dosage is 0.125% once a day, although more intensive therapy has been used for short periods.

Technique – (See "DOSAGE AND ADMINISTRATION, Glaucoma.")

Duration of Treatment – In diagnosis, only a short period is required and little time will be lost in instituting other procedures if the esotropia proves to be unresponsive. In therapy, there is no definite limit so long as the drug is well tolerated. However, if the eyedrops, with or without eyeglasses, are gradually withdrawn after about a year or two and deviation recurs, surgery should be considered. As with other miotics, tolerance may occasionally develop after prolonged use. In such cases, a rest period will restore the original activity of the drug.

HOW SUPPLIED

Each package contains sterile echothiophate iodide for ophthalmic solution, sterile diluent, and dropper for dispensing 5 mL eyedrops of the strength indicated on the label. Four potencies are available:

NDC 0046-1062-05....................................1.5 mg package for 0.03%

White amorphous deposit on bottle walls. Aluminum crimp seal is blue.

NDC 0046-1064-05...................................3 mg package for 0.06%

White amorphous deposit on bottle walls. Aluminum crimp seal is red.

NDC 0046-1065-05...................................6.25 mg package for 0.125%

White amorphous deposit on bottle walls. Aluminum crimp seal is green.

NDC 0046-1066-05...................................12.5 mg package for 0.25%

White amorphous deposit on bottle walls. Aluminum crimp seal is yellow.

Handling and Storage

Prior to reconstitution: Store under refrigeration (2° to 8° C).

After reconstitution: Store at room temperature (approximately 25° C). Do not refrigerate. Discard any unused solution after 4 weeks.

This product's label may have been updated. For current package insert and further product information, please visit www.wyeth.com or call our medical communications department toll-free at 1-800-934-5556. Manufactured for Wyeth Pharmaceuticals Inc. Philadelphia, PA 19101 by Chesapeake Biological Laboratories, Inc. Baltimore, MD 21230. FDA Rev date: 3/9/2006

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

SIDE EFFECTS

  1. Although the relationship, if any, of retinal detachment to the administration of echothiophate iodide for ophthalmic solution has not been established, retinal detachment has been reported in a few cases during the use of echothiophate iodide for ophthalmic solution in adult patients without a previous history of this disorder.
  2. Stinging, burning, lacrimation, lid muscle twitching, conjunctival and ciliary redness, browache, induced myopia with visual blurring may occur.
  3. Activation of latent iritis or uveitis may occur.
  4. Iris cysts may form, and if treatment is continued, may enlarge and obscure vision. This occurrence is more frequent in children. The cysts usually shrink upon discontinuance of the medication, reduction in strength of the drops or frequency of instillation. Rarely, they may rupture or break free into the aqueous. Regular examinations are advisable when the drug is being prescribed for the treatment of accommodative esotropia.
  5. Prolonged use may cause conjunctival thickening, obstruction of nasolacrimal canals.
  6. Lens opacities occurring in patients under treatment for glaucoma with echothiophate iodide for ophthalmic solution have been reported and similar changes have been produced experimentally in normal monkeys. Routine examinations should accompany clinical use of the drug.
  7. Paradoxical increase in intraocular pressure may follow anticholinesterase instillation. This may be alleviated by prescribing a sympathomimetic mydriatic such as phenylephrine.
  8. Cardiac irregularities.

Read the Phospholine Iodide (echothiophate iodide for ophthalmic solution) Side Effects Center for a complete guide to possible side effects »

DRUG INTERACTIONS

Echothiophate iodide for ophthalmic solution potentiates other cholinesterase inhibitors such as succinylcholine or organophosphate and carbamate insecticides. Patients undergoing systemic anticholinesterase treatment should be warned of the possible additive effects of echothiophate iodide for ophthalmic solution.

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

WARNINGS

  1. Succinylcholine should be administered only with great caution, if at all, prior to or during general anesthesia to patients receiving anticholinesterase medication because of possible respiratory or cardiovascular collapse.
  2. Caution should be observed in treating glaucoma with echothiophate iodide for ophthalmic solution in patients who are at the same time undergoing treatment with systemic anticholinesterase medications for myasthenia gravis, because of possible adverse additive effects.

(See "PRECAUTIONS: DRUG INTERACTIONS" for further information.)

PRECAUTIONS

General

  1. Gonioscopy is recommended prior to initiation of therapy. Routine examination to detect lens opacity should accompany clinical use of echothiophate iodide for ophthalmic solution.
  2. Where there is a quiescent uveitis or a history of this condition, anticholinesterase therapy should be avoided or used cautiously because of the intense and persistent miosis and ciliary muscle contraction that may occur.
  3. While systemic effects are infrequent, proper use of the drug requires digital compression of the nasolacrimal ducts for a minute or two following instillation to minimize drainage into the nasal chamber with its extensive absorption area. To prevent possible skin absorption, hands should be washed following instillation.
  4. Temporary or permanent discontinuance of medication is necessary if cardiac irregularities occur.
  5. Anticholinesterase drugs should be used with extreme caution, if at all, in patients with marked vagotonia, bronchial asthma, spastic gastrointestinal disturbances, peptic ulcer, pronounced bradycardia and hypotension, recent myocardial infarction, epilepsy, parkinsonism, and other disorders that may respond adversely to vagotonic effects.
  6. Anticholinesterase drugs should be employed prior to ophthalmic surgery only as a considered risk because of the possible occurrence of hyphema.
  7. Echothiophate iodide for ophthalmic solution should be used with great caution, if at all, where there is a prior history of retinal detachment.
  8. Temporary discontinuance of medication is necessary if salivation, urinary incontinence, diarrhea, profuse sweating, muscle weakness, or respiratory difficulties occur.
  9. Patients receiving echothiophate iodide for ophthalmic solution who are exposed to carbamate- or organophosphate-type insecticides and pesticides (professional gardeners, farmers, workers in plants manufacturing or formulating such products, etc.) should be warned of the additive systemic effects possible from absorption of the pesticide through the respiratory tract or skin. During periods of exposure to such pesticides, the wearing of respiratory masks, and frequent washing and clothing changes may be advisable.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No data is available regarding carcinogenesis, mutagenesis, and impairment of fertility.

Pregnancy

Teratogenic Effects – Pregnancy Category C

Animal reproduction studies have not been conducted with echothiophate iodide for ophthalmic solution. It is also not known whether echothiophate iodide for ophthalmic solution can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Echothiophate iodide for ophthalmic solution should be given to a pregnant woman only if clearly needed.

Nursing Mothers

Because of the potential for serious adverse reactions in nursing infants from echothiophate iodide for ophthalmic solution, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric patients have been established.

Geriatric Use

No overall differences in safety or effectiveness have been observed between elderly and younger patients.

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

OVERDOSE

No information provided.

CONTRAINDICATIONS

  1. Active uveal inflammation.
  2. Most cases of angle-closure glaucoma, due to the possibility of increasing angle block.
  3. Hypersensitivity to the active or inactive ingredients.

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

CLINICAL PHARMACOLOGY

Echothiophate iodide for ophthalmic solution is a long-acting cholinesterase inhibitor for topical use which enhances the effect of endogenously liberated acetylcholine in iris, ciliary muscle, and other parasympathetically innervated structures of the eye. It thereby causes miosis, increase in facility of outflow of aqueous humor, fall in intraocular pressure, and potentiation of accommodation.

Echothiophate iodide for ophthalmic solution will depress both plasma and erythrocyte cholinesterase levels in most patients after a few weeks of eyedrop therapy.

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

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PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 12/9/2008
This monograph has been modified to include the generic and brand name in many instances.

Disclaimer

Phospholine Iodide Consumer

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

ECHOTHIOPHATE SOLUTION - OPHTHALMIC

(eck-oh-THIGH-oh-fate)

COMMON BRAND NAME(S): Phospholine Iodide

USES: This medication is used alone or with other medications to treat certain types of glaucoma and other eye conditions (e.g., accommodative esotropia, synechial formation). It is also used to test for certain eye conditions (e.g., accommodative esotropia). It works by causing the pupil to shrink, decreasing the amount of fluid within the eye, and affecting certain eye muscles.

HOW TO USE: Follow all directions supplied by the manufacturer for mixing the eye drops.

To apply eye drops, wash your hands first. To avoid contamination, be careful not to touch the dropper to any surface or let it touch your eye.

If you are wearing contact lenses, remove them before using eye drops. Wait at least 15 minutes before replacing your contact lenses.

Tilt your head back, look upward, and pull down the lower eyelid to make a pouch. Hold the dropper directly over your eye and place one drop into the pouch. Let go of the eyelid and gently close your eyes. Place one finger at the corner of your eye (near the nose) and apply gentle pressure for 1 to 2 minutes. This will prevent the medication from draining out. Try not to blink and do not rub your eye. Repeat these steps for your other eye if so directed or if your dose is for more than 1 drop.

Remove extra solution around the eye with a tissue, and wash your hands to remove any medicine that may be on them. Do not rinse the dropper. Replace the dropper cap after each use.

If you are using another kind of eye medication (e.g., drops or ointments), wait at least 5 minutes before using the other medication. Use eye drops before ointments to allow the eye drops to enter the eye.

The dosage is based on your medical condition and response to therapy. Do not increase your dose or use more frequently than directed by your doctor. Doing so may increase the risk for serious side effects.

Disclaimer

Phospholine Iodide Consumer (continued)

SIDE EFFECTS: Temporary irritation/burning/stinging of the eye, temporary blurred vision, eyelid muscle twitching, poor vision in dim light, headache, or brow ache may occur. If any of these effects persist or worsen, contact your doctor or pharmacist promptly. (See also Precautions section.)

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: eye pain, flushing, diarrhea, nausea, irregular heartbeat, stomach/abdominal pain or cramps, increased saliva, increased urination, unusual sweating, vision changes.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the Phospholine Iodide (echothiophate iodide for ophthalmic solution) Side Effects Center for a complete guide to possible side effects »

PRECAUTIONS: Before using echothiophate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, epilepsy, other eye problems (e.g., iritis, uveitis, detached retina), heart disease (e.g., heart failure, recent heart attack), low or high blood pressure, myasthenia gravis, overactive thyroid (hyperthyroidism), Parkinsonism, stomach/intestinal problems (e.g., ulcers, spasms), certain urinary problems (e.g., blockage).

After you apply echothiophate, your vision may become temporarily blurred or unstable. Vision in dim light may be affected. Do not drive (especially at night), use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

Avoid exposure to insecticides. Some types of insecticides may increase the risk of certain side effects. If you have contact with insecticides, wear a mask and/or gloves and wash or change clothing frequently. Consult your doctor or pharmacist for more information.

Before having surgery, tell your doctor or dentist that you are using this medication.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known if this drug passes into breast milk. Consult your doctor before breast-feeding.

Disclaimer

Phospholine Iodide Consumer (continued)

DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: other eye medications, certain drugs for myasthenia gravis (e.g., pyridostigmine, neostigmine), succinylcholine.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: This medicine may be harmful if swallowed. If swallowing or overdose is suspected, contact your local poison control center or emergency room immediately. US residents should call the US National Poison Hotline at 1-800-222-1222. Canada residents should call a provincial poison control center. Symptoms of overdose may include: increased saliva, irregular/slow heartbeat, nausea, diarrhea, increased sweating.

NOTES: Do not share this medication with others.

Laboratory and/or medical tests (e.g., eye exams) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

MISSED DOSE: If you are prescribed this medication on a once- or twice-daily schedule and miss a dose, apply it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Ask your doctor ahead of time what you should do if you miss a dose while using this medication on another schedule besides a daily one.

STORAGE: Store the unmixed product in the refrigerator at 36-46 degrees F (2-8 degrees C) away from light and moisture. The mixed solution may be stored at room temperature about 77 degrees F (25 degrees C) for up to 4 weeks. Do not freeze. Do not store in the bathroom. Discard the mixed solution if it changes color, becomes cloudy, or develops particles. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised May 2010. Copyright(c) 2010 First Databank, Inc.

Phospholine Iodide Patient Information Including Side Effects

Brand Names: Phospholine Iodide

Generic Name: echothiophate iodide ophthalmic (Pronunciation: eck oh THYE oh fate EYE oh dide)

What is echothiophate iodide ophthalmic (Phospholine Iodide)?

Echothiophate iodide ophthalmic reduces pressure in the eye by increasing the amount of fluid that drains from the eye. Echothiophate iodide ophthalmic also causes the pupil to become smaller and reduces its response to light or dark conditions.

Echothiophate iodide ophthalmic is used to treat glaucoma by lowering the pressure inside the eye. Echothiophate iodide ophthalmic is also used to treat certain eye disorders involving eye accommodation (focusing).

Echothiophate iodide ophthalmic may also be used for purposes other than those listed in this medication guide.

What are the possible side effects of echothiophate iodide ophthalmic (Phospholine Iodide)?

Contact your doctor immediately if you notice any decrease in vision or an increase in "floaters" in your visual field. Rarely, echothiophate iodide ophthalmic may cause retinal detachment. Retinal detachment can lead to blind spots, floaters in your visual field, and even blindness. Your doctor will want to check your retina before you use this medicine to determine if you have an increased risk of retinal detachment.

If you experience any of the following serious side effects, stop using echothiophate iodide ophthalmic and seek emergency medical attention:

  • an allergic reaction (shortness of breath; swelling of the lips, face, or tongue; or hives);
  • abdominal cramps or diarrhea;
  • watering mouth;
  • excessive sweating;
  • urinary incontinence;
  • muscle weakness;
  • difficulty breathing; or
  • an irregular heart beat.

Other, less serious side effects may be more likely to occur. Continue to use echothiophate iodide ophthalmic and talk to your doctor if you experience

  • burning, stinging, red, or tearing eyes;
  • eyelid muscle twitches;
  • headache or brow ache; or
  • decreased vision in poor light.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Read the Phospholine Iodide (echothiophate iodide for ophthalmic solution) Side Effects Center for a complete guide to possible side effects »

What is the most important information I should know about echothiophate iodide ophthalmic (Phospholine Iodide)?

Contact your doctor immediately if you notice any decrease in vision or an increase in "floaters" in your visual field. Rarely, echothiophate iodide ophthalmic may cause retinal detachment. Retinal detachment can lead to blind spots, floaters in your visual field, and even blindness. Your doctor will want to check your retina before you use this medicine to determine if you have an increased risk of retinal detachment.

Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye.

Apply light pressure to the inside corner of the eye (near the nose) after each drop to prevent the fluid from draining down the tear duct.

Use caution when driving, operating machinery, or performing other hazardous activities. Echothiophate iodide ophthalmic may cause decreased vision at night. If you experience decreased vision, avoid these activities.

Side Effects Centers

Phospholine Iodide Patient Information including How Should I Take

What should I discuss with my healthcare provider before using echothiophate iodide ophthalmic (Phospholine Iodide)?

Rarely, echothiophate iodide ophthalmic may cause retinal detachment. Tell your doctor if you have any type of retinal disease, if you have had a retinal tear, if you are nearsighted, or if you have had cataract surgery. These conditions may increase the risk of retinal detachment with echothiophate iodide ophthalmic use.

Before using this medication, tell your doctor if you have

  • heart failure,
  • high or low blood pressure,
  • ever had a heart attack,
  • asthma,
  • a stomach ulcer or stomach spasms,
  • epilepsy,
  • hyperthyroidism (an overactive thyroid),
  • blockage of the urinary tract or difficulty urinating, or
  • Parkinson's disease.

You may not be able to use echothiophate iodide ophthalmic, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Echothiophate iodide ophthalmic is in the FDA pregnancy category C. This means that it is not known whether echothiophate iodide ophthalmic will be harmful to an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether echothiophate iodide passes into breast milk. Do not use echothiophate iodide ophthalmic without first talking to your doctor if you are breast-feeding a baby.

How should I use echothiophate iodide ophthalmic (Phospholine Iodide)?

Use echothiophate iodide ophthalmic eye drops exactly as directed by your doctor. If you do not understand these instructions, ask your doctor, pharmacist, or nurse to explain them to you.

Wash your hands before and after using the eye drops.

If you wear contact lenses, remove them before applying echothiophate iodide ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication.

To apply the eye drops:

  • Tilt the head back slightly and pull down on the lower eyelid. Position the dropper above the eye. Look up and away from the dropper. Squeeze out a drop and close the eye. Apply gentle pressure to the inside corner of the eye (near the nose) for about 1 minute to prevent the liquid from draining down the tear duct. If you are using more than 1 drop in the same eye, repeat the process with about 5 minutes between drops. Repeat the process in the other eye if needed.

Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye.

Do not use any eyedrop that is discolored or has particles in it.

Echothiophate iodide ophthalmic eye drops can be stored in the refrigerator for up to 6 months. If the eye drops are stored at room temperature, they must be used within 30 days and then discarded. Keep the bottle properly capped.

Side Effects Centers

Phospholine Iodide Patient Information including If I Miss a Dose

What happens if I miss a dose (Phospholine Iodide)?

Apply the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and apply the next one as directed. Do not use a double dose of this medication.

What happens if I overdose (Phospholine Iodide)?

Flush the eye with water and seek emergency medical attention.

Symptoms of an echothiophate iodide ophthalmic overdose include sweating, nausea, vomiting, diarrhea, watering mouth, tearing eyes, fainting, difficulty breathing, and an irregular heartbeat.

What should I avoid while using echothiophate iodide ophthalmic (Phospholine Iodide)?

Use caution when driving, operating machinery, or performing other hazardous activities. Echothiophate iodide ophthalmic may cause decreased vision at night. If you experience decreased vision, avoid these activities.

Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye.

If you wear contact lenses, remove them before applying echothiophate iodide ophthalmic Ask your doctor if contact lenses can be reinserted after application of the medication.

Do not use other eye medications during treatment with echothiophate iodide ophthalmic except under the direction of your doctor.

What other drugs will affect echothiophate iodide ophthalmic (Phospholine Iodide)?

Do not use other eye medications during treatment with echothiophate ophthalmic except under the direction of your doctor.

Organophosphates may increase the effects of echothiophate iodide ophthalmic. If you are a gardener, an organophosphate plant or warehouse worker, or a farmer, you may be exposed to organophosphates. Follow the directions of your doctor and workplace safety guides regarding respiratory masks and the washing and changing of clothes.

Drugs other than those listed here may also interact with echothiophate iodide ophthalmic. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

Your pharmacist has additional information about echothiophate iodide ophthalmic written for health professionals that you may read.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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