Product image of Miochol-E (Acetylcholine Chloride) supplied by GNH India

Miochol-E

Active Ingredient:
Acetylcholine Chloride
Origin:
EU

Miochol-E (Acetylcholine Chloride)

Acetylcholine chloride, the active ingredient in Miochol-E, is a cholinergic agonist presented as an intraocular solution for intraocular use. It produces pupil constriction and facilitates aqueous humor outflow, making it useful during intraocular surgery and as an adjunct in glaucoma management.

GNH India supplies Miochol-E as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, transplant centres, oncology centres, pharmacies and clinics worldwide. The company adheres to stringent quality standards and provides regulatory documentation for global distribution, ensuring traceability and compliance with local regulations.

Manufacturer / TM Owner

Dr. Gerhard Mann Chem.-Pharm. Fabrik Gmbh

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Indications & Clinical Uses

Miochol-E, a cholinergic miotic, is used in ocular conditions that require pupil constriction or enhanced aqueous outflow.

  • Intraocular surgery: provides rapid pupil constriction to improve surgical exposure.
  • Glaucoma (adjunctive): facilitates aqueous humor outflow to help lower intraocular pressure.
  • Diagnostic ocular examinations: induces miosis for better visualization of anterior segment structures.

How It Works

  • Acetylcholine chloride directly stimulates muscarinic (M3) receptors on the sphincter pupillae muscle of the iris, causing contraction of the pupil. The same cholinergic activation increases trabecular meshwork outflow by relaxing the ciliary muscle, thereby promoting aqueous humor drainage and reducing intraocular pressure.

Side Effects

Miochol-E may cause ocular and systemic reactions after administration.

Common Side Effects

  • Blurred vision: transient loss of visual clarity following the drop.
  • Eye pain or discomfort: mild irritation at the site of instillation.
  • Headache: occasional mild headache after pupil constriction.
  • Transient increase in intraocular pressure: brief rise before outflow improves.
  • Photophobia: sensitivity to light due to miosis.

Serious or Rare Side Effects

  • Severe ocular inflammation: uveitis or iritis requiring medical attention.
  • Persistent miosis: prolonged pupil constriction affecting vision.
  • Allergic reaction: rash, swelling, or itching around the eye.
  • Corneal edema: swelling of the cornea that may impair vision.
  • Systemic cholinergic effects: bradycardia or hypotension if absorbed in significant amounts.

Precautions & Warnings

Before using Miochol-E, consider the following precautions.

  • Assess baseline pupil size: ensure adequate baseline before administration.
  • Monitor intraocular pressure: watch for spikes after use.
  • Avoid in narrow‑angle glaucoma: risk of angle‑closure attacks.
  • Use with caution in patients on systemic anticholinergics: potential antagonism of effect.
  • Store at room temperature: keep in the original container, protect from light and moisture.

Avoid Interactions

Miochol-E may interact with other ocular or systemic agents.

Major Interactions (Avoid)

  • Systemic anticholinergics (e.g., atropine): may block the miotic effect.
  • Cholinesterase inhibitors (e.g., donepezil): can potentiate ocular cholinergic response.
  • Topical adrenergic agonists (e.g., phenylephrine): may counteract pupil constriction.

Moderate Interactions (Monitor Closely)

  • Other miotic agents (e.g., pilocarpine): additive miosis may cause excessive constriction.
  • Intraocular anesthetics: may increase risk of ocular irritation.
  • Beta‑blocker eye drops: could reduce overall intraocular pressure‑lowering efficacy when used together.

Frequently Asked Questions

Miochol-E is an intraocular solution containing acetylcholine chloride that is employed to produce rapid pupil constriction during intraocular surgery and as an adjunctive agent to facilitate aqueous humor outflow in the management of glaucoma.

Acetylcholine chloride acts as a direct cholinergic agonist, binding to muscarinic receptors on the iris sphincter muscle to cause contraction (miosis) and on the ciliary body to enhance trabecular outflow, thereby helping to lower intraocular pressure.

The specific dose and frequency are determined by the prescribing ophthalmologist based on the clinical situation. Typically, a single drop is instilled, but the exact regimen is individualized for each patient.

Safety data for acetylcholine chloride in pregnancy and lactation are limited. It should only be used when the potential benefit justifies any possible risk to the fetus or infant, and the decision must be made by the treating physician.

To order, submit an enquiry on the Miochol‑E product page at gnhindia.com, specifying the required quantity. GNH India works with hospitals, pharmacies, and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details and any necessary import documentation.

The most common alternative is pilocarpine, another cholinergic miotic. Both induce miosis, but acetylcholine chloride has a very rapid onset and a short duration of action, whereas pilocarpine may have a longer effect but a slower onset. Choice depends on surgical timing and clinician preference.

Miochol‑E should be stored at room temperature, protected from light and moisture, and kept in its original sealed container. Do not freeze the solution, and discard any product that appears discolored or contaminated.

Miochol‑E is administered as a sterile intraocular drop. The prescribed number of drops is placed directly onto the ocular surface, usually by a trained healthcare professional, immediately before the intended surgical or diagnostic procedure.

Serious risks include severe ocular inflammation such as uveitis, persistent excessive miosis that impairs vision, corneal edema, and systemic cholinergic effects like bradycardia or hypotension if significant absorption occurs. Any of these symptoms require prompt medical evaluation.

Miochol‑E is contraindicated in patients with narrow‑angle or angle‑closure glaucoma, known hypersensitivity to acetylcholine chloride or any formulation components, and in individuals where miosis could exacerbate ocular conditions. Clinicians should assess each patient’s suitability before prescribing.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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