MIOCHOL-E Powder and solvent for instillation solution Ref.[6058] Active ingredients: Acetylcholine

Source: Medicines & Healthcare Products Regulatory Agency (GB)  Revision Year: 2014  Publisher: DR GERHARD MANN CHEM-PHARM FABRIK GMBH BRUNSBUTTELER DAMM 165-173 13581 BERLIN GERMANY

Pharmacodynamic properties

Acetylcholine is a physiological neuromediator of postganglionic parasympathetic nerve fibres (muscarinic action), skeletal muscles and ganglia of the sympathetic system (nicotinic action).

The ocular parasympathetic receptors of the muscarinic type are very numerous and localised:

  • at the level of the pupillary sphincter, whose contraction causes miosis
  • at the level of the ciliary muscle, whose contraction allows accommodation and facilitates the flow of the aqueous humor by opening of the trabecular meshwork. In addition, the acetylcholine can have an inhibitory effect on the aqueous secretion. These two last factors result in a decrease in the intraocular pressure.
  • at the level of the lacrimal glands, whose stimulation causes tearing.

Pharmacokinetic properties

Topical: Not applicable.

Preclinical safety data

The active ingredient of Miochol-E is acetylcholine, a natural neurohormonal transmitter the pharmacological activity and toxicity of which have been clearly defined. The effect of Miochol has been demonstrated in several animal studies. The addition of electrolytes in Miochol-E resulted in very good local tolerability in the cat. Given that a low single dose of acetylcholine is administered by the intraocular route, the risk of systemic toxicity is very low.

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