Acetylcholine Other names: Acetylcholine chloride

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 aqueoushumor 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.

Topical: Not applicable.

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 acetylcholine has been demonstrated in several animal studies. The addition of electrolytes in acetylcholine 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.