Acetylcholine (Miochol-E)

How does it work?

Miochol-E is a medicine used in the eye that contains the active ingredient acetylcholine. Acetylcholine is a compound produced naturally by the body's nervous system.

When applied to the eye, acetylcholine stimulates receptors called cholinoceptors that are present in the circular muscle of the iris (coloured part of the eye). This causes the pupil to constrict.

This medicine is used during eye surgery when the surgeon requires rapid and complete constriction of the pupil. It is used, for example, after replacing the lens in cataract surgery, during corneal transplant surgery, and during surgery to cut away part of the iris (iridectomy).

What is it used for?

  • To obtain rapid and complete constriction of the pupil during eye surgery (lens delivery in cataract surgery, corneal transplant (keratoplasty), removal of part of the iris (iridectomy) or other surgery on the front of the eye).


  • The safety and efficacy of this medicine in children has not been studied by the manufacturer.

Not to be used in

  • Breastfeeding
  • Pregnancy

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The manufacturer states not to use this medicine during pregnancy and breastfeeding as there is insufficient safety information available. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • Difficulties with breathing
  • Sweating
  • Low blood pressure (hypotension)
  • Flushing
  • Slow heart rate (bradycardia)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

There are no significant interactions reported with this medicine.There have been reports that acetylcholine has been ineffective when used in patients treated with eye preparations containing non-steroidal anti-inflammatory medicines (NSAIDs).