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Pilocarpine nitrate is a direct acting parasympathomimetic (cholinergic) agent and a slowly hydrolyzed muscarinic agonist with no nicotinic effects. It is primarily used as an ophthalmic solution to induce miosis (pupil constriction), reverse the action of mydriatics, and lower intraocular pressure in the emergency treatment of glaucoma—including both open-angle and acute angle-closure types. Its mechanism involves stimulating muscarinic receptors in the eye, leading to contraction of the iris sphincter muscle and ciliary muscle, which facilitates aqueous humor outflow through the trabecular meshwork. This reduces intraocular pressure and can also help restore normal pupil size after dilation during eye exams or surgery[2][3][8][9].
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