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TLM-018 is a selective muscarinic M4 receptor antagonist being developed as an ophthalmic solution (eye drops) for the treatment of myopia (nearsightedness), particularly in pediatric populations. Developed by Tsubota Laboratory, the drug aims to inhibit the progression of myopia by targeting specific muscarinic receptors in the eye that are involved in axial elongation. Unlike non-selective muscarinic antagonists such as atropine, TLM-018 is designed to be selective for the M4 receptor subtype to minimize common side effects like pupil dilation (mydriasis) and loss of near-focusing ability (cycloplegia). As of 2024, TLM-018 is in Phase 2 clinical development in Japan.
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