Carbachol (Kar-ba-kol English phonetic spelling]), also known as carbamylcholine (marketed under the brand names Carbastat®, Carboptic®, Isopto Carbachol®, Miostat®), is classified as a cholinergic. It is primarily used for various opthalmic purposes, such as for treating glaucoma, or for use during ophthalmic surgery. It is generally administered as an intraocular solution (i.e. eyedrop).

Chemistry and pharmacology

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Carbachol is a choline ester and a positively charged quaternary ammonium compound. It is not well absorbed in the gastro-intestinal tract and does not cross the blood-brain barrier. It is usually administered topical ocular or through intraocular injection. Carbachol is not easily metabolized by cholinesterase, its duration of action is 4 to 8 hours with topical administration and 24 hours for intraocular administration. Since carbachol is poorly absorbed through topical administration, benzalkonium chloride is mixed in to promote absorption.

Carbachol is a parasympathomimetic that stimulates both muscarinic and nicotinic receptors. In topical ocular and intraocular administration its principal effects are miosis and increased aqueous humour outflow.

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