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miochol-e

Miochol-E (Acetylcholine Chloride) is a medication used to treat Compassion Fatigue, Headache.

Acetylcholine Chloride · by Bausch and Lomb

Not yet rated· sourced from the FDA label
Rated against independent regulatory sources·Last updated June 7, 2026·How we rate
Verified againstopenFDANIH DailyMedRxClass

Key facts

Active ingredient
Acetylcholine Chloride
Form
Kit
Strength
Acetylcholine Chloride 20MG/VIAL
Type
Prescription (Rx)
Brand or generic
Brand-name
Manufacturer
Bausch and Lomb
FDA application
NDA020213

What is Miochol-E?

From the FDA label:Miochol ™ -E (acetylcholine chloride intraocular solution) is a parasympathomimetic preparation for intraocular use. It is packaged in a blister pack containing one vial and one diluent ampule. The vial contains 20 mg acetylcholine chloride and 56 mg mannitol. The accompanying ampule contains 2 mL of a modified diluent of calcium chloride dihydrate, magnesium chloride hexahydrate, potassium chloride, sodium acetate trihydrate, and sterile water for injection. The reconstituted liquid will be a sterile isotonic solution (275–330 milliosmoles/kg) containing 20 mg acetylcholine chloride (1:100 solution) and 2.8% mannitol. The pH range is 5.0–8.2. Mannitol is used in the process of lyophilizing acetylcholine chloride, and is not considered an active ingredient. The chemical name for acetylcholine chloride, C 7 H 16 ClNO 2 , is Ethanaminium, 2-(acetyloxy) -N,N,N -trimethyl-, chloride and is represented by the following chemical structure: ChemStructure

How to use

Miochol ™ -E (acetylcholine chloride intraocular solution) is instilled into the anterior chamber before or after securing one or more sutures. Instillation should be gentle and parallel to the iris face and tangential to pupil border. If there are no mechanical hindrances, the pupil starts to constrict in seconds and the peripheral iris is drawn away from the angle of the anterior chamber. Any anatomical hindrance to miosis must be released to permit the desired effect of the drug. In most cases, 0.5 to 2 mL produces satisfactory miosis. Note that the syringe filter supplied with Miochol-E has a priming volume of 0.6 mL (approximately). In cataract surgery, use Miochol-E only after delivery of the lens. Aqueous solutions of acetylcholine chloride are unstable. Prepare solution immediately before use. Do not use solution that is not clear and colorless. Discard any solution that has not been used.

Side effects

Infrequent cases of corneal edema, corneal clouding, and corneal decompensation have been reported with the use of intraocular acetylcholine. Adverse reactions have been reported rarely, which are indicative of systemic absorption. These include bradycardia, hypotension, flushing, breathing difficulties, and sweating. To report SUSPECTED ADVERSE REACTIONS, contact Bausch & Lomb Incorporated at 1-800-553-5340 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Warnings

Important safety information

If blister or peelable backing is damaged or broken, sterility of the enclosed vial and ampule cannot be assured. Open under aseptic conditions only.

Who should not take Miochol-E

Miochol-E is contraindicated in persons with a known hypersensitivity to any component of this product.

Overdose — what happens if you take too much

Atropine sulfate (0.5 to 1 mg) should be given intramuscularly or intravenously and should be readily available to counteract possible overdosage. Epinephrine (0.1 to 1 mg subcutaneously) is also of value in overcoming severe cardiovascular or bronchoconstrictor responses.

U.S. Poison Control: call or text 1-800-222-1222 (free, 24/7). In an emergency call 911. From the FDA label; not medical advice.

May treat (source: NIH RxClass)

Dosage forms

Kit

The forms currently marketed in the U.S., per the FDA National Drug Code Directory.

Ways to save

Ask for the generic

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Request a 90-day supply

Bulk fills usually lower the per-dose price vs monthly refills.

Use copay cards

Manufacturer copay cards & patient-assistance programs — especially for brand drugs.

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Frequently asked questions

What does Miochol-E treat?
Miochol-E (Acetylcholine Chloride) may be used to treat compassion fatigue, headache, based on NIH RxClass drug-classification data (conditions a drug may treat — not a verbatim copy of the FDA-approved label). This is general reference, not medical advice.
Is there a coupon or discount for Miochol-E?
pharmaranks is an independent ratings site, not a pharmacy — we don't issue coupons or sell Miochol-E. To pay less, ask your prescriber or pharmacist whether a generic equivalent exists, check the manufacturer's copay/savings card and patient-assistance program, and compare a pharmacy discount card against your insurance copay. Prices vary by pharmacy, insurance, and location, so always confirm at the counter. This is general reference, not medical or financial advice.
Who makes Miochol-E?
Miochol-E is marketed by Bausch and Lomb. You can see Bausch and Lomb's full profile, rating, and other products on pharmaranks.
Is Miochol-E a brand-name or generic drug?
Miochol-E is a brand-name product with the active ingredient Acetylcholine Chloride.
Is Miochol-E available over the counter?
No. Miochol-E is a prescription (Rx) medication in the US — you need a prescription from a licensed clinician (in person or via telehealth); it isn't sold over the counter. For some conditions there are OTC alternatives — ask your pharmacist.
What forms does Miochol-E come in?
Miochol-E is currently marketed as kit, per the FDA's National Drug Code Directory.
Is Miochol-E FDA-registered?
Miochol-E is on record with the U.S. FDA under application number NDA020213. You can verify this on its official FDA label.
Is Miochol-E safe?
There's no single safe-or-not verdict, and we don't yet have a composite recall-safety score for Miochol-E. Review its FDA-label side effects and warnings below, and always consult a licensed professional.
What are the side effects of Miochol-E?
Miochol-E's side effects are taken directly from its FDA label. From the label: Infrequent cases of corneal edema, corneal clouding, and corneal decompensation have been reported with the use of intraocular acetylcholine. Adverse reactions have been reported rarely, which are indicative of systemic absorption. These include bradycardia, hypotension, flushing,… Both common and serious reactions are documented in full on this page. This is general reference from the FDA, not medical advice — always consult a professional.

Clinical content sourced from the FDA label via openFDA (U.S. FDA). View the FDA label on DailyMed → Provided for general reference only — not medical advice. Always consult a licensed professional and the current prescribing information.

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