Aceclidine
Glaucoma · Rx
Trade namesVizz
Drug classCholinergic (muscarinic) agonist / miotic, presbyopia formulation
Strength1.44%
AvailabilityRx
Typical quantity25 x 0.25 mL vials (25-day)
Cash cost / month$$ · Moderate · ~$20-100
Mechanism of actionPupil-selective muscarinic agonist; contracts the iris sphincter for a sub-2mm pinhole effect while largely sparing the ciliary muscle, extending depth of focus for near vision without the accommodative spasm or myopic shift seen with pilocarpine.
Indication / reason for usePresbyopia. Not indicated for glaucoma or angle-closure.
Usual adult dosing1 drop each eye, wait 2 minutes, then a second drop each eye, once daily. Onset within 30 minutes, lasts up to 10 hours.
PreservativePreservative-free, single-use vials , a preservative-free option exists
Contact lensesRemove lenses; reinsert after 15 minutes.
Common / important adverse effectsInstillation site irritation, dim vision, headache, conjunctival/ocular hyperemia; mostly mild, transient and self-resolving per trial data.
Contraindications & cautionsHypersensitivity; not recommended with a known history of iritis. The usual relative cautions for miotics (peripheral retinal disease) apply.
Pregnancy / lactationNo adequate human data; animal studies did not show adverse effects at clinically relevant doses. Use only if clearly needed.
Practice notesFDA-approved July 2025 (CLARITY 1-3 trials), launched in the US October 2025. A third FDA-approved presbyopia drop, competing with Vuity (pilocarpine 1.25%) and Qlosi (pilocarpine 0.4%); aceclidine is a distinct molecule from pilocarpine, marketed on a more pupil-selective profile.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.