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Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

ACETYLCHOLINE 10mg/ml CUSÍ powder and solvent for solution for intraocular instillation

Read the entire package leaflet carefully before starting to use this medication, as it contains important information for you.

  • Keep this package leaflet, as you may need to read it again.
  • If you have any questions, consult your doctor or pharmacist.
  • This medication has been prescribed to you only, and you should not give it to others, even if they have the same symptoms as you, as it may harm them.
  • If you experience side effects, consult your doctor or pharmacist, even if they are not listed in this package leaflet. See section 4.

Contents of the Package Leaflet

  1. What ACETYLCHOLINE 10 mg/ml CUSÍ is and what it is used for
  2. What you need to know before you are given ACETYLCHOLINE 10 mg/ml CUSÍ
  3. How to use ACETYLCHOLINE 10 mg/ml CUSÍ
  4. Possible side effects
  5. Storage of ACETYLCHOLINE 10 mg/ml CUSÍ
  6. Contents of the pack and further information

Your doctor will administer ACETYLCHOLINE 10mg/ml CUSÍ. This package leaflet is intended to inform you about the medication.

1. What is Acetylcholine 10 mg/ml CUSÍ and what is it used for

The active substance of this medication is acetylcholine chloride, which is involved in the transmission of nerve impulses in the body. It acts, among other places, on a muscle of the iris of the eye.

Acetylcholine 10 mg/ml Cusí is indicated during cataract surgery and other types of surgery on the anterior segment of the eyes to constrict the pupil (central part of the eye). This helps the surgeon to complete the operation.

Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before you are given Acetylcholine 10 mg/ml CUSÍ

Acetylcholine 10 mg/ml Cusí should not be administered

  • If you are allergic to acetylcholine chloride or to any of the other components of this medication (listed in section 6).

Warnings and precautions

Consult your doctor before you are given Acetylcholine 10 mg/ml Cusí.

Tell your doctor if you have:

  • Angle-closure glaucoma
  • Cardiovascular problems
  • Bronchial asthma
  • Ulcers
  • Hyperthyroidism
  • Intestinal problems
  • Urinary tract problems
  • Parkinson's disease

Patient over 65 years

Patient over 65 years should be cautious as they may be more prone to hypotension and/or bradycardia due to the medication reaching the bloodstream.

Children

The safety and efficacy of Acetylcholine 10 mg/ml Cusí have not been established in children.

Other medications and Acetylcholine 10 mg/ml CUSÍ

Tell your doctor if you are using, have recently used, or may need to use any other medication.

Some medications may interfere with the mechanism of action of this medication. Inform your doctor if you are applying topical preparations containing NSAIDs (non-steroidal anti-inflammatory drugs) to your skin to treat pain and swelling.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before you are given this medication.

Acetylcholine 10 mg/ml Cusí is not recommended during pregnancy.

If you are breastfeeding, you should decide whether to discontinue breastfeeding or discontinue treatment with this medication, considering the benefit of breastfeeding to the child and the benefit of treatment to the mother.

Driving and using machines

You may experience difficulty adapting to darkness, blurred vision, and other visual disturbances for a prolonged period. Do not drive or use machines until this effect has disappeared.

3. How to use Acetylcholine 10 mg/ml CUSÍ

This medication is for Hospital Use Only.

This medication should only be administered by your doctor during eye surgery.

The recommended dose is:

Adults

Your doctor will calculate the correct dose for you.

If you use the extemporaneous solution of 10 mg/ml (solution prepared for use); it is prepared according to the Reconstitution Instructions explained below.

Using 0.5 to 2 ml, in most cases, adequate pupil constriction (miosis) is achieved within seconds. The effect lasts for 10-20 minutes. If longer miosis is needed, the application can be repeated, or a pilocarpine (2%) solution can be used via the ocular route after surgery and before applying the dressing.

Your doctor will decide when to use this solution. In cataract surgery, it should only be used after the lens has been removed.

Your doctor will administer this medication following these instructions:

  • Using a needle, aspirate the contents of the ampoule into a dry and sterile syringe.
  • Add it to the vial containing the acetylcholine chloride lyophilized (powder).
  • Shake carefully until the powder is dissolved.
  • Aspirate the solution again with the syringe and replace the needle with a suitable atraumatic cannula for intraocular instillation.
  • Instill the acetylcholine solution into the anterior chamber before or after securing one or more sutures.
  • The instillation should be gentle, parallel to the iris surface, and tangential to the pupil edge.
  • It is not necessary to remove the solution from the anterior chamber of the eye after achieving miosis.
  • The acetylcholine chloride solution is unstable. Therefore, it should be prepared by a healthcare professional immediately before use and any unused solution should be discarded.

Use in children

The efficacy and safety of Acetylcholine 10 mg/ml Cusí have not been studied in children, so its use is not recommended.

Use in elderly patients

See the "Warnings and precautions" section in section 2.

If you use more ACETYLCHOLINE 10 mg/ml CUSÍ than you should

If you use more than the recommended amount, your doctor may need to administer an injection of atropine or other anticholinergic medications to control the symptoms.

Overdose symptoms may include: slow heart rate, low blood pressure, flushing, difficulty breathing, and sweating.

If you have any other questions about the use of this medication, ask your doctor.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone gets them.

Side effects are classified by frequency, which is defined as: Very common (may affect more than 1 in 10 people); common (may affect up to 1 in 10 people); uncommon (may affect up to 1 in 100 people); rare (may affect up to 1 in 1,000 people); very rare (may affect up to 1 in 10,000 people); frequency not known (cannot be estimated from available data).

The following side effects have been reported with this medication:

Frequency not known:

  • Eye effects: swelling or clouding of the cornea (the transparent layer that protects the front of the eye), inflammation inside the eye. This may affect your vision.
  • General effects: flushing, sweating, slow heart rate, low blood pressure, and difficulty breathing. These effects occur rarely when acetylcholine is absorbed from the eye into the rest of the body. Patients over 65 years may be more prone to these effects.

Reporting side effects

If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this package leaflet. You can also report them directly through the Spanish Medication Surveillance System for Human Use: https://www.notificaRAM.es.By reporting side effects, you can help provide more information on the safety of this medication.

5. Storage of Acetylcholine 10 mg/ml CUSÍ

Keep this medication out of the sight and reach of children.

No special storage conditions are required.

Use immediately after preparing the solution and discard any unused solution.

Do not use this medication after the expiration date shown on the vial and carton after EXP. The expiration date is the last day of the month indicated.

6. Contents of the pack and further information

Composition of ACETYLCHOLINE 10 mg/ml CUSÍ

  • The active ingredient is acetylcholine chloride. One ml of the prepared solution contains 10 mg of acetylcholine chloride (1%).
  • The other ingredients are mannitol (E-421) in the vial and water for injectable preparations in the ampoule.

Appearance of the product and contents of the pack

The medication is presented as a powder and solvent for solution for intraocular instillation.

The pack contains a vial with white powder and an ampoule with clear and colorless solvent. The powder must be reconstituted with the solvent before use, resulting in a clear and colorless solution.

Marketing authorization holder and manufacturer

Marketing authorization holder and manufacturer

Fidia Farmaceutici S.p.A.

Via Ponte della Fabbrica, 3/A - 35031 Abano Terme – Italy

Local representative

Laboratorios Fidia Farmacéutica S.L.U.

Parque Empresarial de la Moraleja

Edificio Torona. Avenida de Europa, 24 – Edificio A – 1 B

Alcobendas 28108 | Madrid Spain

Date of last revision of this package leaflet:November 2016.

Detailed information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

Online doctors for Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution

Discuss questions about Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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She has also developed her professional activity within the Primary Care Management Service, providing consultations in general medicine. In this setting she is responsible for patient follow-up, management of acute and chronic conditions, as well as health promotion and disease prevention.

She has also worked as a physician in a mobile ICU unit, providing medical assistance in out-of-hospital emergencies, treating critical patients and participating in medicalized patient transport.

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Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
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  • bronchitis and mild asthma flare-ups
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  • rashes, allergic reactions, redness, insect bites
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  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

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  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
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He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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  • assessment of sudden or unclear symptoms
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  • follow-up after hospital discharge
  • interpretation of test results
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Dr Cayatte earned his degree from the University of Lisbon and taught internal medicine at Boston University School of Medicine. He holds active medical registrations in both Portugal and the UK and is a Fellow of the American Heart Association. Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

Dr. Antonio Cayatte provides comprehensive care for a broad spectrum of common health concerns, including:

  • Respiratory & ENT: acute bronchitis, concerns related to pneumonia, sinusitis, tonsillitis, ear infections, sore throat conditions, and allergic rhinitis
  • Eye Health: allergic and infectious conjunctivitis, as well as red or irritated eyes
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Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
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Gastroenterology – Digestive health:
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  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
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  • Adult vaccinations – planning, contraindications assessment.
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Currently (since 2025), he works as a Medical Oncologist at Institut Català d’Oncologia (Girona, Spain). Previously, he completed his residency in Medical Oncology and was involved in clinical research at Hospital Universitari Germans Trias i Pujol.

Dr. Chekhun has a strong academic and scientific background. He served as a lecturer in Internal Medicine at O.O. Bohomolets National Medical University and conducted research in experimental oncology at the R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology.

Earlier in his career, he worked as a medical oncologist at the Kyiv City Clinical Oncological Center and contributed to regulatory evaluation of medicinal products at the State Expert Center of the Ministry of Health of Ukraine.

When to consult Dr. Chekhun:

  •  for diagnosis or clarification of a cancer diagnosis
  •  to obtain a second opinion on an existing treatment plan 
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  •  for interpretation of test results, CT, MRI, PET-CT, and biopsies 
  •  when choosing between treatment options (chemotherapy, targeted therapy, immunotherapy) 
  •  in case of doubts about treatment strategy or disease progression 

Consultation format

Dr. Chekhun provides online consultations, where you can receive:

  •  expert second opinion 
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  •  recommendations based on current international treatment guidelines 
  •  personalized treatment and follow-up plan 

Important:
Prescription and monitoring of medications must be carried out by your treating physician in an in-person (offline) setting. An online consultation does not replace a face-to-face visit but helps you make more informed decisions about your treatment.

Dr. Sviatoslav Chekhun combines clinical practice, research, and international experience, enabling him to provide patients with modern, evidence-based approaches in oncology.

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Alexander Nazarchuk

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Dr. Alexander Nazarchuk is a physician specialising in allergology and internal medicine. He provides online consultations for adults, following the principles of evidence-based medicine — no outdated treatments or unnecessary tests, with clear explanations and a personalised approach. He helps patients with a wide range of allergic and therapeutic conditions, from common day-to-day complaints to complex cases involving allergies, gastrointestinal issues, cardiovascular concerns, respiratory symptoms, and more.

You can consult Dr. Nazarchuk for:

  • Test interpretation and guidance on diagnostic plans.
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  • Abdominal pain, bloating, changes in bowel habits, nausea, heartburn.
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During consultations, Dr. Nazarchuk takes a thorough, structured approach — analysing symptoms, identifying potential causes, and helping patients make informed decisions. Whether treatment, further investigation, or monitoring is needed, he explains each step clearly so you understand your health and how best to manage it.

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Frequently Asked Questions

Is a prescription required for Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution?

Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.

What is the active substance in Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution?

The active ingredient in Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution is acetylcholine. This information helps identify medicines with the same composition but different brand names.

Who manufactures Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution?

Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution is manufactured by Fidia Farmaceutici S.P.A.. Pharmacy brands and packaging may differ depending on the distributor.

Which doctors can assess the use of Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution online?

Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.

How to buy Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution in Spain?

Spain has a well-developed healthcare infrastructure across major cities such as Madrid, Barcelona, Valencia, and Seville. Pharmacies are widely available and operate under strict regulations, ensuring access to prescribed medications.

You can buy Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution in Madrid, Barcelona, Seville, or Valencia at any local pharmacy with a valid prescription.

To obtain a prescription, you can use Oladoctor:

What are the alternatives to Acetylcholine 10 mg/mL Cusí Powder and Solvent for Intraocular Instillation Solution?

Other medicines with the same active substance (acetylcholine) include COLIRCUSI PILOCARPINE 20 mg/ml EYE DROPS SOLUTION, ABIPROST 0.3 mg/ml EYE DROPS SOLUTION IN SINGLE-DOSE CONTAINERS, ABRADEL 2 mg/ml EYE DROPS SOLUTION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.

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