About Pilocarpine Alkaloid,Cholinergic (a non-selective muscarinic) agonist, Antiglaucoma, Miotic. Mechanism of Action of Pilocarpine Pilocarpine is a direct acting cholinergic parasympathomimetic agent which acts through direct stimulation of cholinergic receptors and produces both muscarinic and nicotinic actions of Acetylcholine. Pilocarpine produces miosis through contraction of the iris sphincter, causing increased tension on the scleral spur and opening of the trabecular mesh work spaces to facilitate outflow of aqueous humor. This will reduce the outflow resistance and also lowers intraocular pressure. Indications for Pilocarpine 1. Glaucoma 2. To counteract the mydriatic effect of sympathomimetic agents