Various medications are currently used to treat glaucoma. Your doctor may prescribe a combination of medications or change medications over time to reduce side effects or provide more effective treatment. Medications are usually intended to reduce elevated intraocular pressure and prevent damage to the optic nerve.
Eye drops used to control glaucoma reduce eye pressure by helping eye fluids to drain better and / or by decreasing the amount of fluid the eye produces. Drugs to treat glaucoma are classified based on their active ingredient. These include: prostaglandin analogs, beta-blockers, alpha agonists, and carbonic anhydrase inhibitors. Combination drugs are available for patients who require more than one type of medication.
Alpha agonist
|
Company |
Brand |
Generic name |
|
Allergan Inc. |
Alphagan® P |
Brimonidine tartrate 0.1%, 0.15% |
|
Novartis |
Iopidine® |
Apraclonidine HCl 0.5%, 1% |
Alpha antagonists act both to decrease fluid production and to increase your drainage. Alphagan P contains a Purite preservative that breaks down into natural tear components and may be more effective in people who have allergic reactions to preservatives from other eye drops. Alphagan is available in generic form.
Side effects
Side effects may include burning or stinging when putting on the eye drop, fatigue, headache, drowsiness, dry mouth, and dry nose.
Beta-blockers
|
Company |
Brand |
Generic name |
|
Akorn Inc. |
Betimol® |
Timolol hemihydrate 0.25%, 0.5% |
|
Akorn Inc. |
Timolol Maleate USP |
Timolol Maleate 0.5% |
|
Allergan Inc. |
Betagan® |
Levobunolol HCl ophthalmic solution, USP 0.25%, 0.5% |
|
Bausch & Lomb Inc. |
OptiPranolol® |
Metipranolol 0.3% |
|
Bausch & Lomb Inc. |
Istalol® |
Timolol maleate ophthalmic solution 0.5% |
|
Bausch & Lomb Inc. |
Timoptic in Ocudose (PF) |
Timolol Maleate Ophthalmic Solution 0.25%, 0.5% in Ocudose Dispenser |
|
Bausch & Lomb Inc. |
Timoptic-XE® |
Timolol Maleate Ophthalmic Gel Solution 0.25%, 0.5% |
|
Novartis |
Betoptic® S |
Betaxolol HCl 0.25%, 0.5% |
Beta-blockers work by decreasing the production of intraocular fluid. They are available in generic form and are therefore relatively inexpensive. Systemic side effects can be minimized by closing the eyes after application or by using a technique called tear spot occlusion that prevents the drug from entering the tear drain line and systemic circulation.
Read MoreSide effects
Side effects can include low blood pressure, decreased heart rate, and fatigue. Beta-blockers can also cause shortness of breath in people with a history of asthma or other respiratorydisorders. In addition, beta-blockers can modify cardiac activity by decreasing the amount of blood the heart pumps, which can decrease heart rate and / or slow the heart's response speed when exercising. Uncommon side effects include decreased libido and depression.
Carbonic anhydrase inhibitors
|
Company |
Brand |
Generic name |
|
Fera Pharmaceuticals |
Neptazane® |
Methazolamide |
|
Merck & Co. Inc. |
Trusopt® |
Dorzolamide HCl 2% |
|
Novartis |
Azopt® |
Brinzolamide 1% ophthalmic suspension |
|
Teva Pharmaceuticals |
Diamox® Sequels® |
Acetazolamide |
Carbonic anhydrase (IAC) inhibitors reduce eye pressure by decreasing the production of intraocular fluid. They are available as eye drops and tablets. If you need to use more than one type of eye drop, you may need to take each medicine in a particular order, as directed by your doctor. If you use more than one type of eye drop, wait 5 minutes between applications of the eye drop medicine. Tablet presentation is an alternative for people with glaucoma who cannot control it with eye drop medication.
Side effects
Side effects of the tablet form of these medications may include tingling or loss of strength in the hands and feet, upset stomach, lack of mental clarity, memory problems, depression, kidney stones, and frequent urination. Because the eye drop presentation of this drug is relatively new, long-term studies have not yet been completed. Side effects of eye drop include stitches, burning, or other eye discomfort.
Cholinergic (miotic)
|
Company |
Brand |
Generic name |
|
Bausch & Lomb Inc. |
Pilocarpine HCl Ophthalmic Solution USP |
Pilocarpine HCl 1%, 2%, 4% |
|
Novartis |
Isopto® Carpine |
Pilocarpine HCl 1%, 2%, 4% |
|
Novartis |
Isopto® Carbachol |
Carbachol 0.75%, 1.5%, 3% |
|
Novartis |
Pilopine HS® Gel |
Pilocarpine HCl Gel 4% |
These medications reduce eye pressure by increasing intraocular fluid drainage through the trabecular meshwork. Cholinergics can be used alone or in combination with other glaucoma medications. A combination of medications can help control the amount of fluid produced in the eye and increase the amount of fluid that drains out of the eye.
Side effects
Many people using these medications complain of decreased vision, especially at night or in dark areas, such as movie theaters. This is due to constriction of the pupil. Miotics increase intraocular fluid drainage by decreasing pupil size, thereby increasing intraocular fluid flow from the eye.
Combination drugs
|
Company |
Brand |
Generic name |
|
Aerie Pharmaceuticals, Inc. |
Rocklatan® |
Netarsudil and latanoprost ophthalmic solution 0.02% / 0.005% |
|
Akorn Inc. |
Cosopt® |
Dorzolamide HCl and Timolol Maleate |
|
Akorn Inc. |
Cosopt® PF |
Dorzolamide HCl and Timolol Maleate |
|
Allergan Inc. |
Combigan® |
Brimonidine tartrate and timolol maleate 0.2% / 0.5% |
|
Novartis |
Simbrinza® |
Brinzolamide and Brimonidine tartrate 1% / 0.2% |
Reduces the production of intraocular fluid.
Combination medications may offer an alternative for patients who need more than one type of medication. In addition to the convenience of using one eye drop bottle instead of two, there may also be an economic advantage, depending on your insurance plan. Combigan is a combination of beta-blocker and alpha agonist. Cosopt is a combination of beta-blocker and carbonic anhydrase inhibitor.
Side effects
Combigan side effects include symptoms of beta-blockers and alpha agonists. Cosopt side effects include burning and / or stinging of the eyes and changes in the sense of taste. Because these drugs are new to the market, long-term follow-up of individuals using them is not yet available.
Prostaglandin analogs
|
Company |
Brand |
Generic name |
|
Akorn Inc. |
Zioptan® |
Tafluprost ophthalmic solution 0.0015% (PF) |
|
Allergan Inc. |
Durysta ™ |
Bimatoprost 10 mcg implant |
|
Allergan Inc. |
Lumigan® |
Bimatoprost 0.01%, 0.03% |
|
Bausch & Lomb, Inc. |
Vyzulta ™ |
Latanoprostene bunod 0.024% |
|
Novartis |
Travatan® Z |
Travaprost 0.004% |
|
Pfizer Inc. |
Xalatan® |
Latanoprost 0.005% |
|
Sun Ophthalmics |
Xelpros ™ |
Latanoprost ophthalmic emulsion 0.005% |
Prostaglandin analogs work by increasing the outflow of intraocular fluid from the eye. They have few systemic side effects but are associated with changes in the eye itself, including changes in iris color and eyelash growth. Depending on the individual, a brand of this type of medication may be more effective and cause fewer side effects. Prostaglandin analogues are administered in the form of eye drops. They are effective in lowering intraocular pressure in people who have open angle glaucoma.
Side effects
In initial studies, 5% to 15% of people using this medication reported a gradual change in eye color due to a greater amount of brown pigment in the iris of the treated eye. The change in eye color occurs slowly and may not be noticed for many months or years. Other side effects may include stinging, blurred vision, red eyes, itching, and burning. These drugs are relatively new to the market, and there is no long-term follow-up of individuals using them.
Rho kinase inhibitors
|
Company |
Brand |
Generic name |
|
Aerie Pharmaceuticals, Inc. |
Rhopressa® |
Netarsudil 0.02% |
Rho kinase inhibitors increase intraocular fluid drainage by improving the outflow of the trabecular meshwork.
Side effects
Side effects may include redness of the eyes, corneal deposits, stinging, and small bleeds in the whites of the eye.
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