prostaglandin analogs – work by increasing the outflow of fluid from the eye.
beta blockers – work by decreasing production of fluid
alpha agonists – work to both decrease production of fluid and increase drainage
and carbonic anhydrase inhibitors – reduce eye pressure by decreasing the production of intraocular fluid.
Older medications, the cholinergic agonists (such as pilocarpine) are not commonly used these days due to their side effects.
Types of Glaucoma Eye Drops
Prostaglandin analogs include
Travatan Z® (Travoprost),
and Zioptan™ (tafluprost).
They have few systemic side effects but are associated with changes to the eye itself, including change in iris color and growth of eyelashes.
Depending on the individual, one of these preparations may be more effective and produce fewer side effects.
Latanoprost and some formulations of bimatoprost are now available in generic form.
Tafluprost is a preservative-free prostaglandin analog.
Beta blockers such as timolol are the second most often used class of medication. They are available in generic form and, therefore, may be less expensive. Timolol is also available in a preservative-free formulation. Systemic side effects of beta blockers can be minimized by closing the eyes following application or using a technique called punctal occlusion that prevents the drug from entering the tear drainage duct and systemic circulation.
Alphagan P has a purite preservative that breaks down into natural tear components and may be better tolerated in people who have allergic reactions to preservatives in other eye drops. Alphagan is available in a generic form.
Carbonic anhydrase inhibitors (CAIs)
These are available as eye drops
Azopt® (brinzolamide)] as well as
pills [Diamox (acetazolamide) and Neptazane® (methazolamide)].
Except for brinzolamide, all CAIs are available in generic form.
Combined medications can offer an alternative for patients who need more than one type of medication.
In addition to the convenience of using one eyedrop bottle instead of two, there is decreased exposure to preservatives.
They nearly always include a beta-blocker (timolol).
Cosopt® is a combination of a beta blocker (timolol) and a carbonic anhydrase inhibitor (dorzolamide) and is available in generic form and also as a preservative-free formulation (Cosopt® PF).
Azarga Active Substance: timolol brinzolamide
2 contain an alpha agonist (brimonidine) with a betablocker (combigan) or without.
Combigan® combines beta blocker (timolol) with an alpha agonist (brimonidine).
Simbrinza® is a beta blocker-free combination medication consisting of (CAI) brinzolamide and (alpha-blocker) brimonidine.
|TOPICAL GLAUCOMA DRUGS|
|BRAND NAME GENERIC NAME||MANUFACTURER||CONCENTRATION||BOTTLE SIZE|
|Betagan levobunolol hydrochloride||Allergan, and generic||0.25%||5ml, 10ml|
|0.50%||5ml, 10ml, 15ml|
|Betimol timolol hemihydrate||Akorn||0.25%||5ml|
|0.50%||5ml, 10ml, 15ml|
|Betoptic-S betaxolol hydrochloride||Alcon||0.25%||5ml, 10ml, 15ml|
|Istalol timolol maleate||Bausch + Lomb||0.50%||2.5ml, 5ml|
|Timoptic timolol maleate||Valeant Ophthalmics,||0.25%||5ml, 10ml, 15ml|
|and generic||0.50%||5ml, 10ml, 15ml|
|Timoptic (preservative-free) timolol maleate||Valeant Ophthalmics||0.25%||unit-dose|
|Timoptic-XE timolol maleate||Valeant Ophthalmics,||0.25%||2.5ml, 5ml|
|and generic||0.50%||2.5ml, 5ml|
|TIOPEX timolol 1 mg/g, eye gel in single-dose container|
|Bimatoprost bimatoprost||generic||0.03%||2.5ml, 5ml, 7.5ml|
|Lumigan bimatoprost||Allergan||0.01%||2.5ml, 5ml, 7.5ml|
Travatan Z travoprost
|Travoprost travoprost||generic||0.00%||2.5ml, 5ml|
|Xalatan latanoprost||Pfizer, + generic||0.01%|
|Monopost latanoprost||Thea Pharmaceuticals Ltd||1 ml eye drops solution contains 50 micrograms of latanoprost. One drop contains approximately 1.5 micrograms of latanoprost.|
|Alphagan P brimonidine||Allergan||0.1%, 0.15%||5ml, 10ml, 15ml|
|Brimonidine brimonidine||generic||0.15%, 0.2%||5ml, 10ml, 15ml|
|Carbonic Anhydrase Inhibitors|
|Azopt brinzolamide||Alcon||1%||5ml, 10ml, 15ml|
|Trusopt dorzolamide||Merck, + generic||2%||5ml, 10ml|
|Combination Glaucoma Medications|
|Combigan brimonidine/timolol||Allergan||0.2%/0.5%||5ml, 10ml|
|Cosopt dorzolamide/timolol||Akorn, + generic||2%/0.5%||5ml, 10ml|
|Cosopt PF dorzolamide/timolol||Akorn||2%/0.5%||unit-dose|