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Ophthalmic - Glaucoma Agents

Ophthalmic agents - Home Page

Beta Blockers

Betaxolol (Betoptic ®) Carteolol (Ocupress ®)
Levobunolol (Betagan ®) Timolol (Timoptic ®)

Carbonic anhydrase inhibitors

Brinzolamide (Azopt ®) Dorzolamide (Trusopt ®)

Cholinergics

Pilocarpine (Pilocar ®)  

Prostaglandins

bimatoprost (Lumigan ®) Latanoprost (Xalatan ®)
tafluprost ophthalmic solution 0.0015% - ZIOPTAN™ travoprost (Travatan ®)
unoprostone (Rescula ®)  

Other

Apraclonidine (Iopidine ®) Brimonidine (Alphagan ®)
Cosopt ® (dorzolamide 2% + timolol 0.5%) Dipivefrin (Propine ®)
SIMBRINZA (brinzolamide/brimonidine tartrate ophthalmic suspension) 1%/0.2%  

Beta Blockers

Betaxolol (Betoptic ®)  top of page

 Dosing: 1-2 drops twice daily
Supplied: [0.25% susp , 0.5% soln]

Carteolol (Ocupress ®)   top of page

Dosing: 1 drop twice daily.
Supplied:  [1% soln]

Levobunolol (Betagan ®)  top of page

 Dosing: 1-2 drops once or twice daily.
Supplied: [0.25 & 0.5% soln]

Timolol (Timoptic ®)  top of page

 Dosing: drop twice daily. Supplied:  [soln 0.25 & 0.5%].
Timoptic XE: 1 drop once daily. Supplied:  [0.25 & 0.5% gel]

Carbonic anhydrase inhibitors:

Brinzolamide (Azopt ®)   top of page

Dosing: 1 drop three times daily.
Supplied
: [susp: 1%]

Dorzolamide (Trusopt ®)  top of page

 Dosing: 1 drop three times daily
Supplied: [soln: 2%]

Cholinergics

Pilocarpine (Pilocar ®)  top of page

Indications: the treatment of primary open-angle glaucoma and also to lower intraocular pressure prior to surgery for acute angle-closure glaucoma. It may be used in combination with other miotics, beta adrenergic blocking agents, carbonic anhydrase inhibitors, hyperosmotic agents, or epinephrine.

 Dosing: 1-2 drops 3 to 4 times daily or ½" gel at bedtime.
(The initial dose is one or two drops. This may be repeated up to six times daily. )

Prostaglandins

bimatoprost (Lumigan ®)   top of page

Dosing: Instill one drop in the affected eye(s) once daily in the evening. The dosage should not exceed once daily since it has been shown that more frequent administration may decrease the intraocular pressure lowering effect. [Supplied: 0.03% soln]

Latanoprost (Xalatan ®)  top of page

Dosing: 1 drop at bedtime.
Supplied: [soln: 0.005 %]

tafluprost ophthalmic solution 0.0015% - ZIOPTAN™: top of page

INDICATIONS AND USAGE:
ZIOPTAN (tafluprost ophthalmic solution) 0.0015% is a prostaglandin analog indicated for reducing elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

USE IN SPECIFIC POPULATIONS
Use in pediatric patients is not recommended because of potential safety concerns related to increased pigmentation following long-term chronic use.


DOSAGE AND ADMINISTRATION:
One drop in the affected eye(s) once daily in the evening.


DOSAGE FORMS AND STRENGTHS:
Ophthalmic solution containing tafluprost 0.015 mg/mL.


CONTRAINDICATIONS:
None


WARNINGS AND PRECAUTIONS
Pigmentation
Pigmentation of the iris, periorbital tissue (eyelid) and eyelashes can occur. Iris pigmentation is likely to be permanent.

Eyelash Changes
Gradual changes to eyelashes including increased length, thickness and number of lashes. Usually reversible.

ADVERSE REACTIONS
Most common ocular adverse reaction is conjunctival hyperemia (range 4% - 20%).
To report SUSPECTED ADVERSE REACTIONS, contact Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., at 1-877-888-4231 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

travoprost (Travatan ®) top of page

Dosing:  Instill one drop in the affected eye(s) once-daily in the evening. The dosage of TRAVATAN® should not exceed once-daily since it has been shown that more frequent administration may decrease the intraocular pressure lowering effect. [Supplied: 0.004% solution]

unoprostone (Rescula ®)  top of page

Dosing:  Instill one drop in the affected eye(s) twice daily. RESCULA ® may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. If two drugs are used, they should be administered at least five minutes apart. Structural analogue of an inactive biosynthetic cyclic derivative of arachidonic acid. [ Supplied: 0.15% solution ]

Other

Apraclonidine (Iopidine ®) top of page

 Dosing:   1-2 drops three times daily.
Supplied: [ soln: 0.5, 1%]

Brimonidine (Alphagan ®) top of page

 Dosing:   1 drop three times daily.
Supplied: [soln: 0.2%]

Cosopt ® (dorzolamide 2% + timolol 0.5%): top of page

 Dosing:  1 drop twice daily.

Dipivefrin (Propine ®)  top of page

Dosing:   1 drop twice daily.
Supplied: [soln: 0.1%]

 SIMBRINZA (brinzolamide/brimonidine tartrate ophthalmic suspension) 1%/0.2%   top of page

SIMBRINZA (brinzolamide/brimonidine tartrate ophthalmic suspension) 1%/0.2%
[Drug information  /  PDF]  
Dosing:  Click (+) next to Dosage and Administration section (drug info link)

Initial U.S. Approval:  2013

Mechanism of Action:  SIMBRINZA is comprised of two components: brinzolamide (carbonic anhydrase inhibitor) and brimonidine tartrate (alpha 2 adrenergic receptor agonist). Each of these two components decreases elevated intraocular pressure. Elevated intraocular pressure is a major risk factor in the pathogenesis of optic nerve damage and glaucomatous visual field loss. The higher the level of intraocular pressure, the greater the likelihood of glaucomatous field loss and optic nerve damage.

Brinzolamide inhibits carbonic anhydrase in the ciliary processes of the eye to decrease aqueous humor secretion, presumably by slowing the formation of bicarbonate ions with subsequent reduction in sodium and fluid transport. Brinzolamide has a peak ocular hypotensive effect occurring at 2 to 3 hours post-dosing. Fluorophotometric studies in animals and humans suggest that brimonidine tartrate has a dual mechanism of action by reducing aqueous humor production and increasing uveoscleral outflow. Brimonidine tartrate has a peak ocular hypotensive effect occurring at two hours post-dosing. The result is a reduction in intraocular pressure (IOP).

INDICATIONS AND USAGE: SIMBRINZA is a fixed combination of a carbonic anhydrase inhibitor and an alpha 2 adrenergic receptor agonist indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.
DOSAGE & ADMINISTRATION
The recommended dose is one drop of SIMBRINZA in the affected eye(s) three times daily. Shake well before use. SIMBRINZA ophthalmic suspension may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. If more than one topical ophthalmic drug is being used, the drugs should be administered at least five (5) minutes apart.

HOW SUPPLIED: Suspension containing 10 mg/mL brinzolamide and 2 mg/mL brimonidine tartrate.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

Listed dosages are for - Adult patients ONLY. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

David F. McAuley, Pharm.D., R.Ph.  GlobalRPh Inc.
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