Glaucoma Medications

 
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Carbonic Anhydrase Inhibitors

Pill: Diamox, Neptazane

Eye drop: Trusopt, Azopt

Purpose: Decreases production of intraocular fluid.

Side effects of the pill forms of these medications can include tingling or loss of strength of the hands and feet, upset stomach, mental fuzziness, memory problems, depression, kidney stones, and frequent urination. Side effects of the eye drop include stinging, burning and other eye discomfort. It is not clear yet whether Trusopt will be as potent or as effective as Diamox and Neptazane.

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Sympathomimetic Alpha-Adrenergic Agonist

Eye Drops: Alphagan, Iopidine

Purpose: Decreases production of intraocular fluid. (Note) Alphagan also increases drainage of intraocular fluid.

Alphagan can be used for the long-term treatment of glaucoma. Side effects of Alphagan can include burning or stinging upon instillation of the eye drop, fatigue, headache, dry mouth and dry nose. 

Iopidine was originally used to combat “pressure spikes” which are sharp increases in eye pressure that sometimes follow laser surgery. Side effects of Iopidine can include red eyes, allergic reactions, dry mouth, and a change in the sense of taste.

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Beta Blockers

Eye Drops: Betimol, Betoptic S, Betagan, Ocupress, Optipranolol, Timoptic, Timoptic XE

Purpose: Decreases production of intraocular fluid.

The most widely used of all glaucoma medications at the present time, and are usually the first type of medications a doctor will use. Side effects can include low blood pressure, reduced pulse rate, and fatigue. Beta blockers can also cause a shortness of breath in people who have a history of asthma or other respiratory disorders. Additionally, beta-blockers can change cardiac activity by decreasing the amount of blood the heart pumps out, which may reduce the pulse rate and/or slow down the heart’s response rate during exercise. Rare side effects can include reduced libido and depression.

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Miotics

Eye Drops: Isopto Carbachol, Ocusert, Akarpine, E-Pilo, Isopto Carpine, Pilocar, Pilopine, Pilostat, Pilagan

Purpose: Increases drainage of intraocular fluid

Many people who use these medications complain of dim vision, especially at night or in darkened areas such as movie theaters. This dim vision is due to constriction of the pupil. Miotics increase drainage of intraocular fluid by making the pupil size smaller and thereby increasing the flow of intraocular fluid from the eye.

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Sympathomimetic Nonselective

Eye Drops: Propine

Purpose: Increases drainage of intraocular fluid

Allergic reactions to these drops are frequent. Blurred vision can also occur with these drops, and vision can also be decreased in people who have had cataracts removed. Headaches and burning of the eyes are also common side effects. Cardiac side effects can include rapid heart rate or fluctuations in heart rhythm.

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Prostaglandin Analogues

Eye Drop: Xalatan, Travatan, Lumigan, Rescula

Purpose: Increases drainage of intraocular fluid

In initial studies, less than 5 percent of people who used this medication reported a gradual change in eye color, due to an increased amount of brown pigment in the iris of the treated eye. The change in eye color occurs slowly and may not be noticeable for several months to several years. Other side effects from this medication can include stinging, blurred vision, eye redness, itching and burning.


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