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RMC Bayonet Point
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Medications for Glaucoma

The information provided here is meant to give you a general idea about each of the medications listed below. Note that this is not a comprehensive list. Your physician may prescribe a medication that is not on this list. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor. Some medications can cause side effects that are medical emergencies, such as difficulty breathing. If you have a medical emergency, call for an ambulance immediately.

Eye drops or oral medications are often used to help control glaucoma. Both methods attempt to decrease the intraocular pressure by either slowing the production of fluid in the eye or by improving the drainage of fluid from the eye.

Treatment of open-angle glaucoma is started with eye drops, either prostaglandin analogs or beta-adrenergic antagonists. Other types of eye drops may be added if glaucoma does not improve.

Treatment of angle closure glaucoma is usually started with eye drops, although oral medications may also be given. Other types of eye drops may be added if glaucoma does not improve.

Prescription Medications

Eye Drops

Adrenergic Agents

  • Apraclonidine
  • Brimonidine

Beta-blockers

  • Timolol maleate
  • Timolol hemihydrate
  • Levobunolol
  • Metipranolol
  • Carteolol
  • Betaxolol

Prostaglandin analogs

  • Bimatoprost
  • Latanoprost
  • Travoprost

Carbonic Anhydrase Inhibitors

  • Dorzolamide
  • Brinzolamide

Miotics (Parasympathomimetic agents) (rarely used)

  • Pilocarpine
  • Carbachol/Carbamylcholine
  • Echothiophate iodide

Herbals

Medical marijuana

Eye Drops

It is imperative to use the eye drops exactly as prescribed in order to best control your glaucoma. Eye drops can interact with other medications. Make sure you tell your doctor about any other medications or supplements that you are taking.

Beta-Blockers

Common names include:

  • Timolol maleate
  • Timolol hemihydrate
  • Levobunolol
  • Metipranolol
  • Carteolol
  • Betaxolol

Beta-blockers work to lower the intraocular pressure by decreasing the rate at which fluid is produced in the eye.

Possible side effects include, but are not limited to:

Prostaglandin Analogs
  • Bimatoprost
  • Latanoprost
  • Travoprost

Prostaglandin analogs reduce pressure in the eye by increasing the outward flow of fluid from the eye.

Possible side effects include, but are not limited to:

  • Fluid buildup around the macula of the eye causing swelling
  • Conjunctival hyperemia (red eyes)
  • Increased eyelash growth
  • Darkening of skin around eyelids
  • Darkening of the iris (the colored part of the eye)
  • Inflammation of the uvea of the eye
  • Activation of herpes virus

Topical or Oral Medications

Carbonic Anhydrase Inhibitors

Common names include:

  • Dorzolamide
  • Brinzolamide

Carbonic anhydrase inhibitors inhibit the enzyme carbonic anhydrase, which results in a reduction of the production of fluid in the eye. Oral forms are usually only used in emergent situations, such as in an angle-closure attack. They are contraindicated with history of sulfa allergy and should be used with caution in patients with certain medical problems such as blood disorders or liver disease. They are also contraindicated in patients with sickle cell. Blood cell counts are often monitored regularly while taking these drugs.

Possible side effects of topical medications include, but are not limited to:

  • Metallic taste
  • Allergic reaction
  • Swelling of the cornea

Possible side effects of oral medications include, but are not limited to:

  • Skin condition called Stevens-Johnson syndrome, the appearance of dark lesions on the skin
  • Kidney stones
  • Depression, fatigue, and lethargy
  • Abnormal lab tests:
    • Abnormal blood electrolytes (especially potassium)
    • Abnormal blood cell count (red or white blood cells or platelets)
  • Metallic taste
Miotics (Cholinergic Agents) (Rarely Used)

Common names include:

  • Pilocarpine
  • Carbachol
  • Echothiophate

Miotics increase fluid drainage out of the eye by helping to open the drainage network. Miotics also reduce the size of the pupil. Miotics may cause adverse drug interactions with certain anesthetic agents.

Possible side effects include, but are not limited to:

  • Eye irritation
  • Tearing
  • Headache
  • Blurred vision
  • Poor vision in dim light
Herbals

In recent years, some states have approved the use of medical marijuana for certain chronic health conditions. Although medical marijuana does relieve intraocular pressure associated with glaucoma, it is only for a short period of time. Currently, medical marijuana is not recommended for glaucoma treatment. Evidence supports the use of prescription medications and surgery as effective treatment options.

Special Considerations

For most eyedrops, only one drop is necessary at each recommended time interval. Placing more than one drop at one time is usually a waste of medication. Ask your doctor how many drops you need to place.

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.
When to Contact Your Doctor
  • If you have side effects or an allergic reaction to a medication (stop taking the medication and call your doctor immediately)
  • If you begin taking any new vitamins, herbal supplements, or another medication, whether prescribed or over the counter

Revision Information

  • Angle-closure glaucoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 25, 2016. Accessed March 1, 2016.

  • Does marijuana help treat glaucoma? American Academy of Ophthalmology website. Available at: http://www.aao.org/eye-health/tips-prevention/medical-marijuana-glaucoma-treament. Accessed March 1, 2016.

  • Facts about glaucoma. National Eye Institute website. Available at: https://nei.nih.gov/health/glaucoma/glaucoma%5Ffacts. Accessed March 1, 2016.

  • Glaucoma treatment. American Academy of Ophthalmology website. Available at: http://www.aao.org/eye-health/diseases/glaucoma-treatment. Accessed March 1, 2016.

  • Open-angle glaucoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 25, 2016. Accessed March 1, 2016.

  • Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet. 2004;363(9422):1711-1720.

  • What is glaucoma? Glaucoma Research Foundation website. Available at: http://www.glaucoma.org/glaucoma. Accessed March 1, 2016.