Glaucoma Medications in Eye Care

Ophthalmic Glaucoma Pharmaceuticals

Glaucoma Medication Overview

Importance of Managing Intraocular Pressure in Glaucoma

Effective glaucoma management through medications that control intraocular pressure (IOP) is crucial for preserving vision and protecting the optic nerve from progressive damage. Properly maintaining optimal IOP can significantly reduce the risk of glaucoma-related vision loss, underscoring the need for individualized, patient-specific treatment plans.

Primary Classes of Glaucoma Medications

Three primary classes of glaucoma medications are commonly utilized by optometrists:

  • Prostaglandin Analogs (e.g., Latanoprost): Enhance aqueous humor outflow with minimal systemic side effects, typically chosen as first-line treatments.
  • Beta-blockers (e.g., Timolol): Reduce aqueous humor production effectively but require careful use due to potential systemic effects.
  • Alpha Agonists (e.g., Brimonidine): Lower aqueous production and improve outflow, useful as adjunctive treatments with mild local side effects.

Advanced and Combination Glaucoma Treatments

When primary therapies are insufficient, additional therapeutic options include:

  • Carbonic Anhydrase Inhibitors (CAIs): Available in topical or oral forms, these medications significantly reduce aqueous humor production.
  • Combination Eye Drops: Simplify treatment regimens, increasing patient adherence and reducing complexity in medication schedules.

Personalizing Glaucoma Therapy

Choosing appropriate glaucoma medications involves careful assessment of patient-specific factors such as age, ethnicity, ocular and systemic health, and medication tolerance. Special consideration is required for patients with pre-existing conditions like asthma or cardiovascular disease. Regular monitoring and personalized adjustments ensure safe, effective, and sustainable glaucoma management.

Ophthalmic Glaucoma Medications

Ophthalmic Glaucoma Medications
BrandGenericDosingAmountAgesPregnancyMechanism
Alphagan P
Generic
brimonidine 0.1/0.15/0.2*%tid5/10/15mL>2 yearsBα-2 agonist
↓ aqueous production
↑ outflow
Azopt
Generic
brinzolamide 1%tid5/10/15mLNACcarbonic anhydrase inhibitor
↓ aqueous production
Combigan
Generic
brimonidine 0.2%
timolol 0.5%
bid5/10/15mL>2 yearsCα-2 agonist
β blocker
↓ aqueous production, ↑ outflow
Cosopt
Generic
dorzolamide 2%
timolol 0.5%
bid5/10mL>2 yearsCcarbonic anhydrase inhibitor
β blocker
↓ aqueous production
Diamox
GenericPO
acetazolamide500mg po bid125/250mg
500mg 'Sequels'
>12 yearsCcarbonic anhydrase inhibitor
↓ aqueous production
Isopto Carpine
Generic
pilocarpine 1/2/4%qd-qid15mL>2 yearsCcholinergic agonist
↑ outflow
Lumigan
Generic
bimatoprost 0.01/0.03*%qhs2.5/5/7.5mL>16 yearsCprostaglandin analogue
↑ outflow
Rhopressa
netarsudil 0.02%qhs2.5mLNANARho kinase inhibitor
↑ outflow
Rocklatan
netarsudil 0.02%
latanoprost 0.005%
qhs2.5mLNANARho kinase inhibitor
prostaglandin analogue
↑ outflow
Simbrinza
brimonidine 0.2%
brinzolamide 1%
tid8mL>2 yearsCα-2 agonist
carbonic anhydrase inhibitor
↓ aqueous production
↑ outflow
Timoptic
Generic
timolol maleate 0.25/0.5%bid5/10/15mL>2 yearsCβ blocker
↓ aqueous production
Travatan Z
Generic
travoprost 0.004%qhs2.5/5mL>16 yearsCprostaglandin analogue
↑ outflow
Trusopt
Generic
dorzolamide 2%bid-tid5/10mL>2 yearsCcarbonic anhydrase inhibitor
↓ aqueous production
Vyzulta
latanoprostene bunod 0.024%qhs5mL>16 yearsNAprostaglandin analogue
↑ outflow
Xalatan
Generic
latanoprost 0.005%qhs2.5mLNACprostaglandin analogue
↑ outflow
Xelpros
latanoprost 0.005%
(BAK free)
qhs2.5mLNACprostaglandin analogue
↑ outflow
Zioptan
Generic
tafluprost 0.0015%qhs30/90 packNot RecommendedCprostaglandin analogue
↑ outflow