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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 healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider and according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider. 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.
Miotics (Parasympathomimetic agents) (rarely used)
Combination Drops
Carbonic Anhydrase Inhibitors
It is imperative that you take your 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.
Common names include:
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:
Epinephrine constricts blood vessels in the eye and enlarges the pupil. It reduces the amount of fluid in the eye by reducing the production of fluid and increasing the amount of fluid drainage. Dipivefrin is transformed into epinephrine in the eye. Apraclonidine and brimonidine are known as alpha2-adrenergic agonists. They are thought to have fewer side effects. Adrenergic agents should be used with caution in patients with cardiovascular disease, as well as in patients taking certain antidepressant, heart, and blood pressure medications.
Possible side effects include, but are not limited to:
Apraclonidine is often used to control eye pressure after laser or surgical procedures.
Possible side effects include, but are not limited to:
Brimonidine is the most commonly used medication in the category to reduce pressure in the eye.
Possible side effects include, but are not limited to:
Common names include:
Beta-blockers work to lower the intraocular pressure by decreasing the rate at which fluid is produced in the eye. Beta-blockers are usually contraindicated in patients with such medical conditions as asthma, chronic obstructive pulmonary disease, slow heart beat, heart block, or other heart or lung problems.
Possible side effects include, but are not limited to:
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:
Common names include:
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 include, but are not limited to:
Researchers are currently evaluating the possibility of protecting the optic nerve from damage. One of the potential medications that are being considered is brimonidine (Alphagan). Another is memantine , an oral medication used in the treatment of Alzheimer's disease .
Whenever you are taking a prescription medication, take the following precautions:
References:
American Academy of Ophthalmology website. Available at: http://www.aao.org/ .
The Glaucoma Foundation website. Available at: http://www.glaucomafoundation.org/ .
National Eye Institute website. Available at: http://www.nei.nih.gov/ .
Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet. 2004; 363:1711.
Maier PC, Funk J, Schwarzer G, et al. Treatment of ocular hypertension and open angle glaucoma: meta-analysis of randomised controlled trials. BMJ. 2005;331:134.
Last reviewed June 2008 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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