II. Indications

  1. Open Angle Glaucoma
    1. Second-line agent for patients unable to tolerate topical Beta Blocker or as adjunctive agent
  2. Narrow Angle Glaucoma
    1. Acetazolamide (Diamox) IV is used in emergent management
    2. Dorzolamide may also be used

III. Contraindications

IV. Mechanism

  1. Inhibits bicarbonate formation in the ciliary body
  2. Results in decreased aqueous production (lowers IOP 15-20%)

V. Medications (orange cap)

  1. Topical
    1. Dorzolamide (Trusopt) 2%, 1 drop three times daily
    2. Brinzolamide (Azopt) 1%, 1 drop three times daily
      1. Available as combination with Brimonidine (Simbrinza)
  2. Systemic
    1. Methazolamide (Neptazane)
    2. Acetazolamide (Diamox)
      1. See Narrow Angle Glaucoma for protocol

VI. Efficacy

VII. Adverse Effects

  1. Topical
    1. Well tolerated (contrast with systemic)
    2. May cause bitter taste
    3. Punctate Keratitis
    4. Eye burning Sensation
  2. Systemic
    1. Paresthesias in hands and face
    2. Malaise, Anorexia, and severe weight loss
    3. Hypokalemia
    4. Nephrolithiasis

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Related Studies

Cost: Medications

dorzolamide (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
DORZOLAMIDE HCL 2% EYE DROPS Generic $1.23 per ml
DORZOLAMIDE-TIMOLOL 2%-0.5% Generic $1.63 each
DORZOLAMIDE-TIMOLOL EYE DROPS Generic $1.14 per ml
brinzolamide (on 12/13/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
BRINZOLAMIDE 1% EYE DROPS Generic $15.73 per ml
azopt (on 7/27/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
AZOPT 1% EYE DROPS Generic $18.39 per ml