Treating Glaucoma With Medicines

Eye doctors use many medicines to treat glaucoma. These drugs lower pressure inside the eye. Often, people with glaucoma must take these medicines for life to control the pressure and limit vision loss.

An introduction to glaucoma medicines ► An introduction to glaucoma medicines ▼

Glaucoma medicines are usually in the form of drops, but also come in pills or ointment. They work to lower the amount of aqueous fluid produced and/or improve fluid drainage in the eye.

All glaucoma medicines may cause side effects, some of which can be uncomfortable. A few side effects can be quite serious, but those side effects are not common.

The glaucoma medicines listed below are grouped by the way they work. Some of the possible side effects are also listed. Not every drug in a category will have all the possible side effects listed. Your doctor can tell you which side effects are possible with the medicines you use. (NOTE: all glaucoma medicines may not be listed below.)

Remember, you and your doctor must work together to determine the best medicines for you.

Prostaglandin Analogues ► Prostaglandin Analogues ▼

Prostaglandin Analogues are drugs that lower pressure in the eye by improving fluid drainage. They have the advantage of requiring use only once per day.

Possible side effects

A rare side effect may be a darkening of eye color. Often, there is an increased growth of eyelashes. Side effects can also include redness, itching, burning and blurred vision.

Medicine	Brand Name
latanoprost	Xalatan®
travoprost	Travatan®
bimatoprost	Lumigan®
unoprostone	Rescula®

Beta-blockers ► Beta-blockers ▼

Beta-blockers decrease pressure inside the eye by reducing the amount of aqueous fluid your eye makes. These medicines are available as eye drops.

Possible side effects

These include possible respiratory problems, lowered heart rate and blood pressure, blurred vision, tiredness, forgetfulness, and changes in blood cholesterol levels. People with asthma, some kinds of heart disease or low blood pressure should be very careful about using beta-blockers to treat their glaucoma. Also, if a patient is on other "blocker" medicines for other health problems, the combined effect of the drugs could cause problems.

This is why it's important to tell all of your doctors about all the medicines you are taking.

Medicine	Brand Name
betaxolol	Betoptic®, Betoptic® S
carteolol	Ocupress®
levobunolol	Betagan®
metipranolol	OptiPranolol®
timolol hemihydrate	Betimol®
timolol maleate	Timoptic®,Timoptic-XE®,Cosopt® (see also anhydrase inhibitors)

Alpha-adrenergic agonists ► Alpha-adrenergic agonists ▼

Alpha-adrenergic agonists are eye drops that lessen the amount of aqueous fluid the eye makes and may also increase flow of fluid out of the eye. These drops are sometimes used after laser surgery to prevent sudden rises in pressure.

Possible side effects

These include allergic reactions, dry mouth, burning of the eyes, dilated pupils, nasal decongestion, and drowsiness.

Medicine	Brand Name
apraclonidine	Iopidine®
brimonidine tartrate	Alphagan®, Alphagan-P®

Carbonic anhydrase inhibitors ► Carbonic anhydrase inhibitors ▼

Carbonic anhydrase inhibitors come in pills or drops. They reduce the amount of aqueous fluid the eye makes. Often, they are used when other drugs have not worked fully.

Possible side effects

The more common eye drop form of this drug may cause stinging, burning, a feeling of something in the eye, and an odd taste in the mouth. Taken as pills (only rarely nowadays), these drugs can have side effects throughout the body, including fatigue, tingling in the hands and feet, depression, frequent urination, anemia, kidney stones, loss of appetite, weight loss, diarrhea, and stomach cramps. Monitoring the dose of the oral pill and taking the medicine with food may help. Pregnant women and people sensitive to sulfa-related drugs should not take these medicines. A toxic reaction may occur if taken with large doses of aspirin. Very rarely, these drugs can lead to serious conditions known as Stevens-Johnson syndrome and aplastic anemia.

Medicine	Brand Name
acetazolamide	Diamox®
methazolamide	Neptazane®
dichlorphenamide	Daranide®
brinzolamide hydrochloride	Azopt®
dorzolamide hydrochloride	Trusopt®, Cosopt® (see beta blockers)

Miotics ► Miotics ▼

Miotics lower pressure by tightening tiny muscles inside the eye. This helps to open up the eye's drainage system, making it easier for aqueous fluid to flow out of the eye. Miotics come in eye drops or gels. When used as drops, these drugs usually need to be used several times a day, increasing the chance of forgetting a dose. Miotics are not commonly used any more except in certain cases

Possible side effects

These include decreased pupil size, blurred vision, poor night vision, nearsightedness, watering eyes, brow and eye aches, and allergic reactions.

Medicine	Brand Name
carbachol	Isopto® Carbachol
pilocarpine	Isopto® Carpine, Pilocar®, Pilopine®, Pilagan®

Other Medicines ► Other Medicines ▼

Anticholinesterase Iodide

Medicine	Brand Name
echothiophate iodide	Phospholine® Iodide

Combinations containing two medicines in the same bottle

Cosopt® = Timoptic® and Trusopt®

E-pilo® = Epinephrine® and pilocarpine

Follow your treatment plan! ► Follow your treatment plan! ▼

It's up to you to follow your treatment plan and have regular follow-up visits. At follow-up visits, your doctor will check to see if your glaucoma is getting worse. Remember to report anything you believe may be a side effect of the medicine you are taking.

Don't Skip Doses! ► Don't Skip Doses! ▼

Take your medicine as scheduled. Skipping doses of your medicine may put your vision in danger and mislead your doctor. Be sure to tell your doctor if you've missed any doses.

With a chronic disease like glaucoma, it can be hard to remember to use medicines as directed. It may help to link taking medicine to the things you do every day like eating meals or brushing your teeth.

After evaluating your progress, your doctor may try changing your doses, switching medicines or changing other parts of your treatment to find the best results for you. Sometimes simple changes like adjusting your schedule to take your medicines at mealtimes or before bed can make your drug routine more comfortable.

Tips for Taking Your Glaucoma Medicine ► Tips for Taking Your Glaucoma Medicine ▼

Ask your doctor to write down an exact schedule for taking your medicine, especially if you're taking more than one.
Ask your doctor what to do if you accidentally forget a dose. The instructions may be different depending on which medicines you are taking.
Learn about the medicines you are taking and the best way to use them. Find out whether they need special handling, such as storing them in the refrigerator.
If you take a combination of drops and ointments, always apply the drops first.
Schedule your doses around your normal routine, such as when you wake up, when you eat meals, and when you go to bed at night.
Keep your medicines in plain sight; it's easier to remember to take them.
Keep medicines in a clean place. For example, if you carry them in your purse, put them in a ziplock bag to keep them clean.
Take your medicines with you when you're away from home. If you're checking luggage at the airport, keep your medicines with you in your carry-on or in your purse.
If you forget a dose, do not automatically double your next dose. Instead, follow your doctor's instructions on what to do.
If you can't remember whether you took your medicines, simply use one dose at your next scheduled time.
Tell all of your doctors about all the medicines you are taking. Glaucoma medicines may interact with drugs prescribed for other conditions.
Call your eye doctor if you notice any unusual changes in your eyes, your vision or the way you feel in general.
Schedule regular checkups and follow through with them.
Take care of yourself—your eyes and the rest of you along with them!

Taking eye drop medications ► Taking eye drop medications ▼

A simple technique can keep more medicine in your eye and make glaucoma medication more effective. Read More