Medications Used to Treat Glaucoma
Medication | Some Side Effects | Comments |
|---|---|---|
Prostaglandin-like compounds | ||
BimatoprostBimatoprost LatanoprostLatanoprost TafluprostTafluprost TravoprostTravoprost | Increased eye and skin pigmentation Elongated and thickened eyelashes Muscle, joint, and back pain Rash Possible worsening of inflammation within the front part of the eye (uveitis) | How they work: Increase aqueous humor outflow Given as: Eye drops Other comments: These drops have few serious bodywide side effects. |
Beta-blockers | ||
TimololTimolol BetaxololBetaxolol CarteololCarteolol Levobetaxalol LevobunololLevobunolol MetipranololMetipranolol | Shortness of breath in people with asthma or other lung disorders that cause wheezing Slow heart beat Insomnia Fatigue Depression Confusion Sexual dysfunction See table Antihypertensive Medications | How they work: Decrease aqueous humor production Given as: Eye drops Other comments: These drops do not affect pupil size. Some side effects are worse in people with heart or blood vessel disease. Some side effects may develop slowly and may be mistakenly attributed to aging or other bodily processes. |
Cholinergic medications* | ||
CarbacholCarbachol PilocarpinePilocarpine | Sweating Headache Involuntary, shaking movement Tremor Excess saliva production Diarrhea, abdominal cramps, nausea | How they work: Constrict the pupil (miosis) and increase aqueous humor outflow Given as: Eye drops Other comments: These drops are not as effective as beta-blockers. People who have darker pupils may need high-strength drops. These medications make it harder for the eyes to adapt to darkness. |
Cholinesterase inhibitors* | ||
EchothiophateEchothiophate | Same as for cholinergic agonists but more likely to occur | How they work: Constrict the pupil (miosis) and increase aqueous humor outflow Given as: Eye drops Other comments: These drops are very long acting. They can cause cataracts and retinal detachment and should not be taken by people who have closed-angle glaucoma. These medications make it harder for the eyes to adapt to darkness. |
Rho kinase inhibitor | ||
NetarsudilNetarsudil | Eye redness Broken blood vessels in the eye Corneal deposits | How they work: Increase aqueous humor outflow Given as: Eye drops |
Alpha-adrenergic agonists | ||
ApraclonidineApraclonidine BrimonidineBrimonidine | Increase in blood pressure or heart rate Abnormal heart rhythm May excessively dilate the pupil Apraclonidine:Apraclonidine: High rate of allergic reactions and decreased response if given over a period of time so that larger doses are required to have the same effect (tachyphylaxis) Brimonidine:Brimonidine: May cause dry mouth, has a lower rate of allergic reactions than the other medications, and can be fatal in children less than 2 years of age | How they work: Decrease aqueous humor production and increase aqueous humor outflow Given as: Eye drops |
Carbonic anhydrase inhibitors | ||
AcetazolamideAcetazolamide BrinzolamideBrinzolamide DorzolamideDorzolamide MethazolamideMethazolamide | Acetazolamide and methazolamide:Acetazolamide and methazolamide: Fatigue Altered taste Loss of appetite Depression Kidney stones Body salt (electrolyte) abnormalities Numbness or tingling Low or high blood cell counts (blood dyscrasias) Weight loss Nausea Diarrhea Brinzolamide and dorzolamide:Brinzolamide and dorzolamide: Bad taste in the mouth Rash | How they work: Decrease aqueous humor production Given as: For acetazolamide: By mouth or by veinFor acetazolamide: By mouth or by vein For methazolamide: By mouthFor methazolamide: By mouth For brinzolamide and dorzolamide: Eye dropsFor brinzolamide and dorzolamide: Eye drops |
Osmotic diuretics | ||
GlycerinGlycerin MannitolMannitol | Increase urine production Can have serious side effects in some people (for example, worsening of heart failure or brain dysfunction) by changing body salt (electrolyte) levels or may cause dehydration | How they work: Increase concentration of salts in the blood, which draws fluid from the eye by osmosis Given as: For glycerin: By mouthFor glycerin: By mouth For mannitol: By veinFor mannitol: By vein Other comments: These medications are used most often to treat acute closed-angle glaucoma. |
* These medications are rarely used. | ||