Anti-Glaucoma Drugs
Anti-Glaucoma Drugs
Adrenergic neurone blockers:-
GandaAdrenergics:-
Beta-blockers:-
Alphagan , Eppy , Iopidine , Propine , Simplene
Betagan , Betoptic , CoSopt , Glau-Opt , Minims Metipranolol , Teoptic , TimoptolCarbonic anhydrase inhibitors:-
CoSopt , Diamox Parenteral , Diamox Sustets , Diamox Tablets , Trusopt
Miotics:-
IsoptoCarbachol , IsoptoCarpine , Ocusert Pilo , Minims Pilocarpine , Pilogel , Sno PiloProstaglandin analogue:-
Xalatan
Sympathomimetics:- See Adrenergics.
brimonidine hydrochloride 0.2%
Preservatives:- benzalkonium chloride
Category :- POM
Indications for use:- as monotherapy for open angle glaucoma where beta-blockers are ineffective or contraindicated or as an adjunct to beta-blocker therapy in open angle glaucoma or ocular hypertension.
Availability:- ALPHAGAN gtt, 5 ml bottle.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution.
Specific precautions:- pregnacy and breast feeding; history of severe or unstable cardiovascular or severe vascular disease (incl. Raynauds syndrome), cerebral or coronary insufficiency; renal or hepatic impairment; depression; concurrent medication with potential interactive medications (INT, see below). Concurrent use of soft contact lenses not recommended.
Drug-Drug Interactions (INT):- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. anti-depressants (monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine and reserpine), drugs for major cardiovascular disease including digoxin; benzodiazepines; barbiturates; narcotic analgesics; alcohol.
Adverse drug reactions:- allergic reactions of the conjunctiva (including follicular conjunctivitis), irritation of the conjunctiva; occasional reports of dry mouth and / or taste disturbances following repeated use, headache and fatigue / drowsiness.
Comment/s:- new pharmaceutical - any adverse reaction should be reported to CSM. Product use may cause drowsiness and fatigue.
levobunolol hydrochloride 0.5%
Preservatives:- benzalkonium chloride.
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability :- BETAGAN gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (severe emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure); pregnancy.
Special precaution/s:- respiratory impairment; diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); diabetes; myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); breast feeding.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- in the event of adverse drugs reactions developing (including systemic intolerance), levobunolol therapy should be withdrawn gradually. Generic LEVOBUNOLOL 0.5 % eyedrops are also marketed.
levobunolol hydrochloride 0.5 %
preservatives:- none
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma in patients wearing soft contact lenses and / or who are allergic to preservatives commonly used in glaucoma eyedrops.
Category:- POM
Current optometric application/s (UK):- none
Availability:- BETAGAN gtt, UNIT DOSE
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (severe emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure); pregnancy.
Special precaution/s:- respiratory impairment; diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); breast feeding.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), levobunolol therapy should be withdrawn gradually.
betaxolol hydrochloride 0.5%
preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma or ocular hypertension.
Category:- POM
Current optometric application/s (UK):- none
Availability:- BETOPTIC gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; severe cardiac conditions (e.g. sinus brachycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- patients with obstructive airways disease (asthma, emphysema, bronchitis etc); pregnacy and breast feeding; past history of severe or unstable cardiovascular disease; diabetes (especially if poorly controlled); severe hyperthyroid conditions (leading to thyrotoxicosis); concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants). Not recommended for use prior to surgical procedures utilising general anaesthesia. Concurrent use of soft contact lenses not recommended.
Adverse drug reaction/s:- transient discomfort and lacrimation, lid margin erythema, superficial punctate staining of the cornea. A decreased corneal sensitivity has been reported with long term use.
Comment/s:- betaxolol is a cardioselective (beta1) blocker, having lesser broncho-pulmonary effects. However, following repeated use in patients with obstructive airways disease, it can cause life threatening bronchospasm, and the CSM recommends that betaxolol therapy should not be used in such patients unless no alternative therapy is available. In the event of adverse drugs reactions developing (including systemic intolerance), betaxolol therapy should be withdrawn gradually.
betaxolol hydrochloride 0.25%
Preservatives:- benzalkonium chloride; preservative enhancer, N-lauryl sarcosine
Indications for use:- for chronic open angle glaucoma or ocular hypertension.
Category:- POM
Current optometric application/s (UK):- none
Availability:- BETOPTIC microfine suspension, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; severe cardiac conditions (e.g. sinus brachycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- patients with obstructive airways disease (asthma, emphysema, bronchitis etc); pregnacy and breast feeding; past history of severe or unstable cardiovascular disease; diabetes (especially if poorly controlled); severe hyperthyroid conditions (leading to thyrotoxicosis); concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants). Not recommended for use in children or prior to surgical procedures utilising general anaesthesia. Patients with history of dry eye disease should be carefully monitored (see below). Due to the special nature of this pharmaceutical, contact lens wear should be discontinued prior to use of this product.
Adverse drug reaction/s:- transient discomfort and lacrimation (expected to be less than Betoptic®) , lid margin erythema, superficial punctate staining of the cornea. A decreased corneal sensitivity has been reported with long term use. Since the pharmaceutical can cause slight ocular surface effects, it should be used cautiously in patients with keratoconjunctivitis sicca.
Comment/s:- betaxolol is a cardioselective (beta1) blocker, having lesser broncho-pulmonary effects. However, following repeated use in patients with obstructive airways disease, it can cause life threatening bronchospasm, and the CSM recommends that betaxolol therapy should not be used in such patients unless no alternative therapy is available. In the event of adverse drugs reactions developing (including systemic intolerance), betaxolol therapy should be withdrawn gradually.
betaxolol hydrochloride 0.25%
Preservatives:- preservsative-free
Indications for use:- for chronic open angle glaucoma or ocular hypertension.
Category:- POM
Current optometric application/s (UK):- none
Availability:- BETOPTIC microfine suspension, 0.25 mL, pkg 50
Contraindication/s:- known allergy (sensitivity) toany ingredients of the solution; severe cardiacconditions (e.g. sinus brachycardia, cardiogenicshock, uncompensated cardiac failure).Special precaution/s:- patients with obstructiveairways disease (asthma, emphysema, bronchitis etc);pregnacy and breast feeding; past history of severe orunstable cardiovascular disease; diabetes (especiallyif poorly controlled); severe hyperthyroid conditions(leading to thyrotoxicosis); concurrent use ofmedications for substantial hypertension (e.g.catecholamine-depleting drugs such as guanethidineand reserpine); concurrent use of anyanti-depressants / psychotropic drugs of theindirect-acting adrenergic type (e.g. monoamineoxidase inhibitors, RIMA's, SNRI's, NARI's,tricyclic and tetracyclic antidepressants). Notrecommended for use in children or prior to surgicalprocedures utilising general anaesthesia. Patientswith history of dry eye disease should be carefullymonitored (see below). Due to the special nature ofthis pharmaceutical, contact lens wear should bediscontinued prior to use of this product.
Adverse drug reaction/s:- transient discomfort andlacrimation (expected to be less than Betoptic®) , lidmargin erythema, superficial punctate staining of thecornea. A decreased corneal sensitivity has beenreported with long term use. Since the pharmaceuticalcan cause slight ocular surface effects, it should beused cautiously in patients with keratoconjunctivitissicca.
Comment/s:- betaxolol is a cardioselective (beta1)blocker, having lesser broncho-pulmonary effects.However, following repeated use in patients withobstructive airways disease, it can cause lifethreatening bronchospasm, and the CSMrecommends that betaxolol therapy should not beused in such patients unless no alternative therapy isavailable. In the event of adverse drugs reactionsdeveloping (including systemic intolerance),betaxolol therapy should be withdrawn gradually.
timolol maleate 0.5 % - dorzolamide 2 %
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma or ocular hypertension where beta-blocker therapy alone is ineffective or considered inadequate.
Category:- POM
Current optometric application/s (UK):- none
Availability:- COSOPT gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution (see specific precautions); asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus brachycardia, cardiogenic shock, uncompensated cardiac failure); severe renal impairment, hyperchloraemic acidosis; pregnancy, breast feeding.
Special precaution/s:- closed angle glaucoma, sulphonamide hypersensitivity resulting in increased risk of alleric reactions to dorzolamide; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; hepatic impairment; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); Not recommended for children.
Adverse drug reaction/s:- bitter taste, headache; transient discomfort and lacrimation (leading to transient blurred vision), lid margin erythema, superficial punctate staining of the cornea. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis. bitter taste, headache. lid margin erythema, superficial punctate keratitis. In the event of adverse drugs reactions developing (including systemic intolerance), timolol-dorzolamide therapy should be withdrawn gradually.
Comment/s:- new medication - report any adverse reactions to the CSM. In the event of adverse drugs reactions developing (including systemic intolerance), CoSopt® therapy should be withdrawn gradually.
dichlorphenamide 50mg
Category:- POM
Past availability:- DARANIDE tabs.
Comment/s:- withdrawn from general use in 1996
acetazolamide
Preservatives:-
Indications for use:- acute glaucoma
Category:- POM
Availability:- DIAMOX PARENTERAL (500 mg powder in vial for reconstitution)
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the tablets; , sulphonamide hypersensitivity resulting in increased risk of allergic reactions to acetazolamide; chronic closed angle glaucoma; pregnancy; renal hyperchloraemic acidosis; adrenal insufficiency; liver dysfunction, sodium or potassium depletion.
Special precaution/s:- pulmonary obstruction, emphysema; breast feeding.
Drug interaction/s (INT):- the possibility of substantial interactions with a range of other medicines should be considered, e.g. folic acid antagonists (sulphamethoxazole, trimethoprim), oral hypoglycaemics (chlorpropamide), oral anticoagulants (heparin).
Adverse drug reaction/s:- flushing, thirst, headche, drowsiness, polyuria, paraesthesia, blood dyscrasias, skin rashes.
Comment/s:- monitor fluid, electrolytes and blood chemistry during use; advise patients to report unusual rashes. Supply of DIAMOX PARENTERAL is currently uncertain because of manufacturing problems.
acetazolamide
Preservatives:-
Indications for use :- chronic glaucoma
Category:-POM
Availability:- DIAMOX SR, 250 mg, orange sustets
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the tablets; sulphonamide hypersensitivity resulting in increased risk of allergic reactions to acetazolamide; chronic closed angle glaucoma; pregnancy; renal hyperchloraemic acidosis; adrenal insufficiency; liver dysfunction, sodium or potassium depletion.
Special precaution/s:- not recommended for use in children; pulmonary obstruction, emphysema; breast feeding.
Drug interaction/s:- the possibility of substantial interactions with a range of other medicines should be considered, e.g. folic acid antagonists (sulphamethoxazole, trimethoprim), oral hypoglycaemics (chlorpropamide), oral anticoagulants (heparin).
Adverse drug reaction/s:- flushing, thirst, headche, drowsiness, polyuria, paraesthesia, blood dyscrasias, skin rashes.
Comment/s:- Advise patients to report unususal rashes. Monitor fluid, electrolytes and blood chemistry in chronic use.
acetazolamide
Preservatives:-
Indications for use :- acute glaucoma
Category:-POM
Availability:- DIAMOX, 250 mg, white scored tablets
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the tablets; sulphonamide hypersensitivity resulting in increased risk of allergic reactions to acetazolamide; pregnancy; renal hyperchloraemic acidosis; adrenal insufficiency; liver dysfunction, sodium or potassium depletion.
Special precaution/s:- not recommended for use in children; pulmonary obstruction, emphysema; breast feeding; not recommended for chronic use (use DIAMOX SR).
Drug interaction/s:- the possibility of substantial interactions with a range of other medicines should be considered, e.g. folic acid antagonists (sulphamethoxazole, trimethoprim), oral hypoglycaemics (chlorpropamide), oral anticoagulants (heparin).
Adverse drug reaction/s:- flushing, thirst, headche, drowsiness, polyuria, paraesthesia, blood dyscrasias, skin rashes. .
Comment/s:- Advise patients to report unususal rashes. Monitor fluid, electrolytes and blood chemistry in chronic use.
adrenaline 1.0%
Preservatives:- benzalkonium chloride
Indications for use :- chronic open angle glaucoma
Category:-POM
Availability:- EPPY gtt, 7.5 ml bottle.
Current optometric application/s (UK):- none
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; closed angle glaucoma; aphakia.
Special precaution/s:- not recommended for use in children; concurrent medication with potential interactive medications (INT, see below).
Drug interaction/s:- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. anti-depressants (monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine, reserpine and guanethidine); psuedo-aphakic patients.
Adverse drug reaction/s:- eye discomfort, conjunctival irritation (including follicular conjuctivitis, hyperaemia, melanosis / adrenochrome deposits); skin reactions; tachycardia and cardiovascular effects; headache. May precipitate closed angle glaucoma. Macula oedema in aphakic patients (avoid use).
Comment/s:- examine conjunctiva every 6 months during long term use (discontinue if melanosis is seen).
For a Summary of Product Characteristics click here
guanethidine monosulphate 1.0%, adrenaline 0.2%
Preservatives:- benzalkonium chloride
Indications for use :- chronic glaucoma
Category:-POM
Availability:- GANDA gtt, 7.5 ml.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; closed angle glaucoma; aphakia.
Special precaution/s:- concurrent medication with potential interactive medications (INT, see below).
Drug-Drug Interaction/s (INT):- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. anti-depressants (monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine, reserpine and guanethidine); psuedo-aphakic patients.
Adverse drug reaction/s:- eye discomfort, conjunctival irritation (including follicular conjuctivitis, hyperaemia, melanosis / adrenochrome deposits); skin reactions; tachycardia and cardiovascular effects; headache. May precipitate closed angle glaucoma. Macula oedema in aphakic patients (avoid use); ptosis.
Comment/s:- examine conjunctiva and cornea every 6 months during long term use (discontinue if melanosis or keratitis is seen).
For a Summary of Product Characteristics click here
guanethidine monosulphate 3.0%, adrenaline 0.5%
Preservatives:- benzalkonium chloride
Indications for use :- chronic glaucoma
Category:-POM
Availability:- GANDA gtt, 7.5 ml.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; closed angle glaucoma; aphakia.
Special precaution/s:- concurrent medication with potential interactive medications (INT, see below).
Drug-Drug Interaction/s (INT):- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. anti-depressants (monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine, reserpine and guanethidine); psuedo-aphakic patients.
Adverse drug reaction/s:- eye discomfort, conjunctival irritation (including follicular conjuctivitis, hyperaemia, melanosis / adrenochrome deposits); skin reactions; tachycardia and cardiovascular effects; headache. May precipitate closed angle glaucoma. Macula oedema in aphakic patients (avoid use); ptosis.
Comment/s:- examine conjunctiva and cornea every 6 months during long term use (discontinue if melanosis or keratitis is seen).
For a Summary of Product Characteristics click here
timolol maleate 0.25%, 0.5%
Category:-POM
Past availability:- GLAUCOL gtt, unit dose vials
Comment/s:- withdrawn from general use in 1998
timolol maleate 0.5 %
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability:-GLAU-OPT gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blcokers such as verapamil and diltiazem, anti-arrhythmia drugs such as qunidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI’s, tricyclic and tetracyclic antidepressants); pregnancy and breast feeding.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), timolol therapy should be withdrawn gradually. Generic TIMOLOL 0.5 % is also marketed.
apraclonidine hydrochloride 0.5%
Preservatives:- benzalkonium chloride
Category:-POM
Indications for use:- short term adjunctive medication for glaucoma prior to laser treatment or ocular surgery
Availability:- IOPIDINE gtt, 5 ml bottle.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; history of severe or unstable cardiovascular disease.
Specific precautions:- pregnancy and breast feeding; renal or hepatic impairment; concurrent medication with potential interactive medications (INT, see below); concurrent use of soft contact lenses not recommended.
Drug-Drug Interaction/s (INT):- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. antidepressants (monoamine oxidase inhibitors, RIMA's, SNRI's, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine and reserpine), drugs for major cardiovascular disease (including digoxin); concurrent use of any otherCNS depressants (benzodiazepines, barbiturates, alcohol) should be limited or avoided.
Adverse drug reactions:- allergic reactions of the conjunctiva (including follicular conjunctivitis), dry mouth and / or taste disturbances following repeated use.
Comment/s:-
apraclonidine hydrochloride 1.0 %
Preservatives:- benzalkonium chloride
Category:-POM
Indications for use:- short term adjunctive medication for glaucoma prior to laser treatment or ocular surgery
Availability:- IOPIDINE gtt, UNIT DOSE
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; history of severe or unstable cardiovascular disease.
Specific precautions:- pregnacy and breast feeding; renal or hepatic impairment; concurrent medication with potential interactive medications (INT, see below); concurrent use of soft contact lenses not recommended.
Drug-Drug Interactions:- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. antidepressants (monoamine oxidase inhibitors, RIMA's, SNRI's, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine and reserpine), drugs for major cardiovascular disease (including digoxin); concurrent use of any otherCNS depressants (benzodiazepines, barbiturates, alcohol) should be limited or avoided.
Adverse drug reactions:- allergic reactions of the conjunctiva (including follicular conjunctivitis).
Comment/s:-
carbachol 3.0% (with hypromellose 1.0%)
Preservatives:- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- ISOPTOCARBACHOL gtt, 10 mL bottle
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjunctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients); cholinergic reactions affecting gut and cardiovascular system.
Comment/s:-
pilocarpine 0.5% (with hypromellose 1.0%)
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- ISOPTOCARPINE gtt, 10 mL bottle
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:-
pilocarpine 1.0 % (with hypromellose 1.0%)
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- ISOPTOCARPINE gtt, 10 mL bottle
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:- generic PILOCARPINE 1 % eyedrops are also available
pilocarpine 2.0 % (with hypromellose 1.0%)
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- ISOPTOCARPINE gtt, 10 mL bottle
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:- generic PILOCARPINE 2 % eyedrops are also available
pilocarpine 3.0 % (with hypromellose 1.0%)
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- ISOPTOCARPINE gtt, 10 mL bottle
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:- generic PILOCARPINE 3 % eyedrops are also available
pilocarpine 4.0 % (with hypromellose 1.0%)
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- ISOPTOCARPINE gtt, 10 mL bottle
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:- generic PILOCARPINE 4 % eyedrops are also available
metipranolol 0.1%
Preservatives:- none.
Indications for use :- chronic glaucoma in patients wearing soft contact lenses and / or who are allergic to Preservatives commonly used in glaucoma eyedrops; short-term post-operative management of acute rises in intraocular pressure.
Category:-POM
Availability:- MINIMS METIPRANOLOL gtt, unit dose.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (severe emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure); pregnancy.
Special precaution/s:- respiratory impairment; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); diabetes; myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); breast feeding.
Adverse drug reaction/s:- granulomatous and non-granulomatous uveitis (discontinue); transient discomfort and lacrimation (leading to transient blurred vision); there is a possibilty of reduction in corneal sensitivty with with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- in the event of severe adverse drugs reactions developing (including systemic intolerance), metipranolol therapy should be withdrawn gradually.
metipranolol 0.3%
Preservatives:- none.
Indications for use :- chronic glaucoma in patients wearing soft contact lenses and / or who are allergic to Preservatives commonly used in glaucoma eyedrops; short-term post-operative management of acute rises in intraocular pressure.
Category:-POM
Availability:- MINIMS METIPRANOLOL gtt, unit dose.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (severe emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure); pregnancy.
Special precaution/s:- respiratory impairment; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); diabetes; myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); breast feeding.
Adverse drug reaction/s:- granulomatous and non-granulomatous uveitis (discontinue); transient discomfort and lacrimation (leading to transient blurred vision); there is a possibilty of reduction in corneal sensitivty with with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- in the event of severe adverse drugs reactions developing (including systemic intolerance), metipranolol therapy should be withdrawn gradually.
pilocarpine nitrate 1.0 %
Preservatives:- none.
Indications for use:- acute glaucoma (emergency management); chronic glaucoma in patients wearing soft contact lenses and / or who are allergic to Preservatives commonly used in glaucoma eyedrops; short-term post-operative management of acute rises in intraocular pressure.
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- MINIMS PILOCARPINE gtt, unit dose
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:-
pilocarpine nitrate 2.0 %
Preservatives:- none.
Indications for use:- acute glaucoma (emergency management); chronic glaucoma in patients wearing soft contact lenses and / or who are allergic to Preservatives commonly used in glaucoma eyedrops; short-term post-operative management of acute rises in intraocular pressure.
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- MINIMS PILOCARPINE gtt, unit dose
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:-
pilocarpine nitrate 4.0 %
Preservatives:- none.
Indications for use:- acute glaucoma (emergency management); chronic glaucoma in patients wearing soft contact lenses and / or who are allergic to Preservatives commonly used in glaucoma eyedrops; short-term post-operative management of acute rises in intraocular pressure.
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- MINIMS PILOCARPINE gtt, unit dose
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:-
pilocarpine 20ug
Preservatives:- none
Category:-POM
Availability:- OCUSERT PILO ophthalmic insert
Current optometric application/s (UK):- none.
Contraindication/s:- acute infection or inflammation.
Special precaution/s:-
Adverse drug reaction/s:- reduction in visual acuity, irritation, intolerance to insert
Comment/s:- not recommended for children; product should be kept in a 4oC refrigerator.
pilocarpine 40ug.
Preservatives:- none
Category:-POM
Availability:- OCUSERT PILO ophthalmic insert
Current optometric application/s (UK):- none.
Contraindication/s:- acute infection or inflammation.
Special precaution/s:-
Adverse drug reaction/s:- reduction in visual acuity, irritation, intolerance to insert
Comment/s:- not recommended for children; product should be kept in a 4oC refrigerator.
echothiophate 0.03 to 0.125 %
Category:-POM
Past availability:- PHOSPHOLINE IODIDE gtt
Comment/s:- withdrawn from general use in 1993
physostigmine 0.25 %, 0.5 %
Category:-POM
Past availability:- PHYSOSTIGMINE gtt (generic)
Comment/s:- withdrawn from general use in 1994
physostigmine 0.25% or 0.5 %, pilocarpine 2 % or 4 %
Category:-POM
Past availability:- PHYSOSTIGMINE and PILOCARPINE gtt (generic)
Comment/s:- withdrawn from general use in 1994
pilocarpine hydrochloride 4.0 %
Preservatives:- benzalkonium chloride
Indications for use:- chronic glaucoma (especially as a night-time adjunct to other therapies)
Category:-POM
Current optometric applications (UK) :- none
Availability:- PILOGEL ophthalmic gel, 5 g tube
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended; not recommended for use in children; .; concurrent medication with potential interactive medications (INT, see below).
Drug-Drug Interaction/s (INT) :- anticholinergics; corticosteroids
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); keratitis, ciliary spasm and headache (younger patients).
Comment/s:-
dipivefrin hydrochloride 0.1%
Preservatives:- benzalkonium chloride
Indications for use :- chronic glaucoma
Category:-POM
Availability:- PROPINE gtt, 5 ml bottle; 10 ml bottle.
Current optometric application/s (UK):- none
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; closed angle glaucoma; aphakia.
Special precaution/s:- not recommended for use in children; concurrent medication with potential interactive medications (INT, see below).
Drug-Drug interaction/s (INT):- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. anti-depressants (monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine, reserpine and guanethidine); psuedo-aphakic patients.
Adverse drug reaction/s:- eye discomfort, conjunctival irritation and allergic reactions; rebound hyperaemia; tachycardia and cardiovascular effects. May precipitate closed angle glaucoma.
Comment/s:- generic DIPIVEFRINE 0.1 % may also be marketed.
adrenaline 0.5 %
Preservatives:- benzalkonium chloride
Indications for use :- chronic open angle glaucoma
Category:-POM
Availability:- SIMPLENE gtt, 7.5 ml bottle.
Current optometric application/s (UK):- none
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; closed angle glaucoma; aphakia.
Special precaution/s:- not recommended for use in children; concurrent medication with potential interactive medications (INT, see below).
Drug-Drug interaction/s (INT):- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. anti-depressants (monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (ncluding clonidine, reserpine and guanethidine); psuedo-aphakic patients.
Adverse drug reaction/s:- eye discomfort, conjunctival irritation (including follicular conjuctivitis, hyperaemia, melanosis / adrenochrome deposits); skin reactions; tachycardia and cardiovascular effects; headache. May precipitate closed angle glaucoma. Macula oedema in aphakic patients (avoid use).
Comment/s:- examine conjunctiva every 6 months during long term use (discontinue if melanosis is seen).
adrenaline 1.0 %
Preservatives:- benzalkonium chloride
Indications for use :- chronic open angle glaucoma
Category:-POM
Availability:- SIMPLENE gtt, 7.5 ml bottle.
Current optometric application/s (UK):- none
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; closed angle glaucoma; aphakia.
Special precaution/s:- not recommended for use in children; concurrent medication with potential interactive medications (INT, see below).
Drug-Drug interaction/s (INT):- the possibility of substantial interaction with a range of systemic medications should be considered, e.g. anti-depressants (monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); many anti-hypertensive drugs (including clonidine, reserpine and guanethidine); psuedo-aphakic patients.
Adverse drug reaction/s:- eye discomfort, conjunctival irritation (including follicular conjuctivitis, hyperaemia, melanosis / adrenochrome deposits); skin reactions; tachycardia and cardiovascular effects; headache. May precipitate closed angle glaucoma. Macula oedema in aphakic patients (avoid use).
Comment/s:- examine conjunctiva every 6 months during long term use (discontinue if melanosis is seen).
pilocarpine 1.0 %
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- SNOCARPINE gtt, 10 mL bottle
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:- generic PILOCARPINE 1 % eyedrops are also available
pilocarpine 2.0 %
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- product discontinued 7/1999;
generic PILOCARPINE 2% eyedrops are available
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:- product discontinued 7/1999;
generic PILOCARPINE 2 % eyedrops are available
pilocarpine 4.0 %
Preservatives :- benzalkonium chloride
Indications for use:- acute and chronic glaucoma
Category:-POM
Current optometric applications (UK) :- miotic, to reverse mydriasis. Emergency treatment of closed angle glaucoma (use and supply permitted).
Availability:- product discontinued 7/1999;
generic PILOCARPINE 2 % eyedrops are available
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; where miosis is undesirable (e.g. acute iritis); where corneal abrasions are present.
Special precaution/s:- concurrent use with soft contact lenses not recommended.
Adverse drug reaction/s:- conjunctival irritation (including follicular conjuctivitis, conjunctival vascular congestion); ciliary spasm and headache (younger patients).
Comment/s:- product discontinued 7/1999;
generic PILOCARPINE 2 % eyedrops are available
carteolol hydrochloride 1.0%
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability:-TEOPTIC gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure); pregnancy.
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); breast feeding;
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); diffuse superficial keratitis; there is a possibility of reduction in corneal sensitivity with with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), carteolol therapy should be withdrawn gradually.
carteolol hydrochloride 2.0%
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability:-TEOPTIC gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure); pregnancy.
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); breast feeding;
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); diffuse superficial keratitis; there is a possibility of reduction in corneal sensitivity with with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), carteolol therapy should be withdrawn gradually.
timolol maleate 0.25 %
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability:-TIMOPTOL gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); pregnancy and breast feeding.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), timolol therapy should be withdrawn gradually. Generic TIMOLOL 0.25 % is also marketed.
timolol maleate 0.5 %
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability:-TIMOPTOL gtt, 5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blcokers such as verapamil and diltiazem, anti-arrhythmia drugs such as qunidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); pregnancy and breast feeding.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), timolol therapy should be withdrawn gradually. Generic TIMOLOL 0.5 % is also marketed.
timolol maleate 0.25 %
Preservatives:- none
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma in patients wearing soft contact lenses and / or who are allergic to Preservatives commonly used in glaucoma eyedrops;
Category:- POM
Current optometric application/s (UK):- none
Availability:-TIMOPTOL gtt, unit dose.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); pregnancy and breast feeding.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), timolol therapy should be withdrawn gradually.
timolol maleate 0.5 %
Preservatives:- none
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma in patients wearing soft contact lenses and / or who are allergic to Preservatives commonly used in glaucoma eyedrops;
Category:- POM
Current optometric application/s (UK):- none
Availability:-TIMOPTOL gtt, unit dose.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); pregnancy and breast feeding.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), timolol therapy should be withdrawn gradually.
timolol maleate 0.25 %
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability:-TIMOPTOL-LA ophthalmic gel-forming solution, 2.5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); pregnancy and breast feeding; contact lens wear should be discontinued prior to use of this product.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), timolol therapy should be withdrawn gradually.
timolol maleate 0.5 %
Preservatives:- benzalkonium chloride
Indications for use:- for open angle glaucoma, ocular hypertension or secondary glaucoma.
Category:- POM
Current optometric application/s (UK):- none
Availability:-TIMOPTOL-LA ophthalmic gel-forming solution, 2.5 ml bottle.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; asthma (emphysema, bronchitis etc), history of obstructive pulmonary disease, severe cardiac conditions (e.g. sinus bradycardia, cardiogenic shock, uncompensated cardiac failure).
Special precaution/s:- diabetes; uncontrolled hyperthyroid conditions (leading to thyrotoxicosis); myasthenia gravis; concurrent use of medications for substantial hypertension (e.g. catecholamine-depleting drugs such as guanethidine and reserpine), select medications for cardiovascular disorders (e.g. Ca channel blockers such as verapamil and diltiazem, anti-arrhythmia drugs such as quinidine); concurrent use of any anti-depressants / psychotropic drugs of the indirect-acting adrenergic type (e.g. monoamine oxidase inhibitors, RIMA's, SNRI's, NARI's, tricyclic and tetracyclic antidepressants); pregnancy and breast feeding; contact lens wear should be discontinued prior to use of this product.
Adverse drug reaction/s:- transient discomfort and lacrimation (leading to transient blurred vision); there is a possibility of reduction in corneal sensitivity with long term use. Systemic beta-blockade leading to bronchopulmonary or cardiovascular problems; exacerbation of myasthenia gravis; masking of diabetic hypoglycaemia.
Comment/s:- In the event of adverse drugs reactions developing (including systemic intolerance), timolol herapy should be withdrawn gradually.
demecarium 0.1 %
Category:-POM
Past availability:- TOSMILEN gtt
Comment/s:- withdrawn from general use in 1993
dorzolamide hydrochloride 2.0%
Preservatives:- benzalkonium chloride
Indications for use:- for open-angle glaucoma or ocular hypertension where beta-blocker therapy is contraindicated or ineffective
Category:-POM
Availability:- TRUSOPT gtt, 5 mL bottle.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution (see specific precautions); severe renal impairment, hyperchloraemic acidosis, pregnancy, breast feeding.
Special precaution/s:- hepatic impairment, closed angle glaucoma, sulphonamide hypersensitivity resulting in increased risk of alleric reactions to dorzolamide. Not recommended for use in children.
Adverse drug reaction/s:- bitter taste, headache. The use of dorzolamide eyedrops has been associated with transient ocular discomfort and lacrimation, lid margin erythema, superficial punctate keratitis.
Comment/s:- new medication - report any adverse reactions to the CSM.
latanoprost 0.005 %
Preservatives:- benzalkonium chloride
Indications for use:- for open-angle glaucoma or ocular hypertension where other therapies are contraindicated or ineffective.
Category:-POM
Availability:- XALATAN gtt, 2.5 mL bottle.
Current optometric application/s (UK):- none.
Contraindication/s:- known allergy (sensitivity) to any ingredients of the solution; pregnancy, breast feeding.
Special precaution/s:- closed angle glaucoma; inflammatory, neovascular, congenital or pigmentary (secondary) glaucoma; aphakia; severe asthma; not recommended for use in children; contact lens wear should be discontinued prior to use of this product.
Adverse drug reaction/s:- conjunctival irritation (including hyperaemia and foreign body sensation); superficial punctate keratitis; iritis and uveitis; macula oedema in aphakic patients (avoid use); darkening of mixed coloured irides; darker, longer or thicker eyelash growth.
Comment/s:- new medication - report any adverse reactions to the CSM.