Prostaglandins

Column2

Column3

Concentration
0.004%
0.004%
0.004%/0.5%

Dosage
QHS
QHS
once daily

0.005%
0.005%/0.5%

QHS
once daily

0.01%
0.03%/0.5%

QHS
once daily

Zioptan (tafluprost)

0.0015%

QHS

Tip: Prostaglandins have been found

to produce the most significant standBeta-Blockers
alone IOP lowering effects compared
to
other monotherapy options
Drop

Column2

Column3

Timoptic (timolol maleate)

Concentration
0.25%, 0.5%

Dosage
BID

Timoptic -XE (timolol maleate

Timoptic
eye gel) Ocudose (timolol
Istalol (timolol maleate)
maleate)
Betoptic-S (betaxolol)

0.25%, 0.5%
0.25%, 0.5%
0.5%
0.25%

QD
BID
QD
BID

Betoptic (betaxolol)
Betimol (timolol)

0.5%
0.25%, 0.5%

BID
BID

Betagan (levobunolol)

0.25%, 0.5%

QD*

Column2

Column3

Concentration
0.2%

Dosage
TID; BID*

0.2%/0.5%

BID

Drop
Travatan Z (travaprost)
Travatan (travaprost)
DuoTrav Travoprost/timolol
Xalatan (latanoprost)
Xalacom
Latanoprost/timolol
Lumigan (bimatoprost)
Ganfort
Bimatoprost/timolol

*Can be dosed BID if desired result

not attained

Alpha-Adrenergic
Agonists

Drop
Alphagan (brimonidine)

Combigan
(brimonidine/timolol
maleate)
Alphagan-P (brimonidine)
Iopidine (apraclonidine)

* TID dosing when using as

monotherapy; BID dosing when used
**
1% apraclonidine
typicallydrop
used for
in combination
with another
post-op IOP control and reduction of
IOP spikes. Post-op dosing is 1-2
drops after surgery. For elevated IOPiqt q 10-20 min until resolution; 0.5%
can also be used in the same way as
1%

0.1%, 0.15%
0.5%, 1%

TID; BID*
0.5%-TID;
1% **

Carbonic Anhydrase
Inhibitors (CAIs)

Column2

Column3

Drop
Azopt (brinzolamide)

Concentration
1%

Dosage
TID; BID*

Azarga
(brinzolamide/timolol
maleate)

1%/0.5%

BID

Trusopt (dorzolamide)

2%

TID; BID*

2%/0.5%

BID

Column2
Concentration
2%/0.5%
1%/0.2%

Column3
Dosage
BID
TID/BID*

Column2
Concentration
0.15%
4%

Column3
Dosage
BID
QHS

Cosopt
(dorzolamide/timolol
maleate)
* TID dosing when using as
monotherapy; BID dosing when used
Combination
Agents
in combination with another
drop

Drop
Cosopt PF (dorzolamide/timolol
maleate)
Simbrinza
(brinzolamide/brimonidine)
* TID dosing when using as
monotherapy; BID dosing when used
in combination with another drop
Other

Drop
Rescula (unoprostone
isopropyl)*
Pilopine HS (pilocarpine HCl)

Isopto Carpine (pilocarpine

1%, 2%, 4%, 6%**
HCl)
*once listed as a prostaglandin (PGA),

up to QID***

but FDA has since removed that

** multiple other concentrations
designation from bottle's label
available,
but rarely
used
*** most often
TID-QID

Oral/IV Medications
Medication
Diamox (acetazolamide)
Glycerol 50%

Column2

Column3

Strength
125 mg*, 250 mg

Dosage
BID-QID
1-1.5 g/Kg

Mannitol 20%

IV

Diamox Sequels
(acetazolamide)
Neptazane (methazolamide)
*This strength often only available in
generic form

0.5-2.0 g/Kg

500 mg
25 mg, 50 mg

BID
50-100mg
BID-TID

Column5
Mechanism of Action
Increase uveoscleral outflow
Increase uveoscleral outflow

Increase uveoscleral outflow

Increase uveoscleral outflow

Increase uveoscleral outflow

Column5
Mechanism of Action
Decrease aqueous production
Decrease
Decrease
Decrease
Decrease

aqueous
aqueous
aqueous
aqueous

production
production
production
production

Decrease aqueous production

Decrease aqueous production
Decrease aqueous production
Column5
Mechanism of Action
Decreases aqueous production
Increase outflow
Decrease aqueous production
Increase outflow
Decreases aqueous production
Increase outflow
Decreases
aqueous production
Increase outflow

Column5
Mechanism of Action
Decrease aqueous production

Decrease aqueous production

Decrease aqueous production

Decrease aqueous production

Column5
Mechanism of Action
Decrease aqueous production
Decrease aqueous production
Increase outflow
Column5
Mechanism of Action
Exact mechanism unclear;
Thought
increase outflow
Increase to
outflow
Increase outflow

Column5
Mechanism of Action
Decrease aqueous production
Creates osmotic gradient;
dehydrates vitreous

Creates osmotic gradient;

dehydrates vitreous

Decrease aqueous production

Decrease aqueous production

Column6

Column7

Contraindications
Ocular inflammation (current or significant history)
Ocular inflammation (current or significant history)

Other
Preservative-free
Preservative-free

Ocular inflammation (current or significant history)

Ocular inflammation (current or significant history)

0.03% available as Latisse

Ocular inflammation (current or significant history)

Preservative-free

Column6

Column7

Contraindications
Respiratory problems (e.g. asthma, COPD); Bradycardia;
Caution in other heart conditions

Other
QAM dosing suggested as
equally effective

Respiratory problems (e.g. asthma,

Respiratory
problems
asthma,
Caution in other
heart(e.g.
conditions
Respiratory
problems
asthma,
Caution in other
heart(e.g.
conditions
Caution in other
heart(e.g.
conditions
Respiratory
problems
asthma,
Caution in other heart conditions

Soln forms gel consistency on

Preservative-free;
QAM
eye to extend length
of dosing
suggested
as
equally
effective
effectiveness
Beta-1 selective = less effect
on respiratory system;
suspension

COPD);
COPD);
COPD);
COPD);

Bradycardia;
Bradycardia;
Bradycardia;
Bradycardia;

Respiratory problems (e.g. asthma, COPD); Bradycardia;

Caution in other
heart(e.g.
conditions
Respiratory
problems
asthma, COPD); Bradycardia;
Caution
in other
heart(e.g.
conditions
Respiratory
problems
asthma, COPD); Bradycardia;
Caution in other heart conditions
Column6

Less commonly used than

Betoptic-S

Contraindications
Possible allergic potential

Other
Possible neuroprotective
qualities; Common SE- dry
mouth

Possible allergic potential; Respiratory problems (e.g.

asthma, COPD); Bradycardia; Caution in other heart
conditions

Possible neuroprotective
qualities secondary to
brimonidine

Possible allergic potential

Possible allergic potential

Possible neuroprotective
qualities;
Common SEdry
More
tachyphylaxis
than
mouth; Puriterarely
preservative
brimonidine;
used for
chronic treatment

0.5% more readily available

than 0.25%
Column7

Column6

Column7

Contraindications
Sulfa allergy (relative CI); Kidney problems

Other
Higher pH than Trusopt = more
comfortable; suspension

Sulfa allergy (relative CI); Kidney problems; Respiratory

problems (e.g. asthma, COPD); Bradycardia; Caution in
other heart conditions

suspension

Sulfa allergy (relative CI); Kidney problems

pH = 5.6, so often burns on

instillation

Sulfa allergy (relative CI); Kidney problems; Respiratory

problems (e.g. asthma, COPD); Bradycardia; Caution in
other heart conditions

Available in Cosopt Ocudose

Plus- packaged in bottle c
controlled drop tip (by Merck)

Column6
Contraindications
Sulfa allergy (relative CI); Kidney problems; Respiratory
problems
(e.g.
asthma,
COPD);
Bradycardia;
Caution in
Sulfa allergy
(relative
CI);
Kidney
problems; Possible
other heart
conditions
allergic
potential

Column7
Other
Preservative-free
Newest glaucoma medication;
suspension

Column6
Contraindications
May increase inflammation, so caution in patients with
ocular iritis,
inflammation
of significant
history)
Acute
pupillary(current
block glaucoma,
caution
in primary
congenital glaucoma
Acute iritis, pupillary block glaucoma, caution in primary
congenital glaucoma

Column7
Other
Overall safe drug for most pts;
Can
Gel cause periorbital, iris, and
lash changes similar to PGAs
6% can be used for heavily
pigmented eyes

Column6

Column7

Contraindications
Sulfa allergy; Kidney problems

Other
Tablet; Doses >1 g rarely more
effective

Patients in renal failure or on dialysis; caution in heart

failure; useful in acute increased IOP; may precipitate
diabetic ketoacidosis

S/E: urimary retention,

headache, CHF, expansion of
blood volume, diabetic
complications, N, V, D,
electrolyte disturbance, renal
failure, mental confusion,
backache, MI

Patients in renal failure or on dialysis; caution in heart

failure; useful in acute increased IOP

S/E: urimary retention,

headache, CHF, expansion of
blood volume, diabetic
complications, N, V, D,
electrolyte disturbance, renal
failure, mental confusion,
backache, MI

Sulfa allergy; Kidney problems

Extended release capsule

Sulfa allergy; Kidney problems

Tablet