Carbonic anhydrase inhibitors are sulphonamide related drugs and may give rise to associated side effects especially with systemic treatment e.g. blood disorders.
Topical carbonic anhydrase inhibitors are licensed as an adjunct to beta-blocker therapy or used alone in patients unresponsive to beta-blockers or if beta-blockers contra-indicated.
Brinzolamide can also be used as an adjunct to a prostaglandin analogue.
Systemic side effects are less compared to oral / IV acetazolamide.
- Eye drops 10mg/ml (£2.00 = 5ml)
- Apply twice daily increased if necessary to 3 times daily
- Eye drops 20mg/ml (£2.04 = 5ml)
- Multi-dose preservative free eye drops 20mg/ml (£12.09 = 5ml)
- Unit dose preservative free eye drops 20mg/ml (£24.18 = 60 x 0.2ml unit dose)
Topical combination therapy
- Eye drops, brinzolamide 10mg/ml, brimonidine 2mg/ml (£9.23 = 5ml)
- Apply one drop twice daily
- Eye drops, brinzolamide 10mg/ml, timolol 5mg/ml (£11.05 = 5ml)
- Eye drops, dorzolamide 20mg/ml, timolol 5mg/ml (£1.85 = 5ml)
- Multi-dose preservative free eye drops, dorzolamide 20mg/ml, timolol 5mg/ml (£14.29 = 5ml)
- Unit dose preservative free eye drops, dorzolamide 20mg/ml, timolol 5mg/ml (£28.59 = 60 x 0.2ml unit dose)
Acetazolamide is generally used as parenteral or occasionally oral therapy for acute glaucoma. Side effects include paraesthesia, general malaise / fatigue, dizziness, electrolyte imbalance and depression. Caution is required in patients with a history of renal stones.
- Tablets 250mg (£13.87 = 1g daily)
- Capsules modified release, 250mg (£33.32 = 500mg daily)
- Powder for solution for injection 500mg vials
- Standard release oral or by intravenous injection, 250mg - 1g daily in divided doses
- Modified release, 250mg - 500mg daily
11. Eye >
11.6 Treatment of glaucoma >
11.6.4 Carbonic anhydrase inhibitors and systemic drugs
- First line
- Second line