Eye Drops for Glaucoma

What Is Glaucoma?

Glaucoma is almost always caused by too much pressure inside one or both eyes. Elevated intraocular pressure (IOP) can damage the optic nerves, which are the information pathways between the eyes and brain.

There are two major glaucoma categories, including open-angle or wide-angle glaucoma (most common)and angle-closure or narrow-angle glaucoma (more common in Asia). 
In open-angle glaucoma the drainage system in your eye looks normal but the fluid doesn’t flow out like it should.

In angle-closure glaucoma, the eye does not drain because the drain space between the iris and the cornea becomes too narrow, which can cause a sudden build-up of pressure in the eye.

Why Glaucoma Should Be Treated

If left untreated, glaucoma can lead to peripheral vision loss and cause blindness. Glaucoma is the second leading cause of blindness across the world, next to cataracts. While there is no cure for glaucoma, it can be controlled with proper management.

Glaucoma Treatment

The damage caused by glaucoma cannot be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages.

Glaucoma treatment often involves medication (usually eye drops, but sometimes oral medications as well), laser surgery or microsurgery, with the goal of lowering
pressure in your eye.

Eye Drops for Glaucoma 

Glaucoma treatment most often starts with eye drops. They are used to help the fluid in your eyes drain better. In some cases, they can also reduce the amount of fluid your eyes make.

Various glaucoma eye drops are classified by the active ingredient chemical that helps make it work. Depending on how low your eye pressure needs to be, more than one of the eyedrops below may need to be prescribed.

1. Prostaglandin analogs or prostamides 

These glaucoma eye drops often have the best user compliance because they are required only once daily, except for Rescula, which is taken twice per day.

Prostaglandin analogs generally work by relaxing muscles in the eye's interior structure to allow better outflow of the aqueous humor, the fluid made continuously by the eye.

Eyedrops in this category include:

• Travoprost, 0.004%

Brand Product

Travatan Z - Product of Canada - Manufactured by Alcon

Travatan - Product of Belgium - Manufactured by Alcon

Travatan - Product of United Kingdom - Manufactured by Alcon

Generic Product

Travoprost Z Opht Solution - Product of Canada - Manufactured by various generic Manufacturers

Lupitros Z Opht Solution - Product of India - Manufactured by various generic Manufacturers

Travoprost - Product of United Kingdom - Manufactured by various generic Manufacturers

• Bimatoprost, 0.01%, 0.03% 

Brand Product

Lumigan - Product of New Zealand, United Kingdom - Manufactured by Allergan Inc

Lumigan UDV - Product of United Kingdom - Manufactured by Allergan Inc

Lumigan RC - Product of Canada - Manufactured by Allergan Inc

Generic Product

Bimat - Product of India - Manufactured by various generic Manufacturers

Bimatoprost - Product of New Zealand - Manufactured by various generic Manufacturers

Bimatoprost - Product of United Kingdom - Manufactured by various generic Manufacturers 

Bimat LS - Product of India - Manufactured by various generic Manufacturers

• Latanoprost, 0005%

Brand Product

Xalatan - Product of Turkey, United Kingdom - Manufactured by Pfizer Inc

• Latanoprostene bunod, 0.024%

Brand Product

Vyzulta Eye Drops - Product of Canada - Manufactured by Bausch & Lomb Inc

• Tafluprost 0.0015% (Zioptan)

• Unoprostone (Rescula)

Possible side effects include stinging and burning, eye color change, and lengthening and curling of the eyelashes.

2. Beta blockers

These reduce the production of fluid in your eye, thereby lowering the pressure in your eye.

Examples include:

• Timolol, 0.25%, 0.5%

Brand Product

Timoptol - Product of United Kingdom - Manufactured by Santen - This product is known as Timoptic in the U.S.

Glucomol Eye Drops - Product of India - Manufactured by Allergan Inc - This product is known as Betimol in the U.S.

Timoptol XE - Product of New Zealand - Manufactured by Mundipharma Pharm

Generic Product

Timolol Eye Drops - - Product of New Zealand - Manufactured by various generic Manufacturers

Iotim Eye Drops - Product of India - Manufactured by various generic Manufacturers - This product is the generic of the U.S. brand Betimol

• Betaxolol Hydrochloride, 0.25%

Brand Product

Betoptic S - Product of Belgium - Manufactured by Alcon

• Levobunolol Hydrochloride, 0.5%

Brand Product

Betagan Eye Drops - Product of United Kingdom - Manufactured by Allergan

Possible side effects include burning and stinging upon instillation. Less frequent side effects may include difficulty breathing, slowed heart rate, decreased blood pressure, impotence and fatigue. This class of medication can be prescribed for once- or twice-daily use depending on your condition and the prescribed medication.

3. Alpha-adrenergic agonists

These drops help with drainage, like prostaglandin analogs do. However, they also lessen the amount of fluid your eye makes.

Examples of these drops include:

• Brimonidine, 0.2%, 0.15%, 0.1%

Brand Product

Alphagan - Product of Canada, India, United Kingdom - Manufactured by Allergan Inc

Alphagan P - Product of Australia, Canada, India - Manufactured by Allergan Inc

Alphagan Z - Product of India - Manufactured by Allergan Inc

Generic Product

Brimonidine  - Product of Canada, United Kingdom - Manufactured by various generic Manufacturers 

Brimonidine P - Product of Canada, India - Manufactured by various generic Manufacturers

• Apraclonidine (Iopidine)

• Dipivefrin (Propine)

Possible side effects include an irregular heart rate, high blood pressure, fatigue, red, itchy, or swollen eyes, and dry mouth. This class of medication is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day.

4. Carbonic anhydrase inhibitors

These medications work by decreasing the rate of aqueous humor production. They usually are used in combination with other anti-glaucoma eye drops and not alone.

Examples include:

• Brinzolamide, 1%

Brand Product

Azopt Eye Drops - Product of Belgium - Manufactured by Alcon

Generic Product

Brinzolamide Eye Drops - Product of United Kingdom - Manufactured by various generic Manufacturers

• Dorzolamide, 2%

Brand Product

Trusopt - Product of United Kingdom - Manufactured by Merck

Generic Product

Dorzolamide Eye Drops - Product of Canada, United Kingdom - Manufactured by various generic Manufacturers

Dorzox - Product of India - Manufactured by various generic Manufacturers

Possible side effects include a metallic taste, frequent urination, and tingling in the fingers and toes. This class of eye drops is usually prescribed for twice-daily use but sometimes can be prescribed for use three times a day.

5. Rho-associated Protein Kinase Inhibitors or ROCK Inhibitors

This is a novel class of medications which inhibit rho-kinases and are thought to lower eye pressure by relaxing the canal that drains the aqueous humor resulting in decreased resistance to drainage and decreased ocular pressure.

• Netarsudil 0.02% (Rhopressa)

Brand Product

Rhopressa Eye Drops - Product of USA, produced by Aerie Pharmaceuticals

Possible side effects include eye redness, small bleeds in the conjunctiva, and corneal changes.

6. Combined Agents

Several eyedrops are available that combine the actions of two medications from different categories.

The reasoning behind the use of combined agents is that it is easier for patients to put just one drop in their eyes instead of two; it may also be healthier for the eye as less preservative is being applied.

Examples include:

• Brimonidine Tartrate/ Timolol Maleate, 0.2%/0.5%

Brand Product

Combigan Eye Drops - Product of Canada, Ireland, United Kingdom - Manufactured by Allergan Inc

• Dorzolamide Hydrochloride/ Timolol Maleate, 2%/ 0.5%

Brand Product

Cosopt - Product of Canada - Manufactured by Purdue Pharma

Cosopt - Product of United Kingdom - Manufactured by Merck Sharp & Dohme

Generic Product

Dorzox-T  - Product of India - Manufactured by various generic Manufacturers  - This product is the generic of the U.S. brand Cosopt

Xolatim  - Product of Turkey - Manufactured by various generic Manufacturers  - This product is the generic of the U.S. brand Cosopt

• Travoprost/ Timolol Maleate, 0.004%/ 0.5%

Brand Product

DuoTrav PQ - Product of Canada - Manufactured by Novartis

DuoTrav  - Product of United Kingdom - Manufactured by Alcon

Generic Product

Travoprost-Timop PQ  - Product of Canada - Manufactured by various generic Manufacturers

• Timolol Maleate/ Latanoprost, 5mcg/ 50mcg

Brand Product

Xalacom - Product of Canada - Manufactured by Pfizer Inc

• Brinzolamide/ Brimonidine Tartrate, 1%/ 0.2%

Brand Product

Simbrinza - Product of United Kingdom - Manufactured by Alcon - Marketed as 10mg/mL-2mg/mL in the UK

• Netarsudil 0.02% / Latanoprost 0.005% (Rocklatan)

Brand Product

Rocklatan - Product of USA, Manufactured by Aerie Pharmaceuticals

For glaucoma medications to work, you must take them regularly and continuously as prescribed by your doctor.

Where to Buy Safe and Affordable Eye Drops? 

Eye drops can be incredibly expensive. We provide excellent eye drops prices at our Canadian pharmacy partner or our other international pharmacy partners. Search for the prescription eye drop prices using our search feature above.

References:

• webmd.com

• mayoclinic.org

• epso.ca