The goal of glaucoma drug treatments is to keep the eye pressure in a range that is thought to be safe for your eyes. There are two main drug treatment options, eye drops and medications by mouth. Below are commonly used classes of medications. Many of the side effects are from preservatives in the eye drops, and preservative free versions of some eye drops are available.
Classes
Examples
Trade name (generic name)
Common Side Effects
Prostaglandins – increase fluid drainage out of eye
Travatan (travaprost 0.004%)
Xalatan (latanoprost 0.005%)
Lumigan (bimatoprost 0.03%)
Monoprost (latanoprost 0.005%, preservative free)
Change colour of iris – darker
Longer eyelashes
Redness of eyes
Redness of skin around eyes
Beta-blockers – make less fluid in eye
Timoptic (Timolol maleate 0.25% or 0.5%)
Betagan (Levobunolol HCL 0.25%, 0.5%)
Betoptic (Betaxolol 0.25%)
Slow heart rate
Tired
Trouble breathing (especially if you usually use a puffer)
Irregular heart beat
Carbonic Anhydrase Inhibitors – make less fluid in eye
Azopt (brinzolamide 1%)
Trusopt (dorzolamide 2%)
Should not be used if you have kidney failure
Metallic taste
Numbness in fingers/toes/around mouth
Fatigue
Kidney stones
Alpha-adrenergic Agonists – make less fluid in eye, may increase fluid drainage out of eye
Alphagan (Brimonidine tartrate 0.2%)
Iopidine (apraclonidine 0.5%, 1.0%)
Burning
Redness in eyes
Itching and watering
Higher blood pressure
Higher heart rate
Irregular heart beat
Parasympathomimetics – increase fluid drainage out of eye
Isopto-Carpine (pilocarpine 2%)
Brow ache
Blurred vision
If you need more than one class of medication, your doctor may prescribe you a combination medication, which includes two types of medication.
Combinations
Examples
Trade name
Common Side Effects
Prostaglandins + beta blocker
Xalacom (latanoprost + timolol)
Duotrav (travoprost + timolol)
As above, for the separate components
Carbonic anhydrase inhibitor + beta blocker
Cosopt (dorzolamide + timolol)
Azarga (brinzolamide + timolol)
As above, for the separate components
Alpha agonist + beta blocker
Combigan (brimonidine + timolol)
As above, for the separate components
Carbonic anhydrase inhibitor + Alpha agonist
Simbrinza (brinzolamide + brimonidine)
As above, for the separate components
Class
Examples
Side Effects
Carbonic Anhydrase Inhibitor – makes less fluid in eyes
Diamox (Acetazolamide)
Neptazane (Methazolamide)
Should not be used if you have kidney failure
Tingling fingers/toes/around mouth
Metallic taste
Nausea
Fatigue
Kidney stones
Osmotics- draws water into blood, and reduces pressure in your eye
*Will only be given in hospital for emergency treatment and not as home medication
Glycerol (oral)
Mannitol (intravenous)
Nausea, vomiting
Dizziness, headache
Thirst
