Medication Guide
A number of medications are currently in use to treat glaucoma. Your doctor may prescribe a combination of medications or change your prescription over time to reduce side effects or provide a more effective treatment. Typically, medications are intended to reduce elevated intraocular pressure and prevent damage to the optic nerve.
Eye drops used in managing glaucoma decrease eye pressure by helping the eye’s fluid to drain better and/or decreasing the amount of fluid made by the eye. Drugs to treat glaucoma are classified by their active ingredient. These include: prostaglandin analogs, beta blockers, alpha agonists, carbonic anhydrase inhibitors, and rho kinase inhibitors. Combination drugs are available for patients who require more than one type of medication.
Alpha Agonist
| Drug Name | Brand Name | Manufacturer |
| Apraclonidine HCI 0.5%, 1% | Iopidine® | Novartis |
| Brimonidine tartrate 0.1%, 0.15%, 0.2% | Alphagan® P | AbbVie Inc. |
Actions: Decreases the production of intraocular fluid. Also increases drainage of intraocular fluid.
Notes: Side effects can include burning or stinging upon instillation of the eye drop, fatigue, headache, drowsiness, dry mouth, and dry nose.
Beta Blockers
| Drug Name | Brand Name | Manufacturer |
| Betaxolol HCI 0.25%, 0.5% | Betoptic® S | Novartis |
| Levobunolol HCI 0.25%, 0.5% | Betagan® | AbbVie Inc. |
| Metipranolol 0.3% | OptiPranolol® | |
| Timolol ophthalmic solution 0.25%, 0.5% | Betimol®, Istalol® | Théa Pharma Inc., Bausch & Lomb, Inc. |
| Timolol maleate ophthalmic solution 0.25%, 0.5% (PF) | Timoptic in Ocudose (PF) | Bausch & Lomb, Inc. |
| Timolol maleate ophthalmic gel forming solution 0.25%, 0.5% | Timoptic-XE® |
Actions: Decreases production of intraocular fluid.
Notes: Side effects can include low blood pressure, reduced pulse rate, and fatigue. Beta blockers can also cause a shortness of breath in people who have a history of asthma or other respiratory disorders. Additionally, beta blockers can change cardiac activity by decreasing the amount of blood the heart pumps out, which may reduce the pulse rate and/or slow down the heart’s response rate during exercise. Rare side effects include reduced libido and depression. “PF” indicates preservative-free medication.
Carbonic Anhydrase Inhibitors (CAI)
| Drug Name | Brand Name | Manufacturer |
| Acetazolamide | Diamox, Diamox Sequels | |
| Brinzolamide ophthalmic suspension 1% | Azopt | Novartis |
| Dorzolamide HCI 2% | Trusopt® | |
| Methazolamide | Neptazane® |
Actions: Decreases production of intraocular fluid.
Notes: Side effects of Acetazolamide and Methazolamide can include tingling or loss of strength of the hands and feet, upset stomach, memory problems, depression, kidney stones, and frequent urination. Side effects of Brinzolamide and Dorzolamide include stinging, burning, and other eye discomfort. Acetazolamide and Methazolamide are oral medications.
Cholinergic (Miotic)
| Drug Name | Brand Name | Manufacturer |
| Carbachol 0.75%, 1.5%, 3% | Isopto® Carbachol | |
| Pilocarpine HCI solution 1%, 2%, 4% | Isopto® Carpine | |
| Pilocarpine HCI gel 4% | Pilopine HS® Gel |
Actions: Increases drainage of intraocular fluid.
Notes: Many people who use these medications complain of dim vision, especially at night or in a darkened area such as movie theaters. This is due to constriction of the pupil. Miotics increase drainage of intraocular fluid by making the pupil size smaller and thereby increasing the flow of intraocular fluid from the eye.
Prostaglandin Analogs
| Drug Name | Brand Name | Manufacturer |
| Bimatoprost 0.01%, 0.03% | Lumigan® | AbbVie Inc. |
| Bimatoprost 10 mcg implant | Durysta® | AbbVie Inc. |
| Latanoprost 0.005% | Xalatan® | Pfizer |
| Latanoprostene bunod 0.024% | Vyzulta® | Bausch & Lomb, Inc. |
| Latanoprost ophthalmic emulsion 0.005% | Xelpros® | Sun Ophthalmics |
| Latanoprost ophthalmic solution 0.005% (PF) | IYUZEH™ | Théa Pharma Inc. |
| Tafluprost ophthalmic solution 0.0015% (PF) | Zioptan® | Théa Pharma Inc. |
| Travoprost 0.004% | Travatan® Z | Novartis |
| Travoprost 75 mcg intra cameral implant | iDose® TR | Glaukos |
Actions: Increases drainage of intraocular fluid.
Notes: Side effects can include eye color change, darkening of eyelid skin, eyelash growth, droopy eyelids, sunken eyes, stinging, eye redness, and itching. “PF” indicates preservative-free medication.
Rho Kinase Inhibitors
| Drug Name | Brand Name | Manufacturer |
| Netarsudil 0.02% | Rhopressa® | Alcon |
Actions: Increases drainage of intraocular fluid.
Notes: Side effects can include eye redness, corneal deposits, stinging, and small bleeds on the white of the eye.
Combined Drugs
| Drug Name | Brand Name | Manufacturer |
| Brimonidine tartrate & Timolol Maleate ophthalmic solution 0.2%/0.5% | Combigan® | AbbVie Inc. |
| Brinzolamide & Brimonidine tartrate 1%/0.2% | Simbrinza® | Alcon |
| Dorzolamide HCI & Timolol Maleate | Cosopt® | Théa Pharma Inc. |
| Dorzolamide HCI & Timolol Maleate PF | Cosopt® PF | Théa Pharma Inc. |
| Netarsudil and Latanoprost ophthalmic solution 0.02%/0.005% | Rocklatan® | Alcon |
Actions: Increases drainage of intraocular fluid.
Notes: Rocklatan® is a combination of a rho kinase inhibitor and a prostaglandin analog—side effects include eye redness and stinging. Combigan® is a combination of beta blocker and alpha agonist–side effects include symptoms of both. Cosopt® is a combination of beta blocker and carbonic anhydrase inhibitor—side effects include burning and/or stinging of the eyes and changes in sense of taste. “PF” indicates preservative-free medication.
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