dorzolamide (Trusopt)
Jump to navigation
Jump to search
Introduction
Tradename: Trusopt.
Indications
Contraindications
Caution:
- not recommended for patients with severe renal insufficiency (creatinine clearance < 30 mL/min)
- use with caution in patients with hepatic impairment
- sulfonamide hypersenstivity
- bacterial keratitis
- acute angle-closure glaucoma
Pregnancy category: C Lactation: not known whether dorzolamide is secreted in human milk
Dosage
2% (5 & 10 mL)
Preservative is benzalkonium chloride.
Storage: 10-25 C
Pharmacokinetics
- systemic absorption occurs with topical administration
- dorzolamide 2% OU TID achieves blood levels similar to dorzolamide 2 mg PO BID[4]
- blood levels below that anticipated for a pharmacologic effect on renal function or respiratory function[4]
- accumulates in erythrocytes with chronic dosing
- 1/2life (phase 2) of erythrocyte elimination is 4 months
- 33% binding to plasma proteins
- excreted largely unchanged in the urine
Monitor
- K+, blood pH (or CO2), intraocular pressure
Adverse effects
- common (> 10%)
- bitter taste (25%), burning, stinging, irritation (up to 33%), ocular allergic reaction (10%) superficial punctate keratitis (10-15%)
- less common (5-10%)
- blurred vision, tearing, dryness, photophobia
- uncommon (< 1%)
- other
- drug adverse effects of sulfonamides
- drug adverse effects of diuretics
- drug adverse effects of carbonic anhydrase inhibitor(s)
- drug adverse effects of antihypertensive agents
Drug interactions
- avoid concurrent administration of oral carbonic anhydrase inhibitors
- salicylate may increase toxicity
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) SGLT2 inhibitors (flozins) with diuretics
- drug interaction(s) of diuretics in combination with Zn+2
- drug interaction(s) of antiarrhythmic agents in combination with diuretics
- drug interaction(s) of calcium channel blockers with diuretics
- drug interaction(s) of antibiotics with warfarin
- drug interaction(s) of diuretics with angiotensin II receptor antagonists
- drug interaction(s) of diuretics with ACE inhibitors
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
- drug interaction(s) of NSAIDs & antihypertensives
Mechanism of action
- inhibits carbonic anhydrase
- produces mean reduction in intraocular pressure of 1-23% (3-5 mm Hg) dosed TID[4]
More general terms
Additional terms
Component of
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 4.0 4.1 4.2 4.3 4.4 Dorzolamide Hydrochloride Ophthalmic Solution 2% Package Insert Hi-Tech Pharmaceutical Company Amityville, NY 11701