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Ophthalmic suspension containing 10mg brinzolamide per ml.

Drugs List

  • AZOPT 10mg/ml eye drops
  • brinzolamide 10mg/ml eye drops
  • Therapeutic Indications


    Adjunctive therapy (to beta blockers or prostaglandin analogues), or monotherapy (if beta-blockers contraindicated or ineffective) to reduce elevated intraocular pressure in ocular hypertension or open angle glaucoma.



    Instil 1 drop into the affected eye(s) twice daily, increasing if needed to three times a day.


    Children from birth to 18 years (unlicensed)
    Instil 1 drop into the affected eye(s) twice daily, increasing if needed to three times a day.

    Patients with Renal Impairment

    Brinzolamide has not been studied in patients with severe renal impairment (creatinine clearance < 30 ml/min) or with hyperchloraemic acidosis. Because brinzolamide and its main metabolite are excreted predominantly by the kidney it is contraindicated in these patients.

    Patients with Hepatic Impairment

    Brinzolamide has not been studied in patients with hepatic impairment and is therefore not recommended in such patients.


    For ocular administration.


    Renal impairment - creatinine clearance less than 30ml/minute

    Hyperchloraemic acidosis

    Precautions and Warnings

    Children under 18 years (see Dosage - Children )

    Hepatic impairment (see Dosage - Hepatic impairment )

    Pregnancy (see Pregnancy )

    Lactation (see Lactation )

    Brinzolamide is absorbed systemically. Discontinue use if signs of serious reactions or hypersensitivity occur.

    Use with caution in patients with significant renal tubular immaturity or abnormalities due to the risk of metabolic acidosis.

    There is limited experience in patients with pseudoexfoliative glaucoma or pigmentary glaucoma.

    There is no experience in patients with angle-closure glaucoma.

    Use with caution in patients with compromised corneas (especially those with low endothelial cell count) e.g. diabetes mellitus or patients who wear contact lenses (due to effects on corneal hydration).

    Contains benzalkonium chloride that may discolour soft contact lenses. Soft contact lenses should be removed before instillation of the eye drops and may be reinserted after 15 minutes.

    Brinzolamide eye drops may impair the ability to perform tasks requiring mental alertness or physical co-ordination in elderly patients.

    Application may cause transient blurring of vision, patients should avoid driving or operating machinery until vision is clear.

    Pregnancy and Lactation


    At the time of writing there are no adequate data on the use of brinzolamide in pregnant women. Animal studies (at many times the human ophthalmic dose) have shown reproductive toxicity, but the potential risk for humans is unknown. Schaefer notes that brinzolamide and other carbonic anhydrase inhibitors have not been systematically studied, but eye drops may generally be used during pregnancy, particularly for compelling indications such as severe glaucoma, providing the dose is kept as low as therapeutically possible.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password at ( ) or if this is unavailable at the backup site ( ).

    Animal data - Reproductive toxicity in rats and rabbits.

    Crosses placenta? - Unknown

    Other information - Eye drops may generally be used during pregnancy for appropriate indications, but consider quantitative absorption via the conjunctiva and dosage and duration should be kept as low as possible.


    It is not known whether brinzolamide is excreted in human milk, but it is excreted in rat milk. The manufacturer strongly recommends avoiding brinzolamide when breastfeeding. Schaefer concludes that the use of carbonic anhydrase inhibitors such as brinzolamide are acceptable, but there are limited data available.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Drug excreted in breast milk? - Unknown in humans, but excreted in rat milk.

    Considered suitable or recommended by manufacturer? - No.

    UK Drugs in Lactation Advisory Service Classification - Not listed.

    Drug substance licensed in infants? - No.

    Effects on Ability to Drive and Operate Machinery

    Instillation of eye drops may cause transient blurring of vision. Avoid driving or operating machinery until vision is clear.

    Brinzolamide eye drops may impair the ability to perform tasks requiring mental alertness or physical co-ordination in elderly patients.


    Advise patient that the product is a suspension and that they should shake the bottle well before use.

    Advise patient to wash their hands prior to use.

    Advise patient to avoid contact of the dropper with the eye or other surfaces as contamination leading to ophthalmic infection may occur.

    Advise patients to leave an interval of at least 5 minutes before instilling another ophthalmic medication.

    Advise patient to compress the lacrimal sac during administration and for one minute afterwards, to reduce systemic absorption.

    Advise patients that instillation of eye drops may cause transient blurring of vision and to avoid driving or operating machinery until vision is clear. In addition, brinzolamide eye drops may impair the ability to perform tasks requiring mental alertness or physical co-ordination in elderly patients.

    Advise patient to remove soft contact lenses before instillation of the eye drops and re-insert them after 15 minutes.

    Advise patient to discard eye drops 4 weeks after first opening.

    Side Effects

    Blurred vision (transient)
    Cardio-respiratory depression
    Angina pectoris
    Decreased erythrocyte count
    Motor disturbances
    Ocular irritation
    Ocular pain
    Dry eyes
    Ocular discharge
    Ocular pruritus
    Ocular hyperaemia
    Increased intra-ocular pressure
    Visual disturbances
    Allergic conjunctivitis
    Scleral disorders
    Abnormal sensation in eye
    Conjunctival hyperaemia
    Eyelid reaction
    Increased lacrimation
    Pharyngolaryngeal pain
    Throat irritation
    Upper respiratory tract congestion
    Postnasal drip
    Nasal dryness
    Dry mouth
    Upper abdominal pain
    Abdominal discomfort
    Gastro-intestinal disturbances
    Renal pain
    Skin tightness
    Back pain
    Muscle spasm
    Chest pain
    Erectile dysfunction
    Reduced libido
    Optic nerve damage
    Peripheral oedema
    Abnormal liver function tests
    Taste disturbances
    Subconjunctival cyst
    Impaired memory
    Sensation of foreign body in eye
    Corneal disorders


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Shelf Life and Storage

    No special requirements.

    Discard any unused contents 4 weeks after opening.

    Further Information

    Last Full Review Date: November 2011

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Summary of Product Characteristics: Azopt eye drops, suspension. Novartis Europharm Limited. Revised May 2017.

    NICE Evidence Services Available at: Last accessed:23 August 2017

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