Dorzolamide hydrochloride ocular
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Eye drops containing dorzolamide hydrochloride (preservative containing and preservative-free).
Drugs List
Therapeutic Indications
Uses
Elevated IOP in ocular hypertension - adjunctive therapy
Elevated IOP in ocular hypertension - alternative to beta-blockers
Elevated IOP in open-angle glaucoma - adjunctive therapy
Elevated IOP in open-angle glaucoma - alternative to beta-blockers
Elevated IOP in pseudoexfoliative glaucoma - adjunctive therapy
Elevated IOP in pseudoexfoliative glaucoma - alternative to beta-blockers
Dosage
Adults
As monotherapy
Instil 1 drop into the affected eye(s) three times a day.
As adjunctive therapy with an ophthalmic beta blocker
Instil 1 drop into the affected eye(s) twice daily.
Children
Limited data exists for use in paediatric patients.
Dorzolamide has not been studied in patients less than 36 weeks gestational age and less than 1 week of age. Hence, because of possible metabolic acidosis risk, patients with significant renal tubular immaturity should only receive dorzolamide after careful consideration of the risk/benefit balance.
Raised intra-ocular pressure in primary and secondary glaucoma (monotherapy) (unlicensed)
Instil 1 drop into the affected eye(s) three times a day.
Raised intra-ocular pressure in primary and secondary glaucoma (in combination with a beta-blocker) (unlicensed)
Instil 1 drop into the affected eye(s) twice daily.
Patients with Renal Impairment
Dorzolamide has not been studied in patients with severe renal impairment (CrCI < 30ml/minute) or with hyperchloraemic acidosis. Dorzolamide and its metabolites are excreted predominantly by the kidney.
In post marketing data, metabolic acidosis in the very young particularly with renal immaturity/impairment has been reported.
Additional Dosage Information
If switching to dorzolamide from another anti-glaucoma product, instil the doses of other product one day, then commence instilling the dorzolamide doses the following day.
Contraindications
Breastfeeding
Hyperchloraemic acidosis
Pregnancy
Renal impairment - creatinine clearance below 30 ml/minute
Precautions and Warnings
Children under 18 years
Neonates
Wearing of contact lenses
Chronic corneal disorder
Hepatic impairment
History of intra-ocular surgery
History of nephrolithiasis
Advise patient blurred vision may affect ability to drive/operate machinery
Contains benzalkonium chloride
Some formulations may contain traces of silver - risk of hypersensitivity
Administer other ophthalmic products at least 10 minutes apart
Increased risk of choroidal detachment with use post filtration procedures
Discontinue if hypersensitivity reactions occur
Advise patient to avoid touching the eye/other surfaces with container tip
If soft contact lenses worn,insert them 15 minutes after using eye drops
Pregnancy and Lactation
Pregnancy
Dorzolamide is contraindicated during pregnancy.
Manufacturers advise that this medication is not recommended during pregnancy. At the time of writing there is limited published experience concerning the use of dorzolamide during pregnancy. In rabbits, dorzolamide produced teratogenic effect at maternotoxic doses. Schaefer concludes that eye drops may generally be used during pregnancy for the appropriate indications and if there are compelling treatment indications they should not be withheld but the dosage kept as low as possible (Schaefer 2015).
Lactation
Dorzolamide is contraindicated during breastfeeding.
Manufacturers advise that this medication is not recommended during breastfeeding. At the time of writing there is little published experience concerning the use of dorzolamide during breastfeeding. It is not known whether dorzolamide is excreted in human milk. In lactating rats receiving dorzolamide, decreases in the body weight gain of offspring were observed. Schaefer concludes that in general eye drops are compatible with breastfeeding as minimal amounts are absorbed systemically (Schaefer 2015).
Side Effects
Angioedema
Asthenia
Bitter taste
Blurred vision
Bronchospasm
Burning and stinging of the eyes
Choroidal detachment (following filtration surgery)
Conjunctivitis
Contact dermatitis
Corneal decompensation
Corneal oedema
Dizziness
Dry mouth
Dyspnoea
Epistaxis
Eye pain
Eyelid inflammation
Eyelid reaction
Fatigue
Headache
Hypersensitivity reactions
Iridocyclitis
Lid margin crusting
Metabolic acidosis
Myopia (transient)
Nausea
Ocular hypotony
Ocular irritation
Ocular itching
Palpitations
Paraesthesia
Pruritus
Rash
Reddening of eyes
Sensation of foreign body in eye
Shortness of breath
Stevens-Johnson syndrome
Superficial punctate keratitis
Tearing
Throat irritation
Toxic epidermal necrolysis
Urolithiasis
Urticaria
Overdosage
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 ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: October 2017
Reference Sources
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Summary of Product Characteristics: Eydelto 20mg/ml eye drops solution. Aspire Pharma Ltd. Revised April 2017.
Summary of Product Characteristics: Trusopt 20mg/ml Eye Drops, solution. Santen Oy. Revised February 2017.
Summary of Product Characteristics: Trusopt Preservative-Free 20mg/ml eye drops solution, single dose container. Santen Oy. Revised February 2017.
Summary of Product Characteristics: Vizidor 20mg/ml eye drops solution. Bausch & Lomb UK Ltd. Revised January 2021.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 27 July 2021
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Dorzolamide. Last revised: December 27, 2007
Last accessed: August 05, 2009
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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