Table 3.5

Combined IOP-lowering topical medications

CompoundMode of actionIOP reductionContra-indicationsSide effects
Topical Brinzolamide 1% Dorzolamide 2%Decreases aqueous humour production20%Patients with low corneal endothelial cell count, due to increased risk of corneal oedemaLocal: Burning, stinging, bitter taste, superficial punctate keratitis, blurred vision, tearing Systemic: Headache, urticaria, angioedema, pruritus, asthenia, dizziness, paresthesia and transient myopia.
SystemicAcetozolamide Methozolamide DichlorphenamideDecreases aqueous humour production 30-40%Depressed sodium and/or potassium blood levels, cases of kidney and liver disease or dysfunction, suprarenal gland failure, hyperchloremic acidosis.Systemic: Paresthesias, hearing dysfunction, tinnitus, loss of appetite, taste alteration nausea, vomiting, diarrhoea, depression, decreased libido, kidney stones, blood dyscrasias, metabolic acidosis, electrolyte imbalance