The first line of treatment for most cases of glaucoma, except emergency situations, is medication–eyedrops and, in extreme situations, pills. Medical researchers continuously work to develop new medications that improve eye pressure with greater convenience and have as few side effects as possible.

All antiglaucoma drugs work to reduce intraocular pressure. Topical treatments, in the form of eye drops, are frequently prescribed because they tend to have fewer side effects.  Some of the most common medications used include:

• Alpha adrenergic agonists reduce aqueous humor production and increase the eye’s fluid outflow. Allergic reactions frequently occur with this class of medication. Side effects may include increased heart rate, elevated blood pressure, headaches, blurry vision, fatigue, dry mouth and redness in or around the eye.
  
  Examples include:

• apraclonidine (Iopidine^®)
• brimonidine (Alphagan^®)
• epinepherine (Gluacon^® and Epifrin^®)
• dipivefrin (Propine^®)
  
  

• Beta-Blockers work to lower the intraocular pressure by decreasing the rate at which fluid flows into the eye. Side effects may include a slow or irregular heartbeat, depression, impotence, drowsiness, double vision and breathing problems for patients with asthma or emphysema.
  
  Examples include:

• timolol (Timoptic XE Ocumeter^® and Timoptic^®)
• levobunolol (Betagan^®)
• carteolol (Ocupress^®)
• metipranolol (OptiPranolol^®)
• betatoxol (Betoptic^®)
  
  

• Carbonic anhydrase inhibitors reduce fluid flow into the eye. Side effects may include skin rash, red eye or irritation, headache, nausea or upset stomach, altered taste (especially with carbonated beverages), weight loss, fatigue and decreased energy.
  
  Examples include:

• dorzolamide (Trusopt^®)
• brinzolamide (Azopt^®)
• acetazolamide (Diamox^®) – oral medication
• methazolamide (Neptazane^®) – oral medication 
  
  

• Miotics (cholinergic agents) help increase the rate of fluid drainage from the eye. Side effects may include red eyes, headache and blurry or cloudy vision.
  
  Examples include:

• pilocarpine (Isopto Carpine^®, Pilocar® and Pilopine HS^® ointment)
• echothiophate (Phospholine Iodide^®)
  
  

• Prostaglandin analogs reduce pressure in the eye by increasing the outward flow of fluid from the eye. Side effects may include eye redness or irritation, a change in eye color (mostly in hazel or green eyes), increase in thickness and number of eyelashes and joint aches or flu-like symptoms.
  
  Examples include:

• latanoprost (Xalatan^®)
• bimatoprost (Lumigan^®)
• travopros (Travatan^®) 
  
  

• Combinations of eye drops are also available for patients who require more than one type of eye drop. The side effects for theses medications are mentioned above.
  
   Examples include:

• dorzolamide and timolol (Cosopt^®)
• latanoprost and timolol (Xalacom^®)
• brimonidine and timolol (Combigan^®)

A thoughtful evaluation must be performed by a physician before taking any medications, over-the-counter drugs, supplements, or herbs. The American Health Assistance Foundation does not endorse any of these medications, vitamins, or herbs. A qualified physician should make an informed decision based on each person's medical history and current prescriptions. The medication summaries provided do not include all of the information important for patient use and should not be used as a substitute for professional medical advice.  The prescribing physician should be consulted concerning any questions that you have.

The information provided in this section of our website was obtained from the National Institutes of Health (NIH)/National Eye institute (NEI), the Food and Drug Administration (FDA), the National Library of Medicine, and research scientists specializing in glaucoma.

Reviewed on 2/14/2008