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Diltiazem and Triamterene/HCTZ 37 appear to have side effects that impact the eye. Are there blood pressure medications that do not affect vision?

Thank you for your question. I will look at each medication individually. First, taking diltiazem is not contraindicated in patients with glaucoma. In fact, quite the opposite may be true. Currently there are studies being completed looking at a topical drop form of diltiazem to see if it may actually assist in lowering intraocular pressure for the treatment of glaucoma. Studies at this timeCurrently, studies are not conclusive, but we are continuing to do research in this area. At. I have multiple glaucoma patients that take diltiazem, and at this time, there is no evidence to suggest stopping this medication. Triamterene/Hydrochlorothiazide (HCTZ) is a combination of two different medications. The first, triamterene, is a diuretic that works in the kidneys primarily. It is what we call a potassium sparing diuretic. Again, there are no contraindications to using this medication if you have been diagnosed with glaucoma. This medication is also being studied to determine if it actually lowers intraocular pressure. The studies were not conclusive, but it is being examined further.

Finally, we should discuss hydrochlorothiazide. Of the medications that you have asked about, this medication can have adverse side effects in patients with glaucoma. HCTZ is a sulfonamide (in the same family as sulfa drugs). While it is relatively rare, sulfonamides have been known to cause attacks of angle closure in some patients. Your eye doctor has likely already done a procedure called gonioscopy to determine if you have open- angle glaucoma, narrow- angle glaucoma, or angle- closure glaucoma. This will help your eye doctor determine how much of a risk using HCTZ is for you. The risk of angle closure is very small and the majority of glaucoma patients can still use HCTZ. I have multiple patients on HCTZ and Mmost glaucoma patients that use this medication never have problems; however, a small number of patients can have further narrowing of their angle or closure of the drainage system when using this medication, so I encourage you to discuss this with your doctor further.

Posted 06 Oct 2009

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