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Dorzolamide

Dorzolamide Hydrochloride

Dorzolamide Hydrochloride, sold under the brand name Trusopt, is a prescription medication recommended by doctors for the treatment of open-angle glaucoma and high pressure inside the eye. Besides, it helps prevent blindness by lowering high pressure in the eyes. Usually, it is advised to use these eye drops three times a day. The plus point of this medication is that it can be used by both adult and pediatric patients, but remember that their dosage may vary. So, always consult your doctor before using these eye drops to avoid complications. Lastly, if you are hypersensitive to any ingredient in this product, avoid using it.        

Product Overview

Dorzolamide Hydrochloride is an effective prescription medication used to reduce high intraocular pressure in patients with open-angle glaucoma or ocular hypertension. This ophthalmic solution contains the active ingredient dorzolamide, a carbonic anhydrase inhibitor that reduces aqueous humor production, thereby lowering eye pressure. Dorzolamide Hydrochloride is FDA-approved, which ensures its safety and effectiveness when used as instructed by a healthcare professional.

Each ml of Dorzolamide Hydrochloride ophthalmic solution contains 20 mg of dorzolamide. The recommended dose is one drop in the infected eye(s) thrice daily. This medication is suitable for adults and children over the age of three. Dorzolamide Hydrochloride restricts the enzyme carbonic anhydrase in the ciliary processes of the eye, leading to reduced fluid production and decreased intraocular pressure.

Common side effects of Trusopt include ocular burning, stinging, discomfort immediately after instillation, and a bitter taste, headache, or nausea. Patients should avoid touching the dropper tip to minimize potential side effects and to prevent contamination. If a dose is missed, take it as soon as possible unless it is almost time for the next dose. Do not double the dose to catch up. In case you have overdosed on the medication, seek immediate medical help. Keep the bottle tightly closed when not in use and out of reach of children. Talk to your healthcare practitioner for proper guidance and usage instructions for any concerns or questions.

Uses of Dorzolamide Hydrochloride

It is used to treat:

  • Elevated pressure inside the eye due to open-angle glaucoma and ocular hypertension.
  • Reduces the risk of blindness 
  • Lowers the fluid amount within the eye.

How to Use Dorzolamide Hydrochloride?

Dosage

Strengths and Forms

Dorzolamide Hydrochloride is an ophthalmic solution of 2% strength, equivalent to 20 mg of dorzolamide. 

Recommended Dosage for Different Patients

  • For Adults: The recommended dose is one drop of Trusopt ophthalmic solution in the infected eye three times a day. Other medications can be used in combination with Trusopt to reduce intraocular pressure. 
  • For Pediatric Patients: The dose will be determined by the doctor. 

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

  • First and foremost, follow your eye specialist’s advice. Do not exceed or subceed the dosage without asking your doctor.
  • Read the Patient Information Leaflet for detailed information.
  • Use the medication thrice daily, usually one drop in the affected area.
  • Wash your hands before instilling the drops.
  • Do not touch the dropper or let it touch your eye, as there is a chance that it will become contaminated.
  • Avoid wearing contact lenses when using eye drops, as these eye drops may contain certain preservatives that can be absorbed into the lenses. 
  • Wear your lenses 15 minutes after using the eye drops. 
  • When instilling eye drops, try tilting your head, looking upward, and making a small area by pulling your lower eyelid.
  • Hold the dropper over the eye and place one drop. 
  • Keep your eyes closed for a few minutes and apply gentle pressure on it. 
  • Do not blink or rub your eyes while using eye drops. 
  • Do not rinse the eye dropper.
  • If you use Trusopt with other solutions, wait at least 10 minutes before using the other medications.
  • If you are using ointments, use your drops before it so that your eye drops enter the eye.     
  • Use it regularly to get the best results.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Dorzolamide Hydrochloride Work?

Carbonic anhydrase, or CA, is an enzyme found in various body tissues, including the eye. It activates the reversible reaction that involves carbon dioxide’s hydration and carbonic acid’s dehydration. In humans, carbonic anhydrase exists in several isoenzymes, with CA-II being the most active. These isoenzymes are primarily found in red blood cells but are also present in other tissues. When patients use their eye drops in the affected eye, it restricts carbonic anhydrase in the ciliary processes of the eye, reducing the secretion of aqueous humor. 

This is likely due to slowing the formation of bicarbonate ions, which subsequently decreases sodium and fluid transport. This leads to a reduction in intraocular pressure (IOP). Trusopt ophthalmic solution contains dorzolamide hydrochloride, an inhibitor of human carbonic anhydrase II. When applied to the eye, the medication lowers elevated intraocular pressure.

Important Safety Information

Side Effects

Common side effects of Dorzolamide Hydrochloride may include:

  • Burning
  • Stinging or discomfort 
  • Itching
  • Redness
  • Swelling
  • eyelid irritation
  • Bitter taste 
  • Bacterial infection 
  • Allergic reaction
  • Blurry vision
  • Dry eye
  • Tearing
  • Light sensitivity

Serious side effects of Dorzolamide Hydrochloride may include:

  • Kidney stone
  • Abdomen pain
  • Vomiting
  • Blood in urine
  • Yellowing of eyes or skin
  • Dark urine
  • Bruising
  • Sore throat
  • Infections
  • Fever
  • Chills
  • Eye discharge
  • Swelling on the face

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

  • Sulfonamide Hypersensitivity: Trusopt contains dorzolamide, a sulfonamide. While it is an ophthalmic solution, it can be absorbed into the body, causing the same adverse reactions as sulfonamides taken by mouth. Rarely, severe reactions to sulfonamides have led to death, including conditions like Stevens-Johnson syndrome, toxic epidermal necrolysis, severe liver damage, agranulocytosis, aplastic anemia, and other blood disorders. 
  • Bacterial Keratitis: Patients have reported bacterial keratitis (an eye infection) linked to the use of multi-dose containers of eye drops.  These containers were accidentally contaminated by patients, often those with existing corneal disease or damage to the eye surface.
  • Corneal Endothelium: Patients lacking endothelial cell counts have a higher chance of developing corneal edema (swelling). So, patients use this medication carefully under medical guidance, and professionals remain cautious when prescribing these eye drops to patients. 
  • Allergic Reactions: Long-term use of Dorzolamide hydrochloride ophthalmic solution may cause local ocular side effects in patients, mainly conjunctivitis and eyelid reactions. Many of these reactions appeared to be allergic and went away after stopping the medication. If such reactions are noticed, discontinue using your eye drops. 

Precautions

  • Before using this product, make sure to inform your medical professional about your allergies or if you are allergic to any of the medication’s ingredients. This product may contain certain inactive ingredients like preservative benzalkonium chloride that can cause allergic reactions in patients. 
  • Tell your healthcare practitioner about your medical history, especially of kidney or liver problems and kidney stones.
  • If you get an eye infection while using the product or are undergoing eye surgery, tell your eye specialist and ask them whether you should continue the medication or not.
  • Before undergoing any medical surgery or procedure, inform the professionals about the products you use. This includes prescription drugs, nonprescription drugs, and herbal products.
  • Avoid oral consumption of the medication.
  • Do not drive or operate machinery that demands full attention, as the medication may blur your vision temporarily.
  • Pregnant women or those planning to become pregnant should consult their medical professional before using these eye drops. Discuss every risk and benefit to prevent any complications.
  • It is not known whether the drug enters into breast milk or not. So, talk to your doctor if you are breastfeeding.

Contraindications 

It is contraindicated in patients with:

  • Hypersensitivity: Do not use this product if you are hypersensitive to any of the drug’s ingredients, including non-medicinal components.
  • Severe Renal Impairment: Patients with severe renal problems (CrCl < 0.5 mL/s) should avoid using dorzolamide hydrochloride since the product and its metabolite are mostly eliminated by the kidneys. Trusopt and Trusopt preservative-free have not been tested on these patients and are not recommended for them.
  • Oral Carbonic Anhydrase Inhibitors: Patients taking these inhibitors should also avoid this medication due to the increased risk of adverse effects from carbonic anhydrase inhibition. The combined use of these eye drops with oral CA inhibitors has not been studied and is not recommended.

Missed Dose

  • If you have forgotten to take a dose of your eye drops, then you can do the following things:
  • Take the missed dose as soon as you remember or whenever possible.
  • If it is almost time for your next dose, omit the previous one and continue your usual dosing schedule.
  • Do not try to take double doses, as it may cause adverse reactions.
  • Use medication apps or set reminders on your phone to avoid skipping any doses.
  • You can even talk to your eye specialist if you have any concerns or questions. 

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Generally, it is advised not to exceed your maximum daily dose, but if someone has overdosed on dorzolamide hydrochloride and starts experiencing symptoms like difficulty in breathing or fainting, do not panic; get medical help immediately or call 911. 

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

  • Store the solution at a temperature of 15-30°C.
  • Try to protect your medication from light.
  • Do not keep them under direct sunlight.
  • Avoid contact with children or pets.
  • Avoid keeping eye drops in moist or damp areas like the bathroom or the sink.
  • Store the medicine in the original container with a tight cap.
  • Keep it from freezing.
  • Do not store outdated medications or when not in use.
  • Do not flush the medicine down the toilet.
  • Read the product label for detailed storage instructions.
  • Ask your pharmacist or doctor to know how you can dispose of the medicine properly.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Dorzolamide Hydrochloride Interactions

  • Acetazolamide
  • Aspirin
  • Bismuth subsalicylate
  • Choline salicylate
  • Dichlorphenamide
  • Diflunisal
  • Magnesium salicylate
  • Methazolamide
  • Salsalate
  • Sodium salicylate
  • Sodium thiosalicylate
  • Topiramate
  • Zonisamide

[Note: This isn’t a complete list, and there could be other drugs that interact with Dorzolamide Hydrochloride. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Dorzolamide Hydrochloride Alternatives

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Is there any difference between Cosopt and Trusopt?

Yes, there is a difference between Cosopt and Trusopt. Trusopt contains dorzolamide hydrochloride, which effectively lowers intraocular pressure in patients with open-angle glaucoma by reducing aqueous humor production. Cosopt, on the other hand, is a blend of eye drops that contains dorzolamide (a carbonic anhydrase inhibitor) and timolol (a beta-blocker) for a dual mechanism to more effectively lower eye pressure in similar conditions.

How long does it take for Trusopt to start working?

Trusopt generally starts to reduce intraocular pressure within one hour of administration. There is a chance that the medication will take longer, depending on the severity of the infection. However, patients generally notice the peak effect within two hours. It is important to note that using your medication timely as prescribed by your healthcare provider is crucial for optimal results in managing conditions like glaucoma or ocular hypertension.

Are there any dietary restrictions while using Trusopt?

While no fixed dietary restrictions are associated with using Trusopt, maintaining a balanced diet and staying hydrated can support overall eye health. Always follow any additional dietary advice your healthcare practitioner provides, especially if you have other medical conditions.

Can Trusopt be used in combination with other glaucoma medications?

Yes, Trusopt can be used in combination with other glaucoma medications. It is often prescribed alongside other eye drops to achieve better control of intraocular pressure. However, it is crucial to stick to your healthcare provider’s instructions regarding dosage and administration to avoid potential interactions and maximize the effectiveness of the treatment.

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