Combination of systemic acetazolamide and topical dorzolamide in reducing intraocular pressure and aqueous humor formation

The Additive Effect of Topical Dorzolamide and Systemic Acetazolamide in Pediatric Glaucoma

“…[6][7][8][9][10][11][12][13] The studies have been conducted in various circumstances, including after cataract extraction and lens implantation, after YAG laser capsulotomy, normal adult cases, and primary open angle glaucoma. The results have been variable, with some studies suggesting topical CAI to be superior, oral CAI to be superior, or equally effective in lowering the IOP.…”

“…8 All glaucoma medications were stopped at least 1 week before enrollment. In the first arm of the study topical dorzolamide 2% for 1 week was followed by one tablet of oral acetazolamide at 250 mg.…”

“…4,5 In 1998 the U.S. Food and Drug Administration (FDA) approved the use of Cosopt, a combination topical medication, containing 2% dorzolamide and 0.5% timolol. Compared with acetazolamide, dorzolamide has been reported to be more, 6,7 equally, [8][9][10][11] or less effective. 12,13 Topical dorzolamide was better tolerated and produced a significant intraocular pressure reduction in a group of pediatric glaucoma patients.…”

“…In a study on adults older than 30 years of age with ocular hypertension or glaucoma, no additive effect was found. 8 Either drug alone resulted in maximum reduction in intraocular pressure (IOP). In a study of adult subjects with normal IOP, increasing doses of oral acetazolamide were added to topical dorzolamide.…”

Pressure Lowering Medications

“…Three applications per day provide better overall ocular hypotensive effect (Lippa et al, 1992). The combination of topical dorzolamide and oral acetazolamide failed to demonstrate an additive effect (Rosenberg et al, 1998); therefore, combination therapy is not recommended as it may increase the risk of unwanted systemic side effects. Topical dorzolamide also provided further IOP reduction as adjunctive therapy with topical timolol, especially in gel solution (Adamsons et al, 1998a).…”