Prescription eye medications
If you are diagnosed with glaucoma or other eye diseases, your doctor may prescribe one of the following prescription medications. Learn more about how these medications work, safety information, and side effects.
Generic name
Brimonidine tartrate
Concentration
0.15%
Mechanism of action
This selective alpha-2 adrenergic agonist reduces the aqueous humor production and increases aqueous humor outflow.
Use with caution in patients with/during:
- Severe cardiac disease, cerebrovascular disease, or coronary artery disease
- Depression; contraindicated in patients receiving monoamine oxedase (MaO) inhibitor therapy
- Raynaud's disease, thromboangiitis obliterans (Buerger’s disease), depression, and orthostatic hypotension
- Contact lens wearers due to the preservative BAK. Drops should be instilled 15 minutes before putting in contacts
- Renal impairment or damage or hepatic disease
- Pregnancy, breastfeeding, or in children
Common side effects
- Ocular allergic reactions
- Oral dryness
- Stinging
- Ocular pruritus (itchy eyes)
- Ocular hyperemia (red eyes)
- Headache
- Foreign body sensation
- Fatigue
- Drowsiness
- Conjunctival follicles (mass of cells on the conjunctiva)
- Blurring of the eyes
- Burning of the eyes
Less common to rare side effects
- Abnormal taste
- Conjunctival hemorrhage (bleeding of the conjunctiva)
- Corneal erosion
- Eyelid erythema (redness of eyelid due to blood vessel dilation)
- Insomnia
- Lid crusting
- Tearing
- Ocular pain
- Photophobia (sensitivity to light)
- Ocular dryness
Generic name
Brinzolamide
Concentration
1%
Mechanism of action
This carbonic anhydrase inhibitor reduces the aqueous humor production, thus lowering the pressure in the eye.
Indications
Treatment of open angle glaucoma or ocular hypertension
Dosage
Instill 1 drop of brinzolamide ophthalmic solution into the affected eye(s) three times daily, 8 hours apart.
Use with caution in patients with/during:
- Renal impairment or severe renal disease (with a creatinine clearance less than 30 milliliters per minute)
- Hepatic disease
- Sulfonamide hypersensitivity
- Acute closed angle glaucoma
- Pregnancy, breastfeeding, or in children
Common side effects
- Blurred vision
- Bitter, sour, or unusual taste
Life-threatening symptoms
- Chest pain
- Jaundice (yellowing of skin or eyes)
Less common to rare side effects
- Dermatitis
- Chest pain
- Conjunctivitis (inflammation of the conjunctiva)
- Diarrhea
- Double vision
- Dry eye
- Dry mouth
- Keratoconjunctivitis
- Dyspepsia (upset stomach)
- Eye discomfort or pain
- Blepharitis (inflammation of the eyelids)
- Keratitis (corneal inflammation)
- Tearing
- Hyperemia (increased amount of blood in eye)
- Headache
- Foreign body sensation in eye
- Dyspnea (shortness of breath)
- Rhinitis
- Keratopathy
- Ocular itching
- Ocular discharge
- Nausea
- Alopecia (hair loss)
Generic name
Levobunolol hydrochloride
Concentration
0.25%, 0.5%
Mechanism of action
This beta blocker reduces the aqueous humor production and changing blood flow in the eye, thus lowering the pressure.
Indications
Treatment of open angle glaucoma or ocular hypertension
Dosage
Instill 1 or 2 drops of the 0.5% solution in the eye(s) once per day or 1 or 2 drops of the 0.25% solution twice per day. In severe glaucoma, put 1 or 2 drops of the 0.5% solution in the eye(s) twice per day. Consult your doctor for the correct dosage.
Use with caution in patients with/during:
- Levobunolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
- Hyperthyroidism because it may mask tachycardia
- Diabetes mellitis because it can mask symptoms of hypoglycemia
- Asthma or pulmonary disease (COPD, emphysema, bronchitis)
- Sulfite hypersensitivity
- Myasthenia gravis
- Pregnancy, breastfeeding, or in children
Common side effects
- Pulse under 50 beats/minute
- Transient stinging or burning on instillation
- Hypotension
Life-threatening symptoms
- Arrhythmias (irregular heart rhythm)
- Cardiac arrest
- Cerebrovascular accident (stroke)
- Congestive heart failure (severe shortness of breath, rapid heartbeat)
- Heart block
Less common to rare side effects
- Dizziness
- Transient ataxia (temporary loss of coordination)
- Difficulty breathing
- Urticaria (an itching attack, may be due to drug sensitivity)
- Rash
- Pruritus (itching)
- Lethargy (state of unconsciousness)
- Asthenia (weakness)
- Dry, burning eyes
- Chest pain
- Headache
Side effects of levobunolol are usually mild and temporary. They seem to subside the longer the drug is used.
Generic name
Timolol hemihydrate
Concentration
0.25%, 0.5%
Mechanism of action
This beta blocker reduces the aqueous humor production and and increasing drainage, thus lowering the pressure.
Indications
Treatment of open angle glaucoma, ocular hypertension, aphakic glaucoma, and other various secondary glaucomas
Dosage
Instill 1 drop of the 0.25% solution into eye every 12 hours twice every day. Increase to 0.5% solution if needed. Decrease to 1 drop every day if condition is controlled. Consult your doctor for the correct dosage.
Use with caution in patients with/during:
- Timolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
- Asthma or pulmonary disease (COPD, emphysema, bronchitis)
- Diabetes mellitis because it can mask symptoms of hypoglycemia
- Hyperthyroidism because it may mask tachycardia
- Using an oral beta blocker
- Kidney or liver impairments
- Raynaud’s disease or peripheral vascular disease
- Myasthenia gravis
- Psoriasis
- Pregnancy, breastfeeding, or in children
Common side effects
- Temporary burning or stinging of eyes
Life-threatening symptoms
- None expected unless there is substantial systemic absorption
Less common to rare side effects
- Skin rash or itching
- Blepharitis (inflammation of the eyelids)
- Conjunctivitis (inflammation of the conjunctiva)
- Keratitis (inflammation of the cornea of the eye)
- Droopy upper eyelid
- Double vision
- Blurred vision
Generic name
Betaxolol hydrochloride
Concentration
0.25%
Mechanism of action
This a beta-1 selective beta blocker that reduces the aqueous humor production, increases drainage, and alters the blood flow of the eye, thus lowering the pressure.
Indications
Treatment of open angle glaucoma and ocular hypertension
Dosage
Instill 1 drop of the 0.25% solution into eye every 12 hours twice every day. Increase to 0.5% solution if needed. Decrease to 1 drop every day if condition is controlled. Consult your doctor for the correct dosage.
Use with caution in patients with/during:
- Betaxolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
- Asthma or pulmonary disease (COPD, emphysema, bronchitis)
- Diabetes mellitis because it can mask symptoms of hypoglycemia
- Hyperthyroidism because it may mask tachycardia
- Using an oral beta blocker
- Kidney or liver impairments
- Raynaud's disease or peripheral vascular disease
- Myasthenia gravis
- Psoriasis
- Pregnancy, breastfeeding, or in children
Common side effects
- None expected
Life-threatening symptoms
- Congestive heart failure (severe shortness of breath, rapid heartbeat)
Less common to rare side effects
- Headache
- Decreased corneal sensitivity
- Cold extremities
- Eyes sensitive to light
- Dry, burning eyes
- Edema (excessive accumulation of fluids in cells or tissues)
- Palpitations (irregular pulsation of the heart)
- Fast heartbeat
- Stinging and discomfort
- Fatigue
- Tearing
Generic name
Dorzolamide hydrochloride and timolol maleate
Concentration
Cosopt® is a combination drug of 2% Trusopt® and 0.5% timolol.
Mechanism of action
This is a combination drug with a carbonic anhydrase inhibitor (dorzolamide) and a beta blocker (timolol). Dorzolamide helps reduce pressure within the eye (intraocular pressure) by decreasing fluid (aqueous humor) production. Timolol lowers intraocular pressure by decreasing aqueous humor production and increasing drainage.
Indications
Treatment of open angle glaucoma and ocular hypertension
Dosage
Instill one drop of Cosopt ophthalmic solution into the affected eye(s) two times daily.
Use with caution in patients with/during:
- Timolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
- Asthma or pulmonary disease (COPD, emphysema, bronchitis)
- Diabetes mellitis because it can mask symptoms of hypoglycemia
- Hyperthyroidism because it may mask tachycardia
- Using an oral beta blocker
- Renal impairment or severe renal disease (with a creatinine clearance less than 30 milliliters per minute)
- Hepatic disease
- Raynaud’s disease or peripheral vascular disease
- Myasthenia gravis
- Sulfonamide hypersensitivity
- Psoriasis
- Pregnancy, breastfeeding, or in children
Common side effects
- Eye itching
- Taste changes
- Ocular burning and/or stinging
- Blurred vision
Life-threatening symptoms
- Chest pain
- Angioedema (swelling of the lips, eyes, or tongue)
- Difficulty breathing
Less common to rare side effects
- Dizziness
- Nausea
- Stomach or back pain
- Upper respiratory infection
- Cloudy vision
- Headache
- Eyelid edema (swelling of the eyelids due to fluid accumulation)
- Conjunctivitis (inflammation of the conjunctiva)
- Hypertension (high blood pressure)
- Dry eyes
- Cough
- Conjunctival edema (swelling of the conjunctiva due to fluid accumulation)
- Corneal erosion or staining
- Upset stomach
- Eye pain, tearing, or discharge
- Increased bleeding
Dorzolamide is a sulfonamide andmay cause a severe allergic reaction in patients with a sulfa drug allergy.
Generic name
Acetazolamide
Concentration
125 mg, 250 mg, 500 mg (sustained release)
Mechanism of action
This is a carbonic anhydrase inhibitor that helps reduce pressure within the eye (intraocular pressure) by decreasing fluid (aqueous humor) production.
Indications
Treatment of open angle glaucoma, secondary glaucoma, and acute angle-closure glaucoma
Dosage
Take by mouth one 125 mg or 250 mg capsule, 1 to 4 times per day, as directed by your doctor. For the 500 mg Diamox Sequels, take one capsule by mouth twice per day.
Use with caution in patients with/during:
- Asthma or chronic pulmonary disease (COPD, emphysema, bronchitis, respiratory acidosis)
- Diabetes mellitis because it can increase blood glucose levels
- Renal or liver impairment
- Gout
- Taking high doses of aspirin
- Sulfonamide hypersensitivity
- Underactive adrenal glands
- Low potassium or sodium levels
- Pregnancy, breastfeeding, or in children
Common side effects
- Loss of appetite
- Metallic taste
- Diarrhea
- Weakness
- Tingling sensation in hands or feet or mouth area
- Hearing disturbance
- Ringing in the ears
Life-threatening symptoms
- Convulsions
- Shortness of breath or difficulty breathing
- Unusual bleeding
- Severe skin rash or eruptions
- Jaundice (yellowing of the skin or eyes)
Less common to rare side effects
- Bone marrow suppression
- Jaundice (shows up as yellowish eyes or skin) with prolonged use
- Mood changes
- Depression
- Blood dyscrasias (abnormal synthesis of different components of the blood)
- Confusion
- Blood in urine; discolored urine
- Drowsiness
- Easy bleeding or bruising
- Lower back pain
- Numbness, tingling, or burning feeling in the mouth, tongue, or lips
Notes
Acetazolamide is a sulfonamide and may cause a severe allergic reaction in patients with a sulfa drug allergy.
Generic name
Apraclonidine hydrochloride
Concentration
0.5%, 1.0%
Mechanism of action
This selective alpha-2 adrenergic agonist reduces the aqueous humor production and thus decreases intraocular pressures.
Indications
Treatment of open angle glaucoma or ocular hypertension
Dosage
Instill 1 to 2 drops of apraclonidine ophthalmic solution into the affected eye(s) three times daily, 8 hours apart. Consult your doctor for dosing.
Use with caution in patients with/during:
- Severe cardiac disease, cerebrovascular disease, or coronary artery disease
- Renal impairment or damage or hepatic disease
- Pregnancy, breastfeeding, or in children
Common side effects
- Tearing
- Eye discomfort
- Red eyes
- Foreign body sensation in eye
- Eyelid swelling
- Dry mouth
- Burning and itching eyes
Generic name
Bimatoprost
Concentration
0.03%
Mechanism of action
This prostaglandin analog enhances aqueous humor outflow through the trabecular meshwork and uveoscleral routes, thus lowering the pressure in the eye.
Indications
Treatment of open angle glaucoma or ocular hypertension
Dosage
Instill one drop of bimatoprost ophthalmic solution into the affected eye(s) once daily—preferably in the evening.
Use with caution in patients during:
- Renal or hepatic impairment
- Aphakic patients, pseudophakic patients with torn posterior lens capsule, and patients with known risk factors for macular edema
- Ocular inflammation (e.g., uveitis)
- Pregnancy or breastfeeding
Side effects
- Conjunctival hyperemia
- Eyelash growth and darkening
- Ocular itching or dryness
- Visual disturbance
- Foreign body sensation
- Increased ocular pigmentation
- Blepharitis
- Cataract
- Superficial keratitis
- Photophobia
- Allergic conjunctivitis
- Headache
- Abnormal liver function test
- Asthenopia
- Hirsutism
- Eyelid erythema
- Ocular irritation
- Eye discharge
- Tearing
- Increased iris pigmentation
- Conjunctival edema
Generic name
Carteolol hydrochloride
Concentration
1%
Mechanism of action
This beta blocker reduces the aqueous humor production and increases drainage, thus lowering the pressure.
Indications
Treatment of open angle glaucoma, ocular hypertension, aphakic glaucoma, and other various secondary glaucomas
Dosage
Instill 1 drop of carteolol solution into eye every 12 hours or twice every day.
Use with caution in patients with/during:
- Carteolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
- Asthma or pulmonary disease (COPD, emphysema, bronchitis)
- Diabetes mellitis because it can mask symptoms of hypoglycemia
- Hyperthyroidism because it may mask tachycardia
- Using an oral beta blocker
- Kidney or liver impairments
- Raynaud’s disease or peripheral vascular disease
- Myasthenia gravis
- Psoriasis
- Pregnancy, breastfeeding, or in children
Common side effects
- Dry mouth, eyes, and skin
- Slight stinging and discomfort upon instillation
- Life threatening symptoms
- Cardiac arrhythmias
- Congestive heart failure
Less common to rare side effects
- Dry, burning eyes
- Reduced alertness
- Visual disturbances
- Headache
- Depression
- Nausea
- Bronchospasm
- Fainting
Generic name
Metipranololetaxolol hydrochloride
Concentration
0.3%
Mechanism of action
This beta blocker reduces the aqueous humor production, increases drainage, and alters the blood flow of the eye—thus lowering the pressure.
Indications
Treatment of open angle glaucoma and ocular hypertension
Dosage
Instill 1 drop of the solution into eye every 12 hours or twice a day.
Use with caution in patients with/during:
- Metipranolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
- Asthma or pulmonary disease (COPD, emphysema, bronchitis)
- Diabetes mellitis because it can mask symptoms of hypoglycemia
- Hyperthyroidism because it may mask tachycardia
- Using an oral beta blocker
- Kidney or liver impairments
- Raynaud’s disease or peripheral vascular disease
- Myasthenia gravis
- Psoriasis
- Pregnancy, breastfeeding, or in children
- Common side effects
- Stinging or irritation of eye when medicine applied
- Redness of eye or inside of eyelid
- Decreased night vision
- Blurred vision
Less common to rare side effects
- Crusty eyelids
- Changes in vision
- Headache
Generic name
Timolol maleate
Concentration
0.25%, 0.5%
Mechanism of action
This beta blocker reduces the aqueous humor production and and increasing drainage, thus lowering the pressure.
Indications
Treatment of open angle glaucoma, ocular hypertension, aphakic glaucoma, and other various secondary glaucomas.
Dosage
Instill 1 drop of the 0.25% solution into eye every 12 hours twice every day. Increase to 0.5% solution if needed. Decrease to 1 drop every day if condition is controlled. Consult your doctor for the correct dosage.
Use with caution in patients with/during:
- Timolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
- Asthma or pulmonary disease (COPD, emphysema, bronchitis)
- Diabetes mellitis because it can mask symptoms of hypoglycemia
- Hyperthyroidism because it may mask tachycardia
- Using an oral beta blocker
- Kidney or liver impairments
- Raynaud’s disease or peripheral vascular disease
- Myasthenia gravis
- Psoriasis
- Pregnancy, breastfeeding, or in children
Common side effects
- Temporary burning or stinging of eyes
Less common to rare side effects
- Blepharitis (inflammation of the eyelids)
- Conjunctivitis (inflammation of the conjunctiva)
- Keratitis (inflammation of the cornea of the eye)
- Droopy upper eyelid
- Double vision
- Blurred vision
- Skin rash or itching
Generic name
Travoprost
Concentration
0.004%
Mechanism of action
This prostaglandin analog enhances aqueous humor outflow, thus lowering the pressure in the eye.
Indications
Treatment of open angle glaucoma or ocular hypertension
Dosage
Instill one drop of travoprost ophthalmic solution into the affected eye(s) once daily—preferably in the evening (should not exceed once daily).
Use with caution in patients with/during:
- Renal or hepatic impairment
- Aphakic patients, pseudophakic patients with torn posterior lens capsule, and patients with known risk factors for macular edema
- Ocular inflammation (e.g., iritis, uveitis)
- Pregnancy or breastfeeding
Side effects
- Increased pigmentation of the iris and periorbital tissue (eyelid) and increased pigmentation and growth of eyelashes (most common)
- Conjunctival hyperemia
- Ocular itching or dryness
- Visual disturbance
- Foreign body sensation
- Increased ocular pigmentation
- Blepharitis
- Cataract
- Keratitis
- Photophobia
- Infection
- Headache
- Abnormal liver function test
- Agnia
- Hirsutism
Generic name
Dorzolamide hydrochloride
Concentration
2%
Mechanism of action
Treatment of open angle glaucoma or ocular hypertension
Indications
This carbonic anhydrase inhibitor reduces the aqueous humor production, thus lowering the pressure in the eye.
Dosage
Instill 1 drop of dorzolamide ophthalmic solution into the affected eye(s) three times daily, 8 hours apart.
Use with caution in patients with/during:
- Renal impairment or severe renal disease (with a creatinine clearance less than 30 milliliters per minute)
- Hepatic disease
- Sulfonamide hypersensitivity
- Acute closed angle glaucoma
- Pregnancy, breastfeeding, or in children
Common side effects
- Allergic eye reaction (eye itchiness, redness, or swelling)
- Bitter taste
- Stinging or burning on application
- Sensation of something in the eye
- Light sensitivity
Life-threatening symptoms
- Allergic reactions in patients who are also allergic to sulfonamides
Less common to rare side effects
- Unusual fatigue
- Blurred vision
- Dry eyes
- Tearing
- Nausea
- Skin rash
Generic name
Latanaprost
Concentration
0.005%
Mechanism of action
This prostaglandin analog enhances aqueous humor outflow, thus lowering the pressure in the eye.
Indications
Treatment of open angle glaucoma or ocular hypertension
Dosage
Instill 1 drop of latanaprost ophthalmic solution into the affected eye(s) once daily, preferably in the evening.
Use with caution in patients with/during:
- Aphakic patients, pseudophakic patients with a torn posterior lens capsule, and patients with known risk factors for macular edema
Iritis - Renal or hepatic impairment
- Closed angle glaucoma, neovascular glaucoma, or inflammatory glaucoma
- Pregnancy, breastfeeding, or in children
Common side effects
- Foreign body sensation
- Blurred vision
- Punctate epithelial keratopathy (a disease of the cornea)
- Increased pigmentation of the iris
- Itching
- Conjunctival hyperemia (increased amount of blood in the conjunctiva)
- Burning
- Stinging
Less common to rare side effects
- Lid erythema (redness of the eyelids due to blood vessel dilation)
- Chest pain
- Conjunctivitis (inflammation of the conjunctiva)
- Vitreous hemorrhage from diabetic retinopathy (bleeding in the posterior chamber of the eye to a degenerative disease of the retina caused by diabetes)
- Diplopia (double vision)
- Discharge from the eye
- Dry eye
- Excessive tearing
- Eye pain
- Lid pain
- Lid edema (swelling of the eyelids due to fluid accumulation)
- Change in eye color or eyelashes
- Upper respiratory tract infection
- Retinal detachment (the separation between the sensory retina and the retinal pigment epithelium)
- Muscle pain
- Photophobia (sensitivity to light)
- Rash
- Retinal artery embolus (a plug or blockade in the retinal artery)
- Lid crusting
Notes
This medication should be refrigerated.