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Indications and Dosage
Ophthalmic
Ocular hypertension, Open-angle glaucoma, Pseudoexfoliation glaucoma Adult: As monotherapy in patients unresponsive to β-blockers or in whom β-blockers are contraindicated: As 2% eye drop solution: Instil 1 drop into the conjunctival sac of affected eye(s) tid. As an adjunct to β-blockers: As 2% eye drop solution: Instil 1 drop into the conjunctival sac of the affected eye(s) bid.
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Renal Impairment
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Contraindications
Hyperchloraemic acidosis. Severe renal impairment.
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Special Precautions
Patient with history of renal calculi, pre-existing chronic corneal defects, history of intraocular surgery, low endothelial cell counts. Hepatic impairment. Pregnancy and lactation.
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Adverse Reactions
Significant: Bacterial keratitis; local ocular effects, conjunctivitis, lid reactions (chronic administration); choroidal detachment (after filtration procedures); corneal oedema. Rarely, urolithiasis.
Eye disorders: Burning sensation, stinging of eyes, blurred vision, eye itching, superficial punctate keratitis, tearing. Gastrointestinal disorders: Bitter taste, nausea. General disorders and administration site conditions: Fatigue, asthenia. Nervous system disorders: Headache. Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis; blood dyscrasias (e.g. agranulocytosis, aplastic anaemia). |
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Ophth: C
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Patient Counseling Information
This drug may cause dizziness or visual disturbances, if affected, do not drive or operate machinery. Remove contact lenses before administration and reinsert them after at least 15 minutes.
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Monitoring Parameters
Perform ophthalmic exams (e.g. optic nerve and visual field assessment). Obtain serial measurement of IOP.
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Overdosage
Symptoms: Nausea, dizziness, headache, fatigue, dysphagia, abnormal dreams; electrolyte imbalance, acidotic state. Management: Symptomatic and supportive treatment. Monitor electrolyte levels (especially K) and blood pH levels.
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Drug Interactions
May have an additive effect with oral carbonic anhydrase inhibitors. May increase the risk of acid-base and electrolyte disturbances with high-dose salicylate therapy.
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Action
Description:
Mechanism of Action: Dorzolamide is a carbonic anhydrase inhibitor. It reversibly inhibits carbonic anhydrase II and IV found in the ciliary epithelium. This results in the decrease of hydrogen ion secretion at the renal tubule and an increase in the renal excretion of Na, K, bicarbonate, and water leading to the reduction of aqueous humour production, thus decreasing intraocular pressure (IOP). Duration: 8-12 hours. Pharmacokinetics: Absorption: Systemically absorbed after topical application. Distribution: Accumulates in RBCs (chronic dosing). Plasma protein binding: Approx 33%. Metabolism: Metabolised into a single N-desethyl metabolite (less active than parent drug). Excretion: Via urine (as unchanged drug and metabolite). |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 5284549, Dorzolamide. https://pubchem.ncbi.nlm.nih.gov/compound/Dorzolamide. Accessed Oct. 24, 2023. |
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Storage
Store below 30°C. Protect from light.
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MIMS Class
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ATC Classification
S01EC03 - dorzolamide ; Belongs to the class of carbonic anhydrase inhibitors. Used in the treatment of glaucoma.
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References
Anon. Dorzolamide. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 06/03/2023. Anon. Dorzolamide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 17/10/2023. Buckingham R (ed). Dorzolamide Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 17/10/2023. Dorzolamide 20 mg/mL Eye Drops, Solution (Aspire Pharma Ltd). MHRA. https://products.mhra.gov.uk. Accessed 17/10/2023. Dorzolamide Hydrochloride Solution/Drops (Bausch & Lomb Incorporated). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 17/10/2023. Joint Formulary Committee. Dorzolamide. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/03/2023. Pharmaco (N.Z.) Ltd. Trusopt 2% Ophthalmic Solution data sheet 05 May 2017. Medsafe. http://www.medsafe.govt.nz. Accessed 06/03/2023. Trusopt Ophthalmic Solution (Santen Pharma Malaysia Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 06/03/2023.
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