dorzolamide hydrochloride: clinical use

Prescribing considerations

• Confirm the glaucoma subtype; acute angle-closure glaucoma requires additional urgent interventions.
• Review renal and hepatic function, previous renal calculi, corneal disease, intraocular surgery and filtration procedures.
• Systemic absorption can produce sulfonamide-type hypersensitivity reactions.
• Use in very young infants with renal tubular immaturity requires particular risk–benefit consideration because metabolic acidosis has been reported.
• Check application technique and adherence before concluding that pressure control is inadequate.

Contraindications and cautions

• Hypersensitivity to dorzolamide or an excipient
• Severe renal impairment
• Hyperchloraemic acidosis
• For this bottle, previous contact hypersensitivity to silver

Monitoring

• Intraocular pressure and the clinical course of glaucoma or ocular hypertension
• New conjunctivitis, eyelid reactions or systemic hypersensitivity
• Corneal status in patients with chronic corneal defects or previous intraocular surgery
• Features of metabolic acidosis in susceptible infants
• Renal-stone symptoms in patients with a relevant history

Clinical pharmacology

Dorzolamide selectively inhibits carbonic anhydrase II, reducing aqueous-humour secretion. After ocular administration it enters the systemic circulation, accumulates in red blood cells through carbonic-anhydrase binding, forms an N-desethyl metabolite and is eliminated mainly in urine.

Formulation and product differences

• The selected Eydelto presentation is a clear, slightly viscous, preservative-free sterile solution in a multidose bottle.
• Its container may release traces of silver, making it unsuitable for patients with contact hypersensitivity to silver.
• Bottle technique differs from conventional droppers and includes first-use practice and a downward shake after application.
• The opened bottle has a 28-day in-use period.

Eye drops

Route: Ophthalmic

Strengths: 20 mg/mL