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  • Antibiotics

    • Topicals

      • 8

        Fluoroquinolones

        • Besivance

          Besifloxacin 0.6%

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            1 year
          • Supplied:
            5 mL bottle
          • Conj. / Prophylaxis Dosing:
            TID (viscous - DuraSite)
          • Ulcer Dosing:
            off label, q1-2h after loading

        • Vigamox

          Moxifloxacin 0.5%

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            1 year
          • Supplied:
            3 mL
          • Conj. / Prophylaxis Dosing:
            TID x7 days
          • Ulcer Dosing:
            off label, q1-2h after loading
          • Pregnancy Category:
            Cat C

        • Moxeza

          Moxifloxacin 0.5% (xanthan gum)

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            4 months
          • Supplied:
            3 mL
          • Conj. / Prophylaxis Dosing:
            BID (viscous - xanthan gum)
          • Ulcer Dosing:
            off label, q1-2h after loading

        • Zymaxid

          Gatifloxacin 0.5%

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            1 year
          • Supplied:
            2.5 mL
          • Conj. / Prophylaxis Dosing:
            Q2h x day 1 then BID-QID
          • Ulcer Dosing:
            off label, q1-2h after loading
          • Pregnancy Category:
            Cat C

        • Ciloxan

          Ciprofloxacin 0.3%

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            1 year soln, 2 years ointment
          • Supplied:
            5, 10 mL soln / 3.5 g ointment
          • Conj. / Prophylaxis Dosing:
            QID
          • Ulcer Dosing:
            Two drops Q15 mins x 6 hours then Q30 mins x 18 hours
          • Pregnancy Category:
            Cat C

        • Iquix

          Levofloxacin 1.5%

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            6 years
          • Supplied:
            5 mL
          • Conj. / Prophylaxis Dosing:
            QID
          • Ulcer Dosing:
            Q30 mins x 2days during waking hours, twice at night

        • Quixin

          Levofloxacin 0.5%

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            1 year
          • Supplied:
            5 mL
          • Conj. / Prophylaxis Dosing:
            QID
          • Ulcer Dosing:
            N/R

        • Ocuflox

          Ofloxacin 0.3%

          • antibiotics topicals fluoroquinolones
          • Pediatric Use:
            1 year
          • Supplied:
            5 & 10 mL
          • Conj. / Prophylaxis Dosing:
            QID
          • Ulcer Dosing:
            Q30 mins x 2days during waking hours, twice at night
      • 2

        Aminoglycosides

        • Tobrex

          Tobramycin 0.3%

          • antibiotics topicals aminoglycosides
          • Pediatric Use:
            2 months
          • Supplied:
            5 mL and 3.5 g ung
          • Conj. / Prophylaxis Dosing:
            QID for drops; BID-QID for ointment
          • Ulcer Dosing:
            Only if fortified
          • Pregnancy Category:
            Cat B

        • Genoptic

          Gentamicin 0.3%

          • antibiotics topicals aminoglycosides
          • Pediatric Use:
            N/A (no lower age established)
          • Supplied:
            5 mL and 3.5 g ung
          • Conj. / Prophylaxis Dosing:
            QID for drops; BID-QID for ointment
          • Ulcer Dosing:
            N/R
          • Pregnancy Category:
            Cat C

      • Combination Antibiotics

        • 3

          Combination Topical Antibiotics

          • Polytrim

            Polymixin B / trimethoprim

            • antibiotics topicals combination topical antibiotics
            • Pediatric Use:
              2 months
            • Supplied:
              10 mL soln
            • Conj. / Prophylaxis Dosing:
              Q 3 hours x 7 days
            • Ulcer Dosing:
              N/R
            • Pregnancy Category:
              Cat C

          • Polysporin

            Polymixin B / Bacitracin

            • antibiotics topicals combination topical antibiotics
            • Pediatric Use:
              N/A
            • Supplied:
              3.5 g ointment
            • Conj. / Prophylaxis Dosing:
              Varies
            • Ulcer Dosing:
              N/R

          • Neosporin

            Polymixin B / Neomycin / Gramicidin

            • antibiotics topicals combination topical antibiotics
            • Pediatric Use:
              N/A
            • Supplied:
              10 mL soln / 3.5 g ointment
            • Conj. / Prophylaxis Dosing:
              Varies
            • Ulcer Dosing:
              N/R
        • 9

          Topical Antibiotic/Steroid Combination

          • Tobradex and available generic

            Tobramycin 0.3% and dexamethasone 0.1%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              5 mL suspension / 3.5 g tube
            • General Purpose Dosing:
              Generally QID for solutions
            • Pregnancy Category:
              Cat C

          • Zylet

            Tobramycin 0.3% and loteprednol 0.5%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              5 & 10 mL suspension
            • General Purpose Dosing:
              Generally QID for solutions

          • Blephamide

            Sodium sulfacetamide 10% and pred acetate 0.2%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              5 & 10 mL suspension / 3.5 g tube ointment
            • General Purpose Dosing:
              Generally QID for solutions

          • Cortisporin

            Neomycin 0.35%, polymixin B 10,000 u/mL, and hydrocortisone 1%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              7.5 mL suspension, 3.5 g tube
            • General Purpose Dosing:
              Generally QID for solutions

          • FML-S

            Sodium sulfacetamide 10% and fluorometholone 0.1%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              5 mL suspension, 3.5 g tube
            • General Purpose Dosing:
              Generally QID for solutions

          • Maxitrol

            Neomycin 0.35%, polymixin B 10,000 u/mL, and dexamethasone 0.1%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              5 mL suspension, 3.5 g tube
            • General Purpose Dosing:
              Generally QID for solutions
            • Pregnancy Category:
              Cat C

          • Poly-Pred

            Neomycin 0.35%, polymixin B 10,000 u/mL, and pred acetate 1%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              5 & 10 mL suspension
            • General Purpose Dosing:
              Generally QID for solutions

          • Pred-G

            Gentamicin 0.3% and pred acetate 1%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              10 mL suspension / 3.5 g tube
            • General Purpose Dosing:
              Generally QID for solutions

          • Tobradex ST

            Tobramycin 0.3% and dexamethasone 0.05%

            • antibiotics topicals Topical Antibiotic/Steroid Combination
            • Supplied:
              2.5 mL, 5 mL, 10 mL suspension
            • General Purpose Dosing:
              Generally QID for solutions
      • 3

        Other

        • AzaSite

          Azithromycin 1%

          • antibiotics topicals other
          • Pediatric Use:
            1 year
          • Supplied:
            2.5 mL soln (viscous)
          • Conj. / Prophylaxis Dosing:
            BID x 2 days then QD x 5 days
          • Ulcer Dosing:
            N/R
          • Pregnancy Category:
            Cat B

        • Erythromycin

          Erythromycin 0.5%

          • antibiotics topicals other
          • Pediatric Use:
            2 months
          • Supplied:
            3.5g ointment
          • Conj. / Prophylaxis Dosing:
            Varies
          • Ulcer Dosing:
            N/R
          • Pregnancy Category:
            Cat B

        • Bacitracin

          Bacitracin 500 m/g

          • antibiotics topicals other
          • Pediatric Use:
            N/A
          • Supplied:
            3.5g ointment
          • Conj. / Prophylaxis Dosing:
            Varies
          • Ulcer Dosing:
            N/R
          • Pregnancy Category:
            Cat C
    • 5

      Orals

      • Vibramycin

        Doxycycline

        • antibiotics orals
        • Uses:
          (1) antibiotic; (2) anti-seborrheic; (3) anti-collagenase
        • Dosing and Supply:
          (1) 100 mg BID x 21 days; (2) 50L100 m g BID or QD for long term (3) 50L100 mg QD
        • Contraindications / Side Effects:
          Not used in children under 8 (some say avoid under age 10) or in pregnant women—category D; interferes with blood clotting (Coumadin); increases photosensitivity; diarrhea common; intracranial HTN risk
        • Other Pearls:
          Not effective against most strains of Strep; reduces MMPs & proLinflammatory IL; not affected by food or dairy (unlike other tetracyclines)

      • Dicloxacillin

        Dicloxacillin

        • antibiotics orals
        • Uses:
          Infectious lid disease, esp when caused by gram +
        • Dosing and Supply:
          Adult: 250 mg QID
          Kid > 40kg: 125 mg QID
          Kid < 40 kg: 3.15 - 6.25 mg/kg QID
        • Contraindications / Side Effects:
          Type 1 hypersensitivity - itching, swelling, anaphylaxis
          Type 2 - hemolytic anemia
          Type 3 - intestinal nephritis, vasculitis, serum sickness
          Type 4 - Steven's Johnson, contact dermatitis
          Alters normal flora causing nausea, vomiting, diarrhea (pseudomembraneous colitis)
          Renders birth control ineffective
        • Other Pearls:
          Penicillin family; 10% allergy prevalence; Gram + coverage; may cross react w/ cephalosporins

      • Augmentin

        Amoxicillin + Clavulanate

        • antibiotics orals
        • Uses:
          Pediatric infectious disease
        • Dosing and Supply:
          200, 250, 400 chewable; suspension; 250-500, 875 amox + 125 clav. Adult dosing 250 mg TID or 500 or 875 BID
        • Contraindications / Side Effects:
          Type 1 hypersensitivity - itching, swelling, anaphylaxis
          Type 2 - hemolytic anemia
          Type 3 - intestinal nephritis, vasculitis, serum sickness
          Type 4 - Steven's Johnson, contact dermatitis
          Alters normal flora causing nausea, vomiting, diarrhea (pseudomembraneous colitis)
          Renders birth control ineffective
        • Other Pearls:
          Contains penicillin; Clavulanate is B-lactamase inhibitor; effective against gram + and H. flu

      • Zithromax

        Azithromycin

        • antibiotics orals
        • Uses:
          General purpose antibiotic, may also be anti-inflammatory; tx of choice for chlamydial disease
        • Dosing and Supply:
          Suspension; "Z pack"=6 x 250 mg tabs; "tri-pack"=3 x 1 g tabs; 250, 500 mg tabs
        • Contraindications / Side Effects:
          GI upset, rash, dizziness. Avoid in heart arrhythmia and blood dyscrasias; use with caution in liver/kidney problems
        • Other Pearls:
          N/A

      • Keflex

        Cephalexin

        • antibiotics orals
        • Uses:
          Preseptal cellulitis, internal hordeolum
        • Dosing and Supply:
          Adults 250 mg QID, children 20-50 mg/kg/day in 3-4 divided doses
        • Contraindications / Side Effects:
          Cross-sensitivity to penicillin allergies so use caution in these patients; diarrhea/GI upset common
        • Other Pearls:
          First generation cephalosporin

  • Antivirals

    • 2

      Topicals

      • Viroptic

        Trifluridine 1%

        • antivirals topicals
        • Pediatric Uses:
          6 years
        • Dosing and Supply:
          7.5 mL soln
        • Conj / Prophylaxis Dosing:
          QID
        • Corneal Dendrite Dosing:
          Q2h up to 9x/day, taper, max 21 days
        • Pregnancy Category:
          Cat C

      • Zirgan

        Ganciclovir gel 0.15%

        • antivirals topicals
        • Pediatric Uses:
          2 years
        • Dosing and Supply:
          5 g tube
        • Conj / Prophylaxis Dosing:
          TID * off label
        • Corneal Dendrite Dosing:
          5x / day
        • Pregnancy Category:
          Cat C
    • 3

      Orals

      • Zovirax

        Acyclovir

        • antivirals orals
        • Uses:
          Herpes simplex and herpes zoster
        • Dosing and Supply:
          Simplex*: 400 mg 5x/day; zoster: 1 g TID x 7 days
        • Contraindications and Side Effects:
          GI upset; use with caution in elderly patients and pts with kidney disorders
        • Other Pearls:
          Relatively inexpensive generic

      • Valtrex

        Valacyclovir

        • antivirals orals
        • Uses:
          Herpes simplex and herpes zoster
        • Dosing and Supply:
          Simplex*: 1 g BID x 7 days; zoster: 1 g TID x 7 days
        • Contraindications and Side Effects:
          GI upset; use with caution in elderly patients and pts with kidney disorders
        • Other Pearls:
          Available generic but more expensive than generic acyclovir

      • Famvir

        Famciclovir

        • antivirals orals
        • Uses:
          Herpes simplex and herpes zoster
        • Dosing and Supply:
          Simplex*: not established; zoster: 500 mg TID x 7 days
        • Contraindications and Side Effects:
          GI upset; use with caution in elderly patients and pts with kidney disorders
        • Other Pearls:
          Available generic but more expensive than generic acyclovir
  • Antihistamines/Anti-Inflammatory/Analgesics

    • Topicals

      • 2

        H1 Antihistamines

        • Emadine

          Emedastine 0.05%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals H1
          • Pediatric Use:
            3 years
          • Supplied:
            5 mL bottle
          • Dosing:
            QID

        • Avil

          Pheniramine Maleate

          • Antihistamines/Anti-Inflammatory/Analgesics topicals H1
          • Use:
            Ingredient in Visine A
      • 4

        Mast Cell Stabilizers

        • Crolom

          Cromolyn Sodium 4%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals mast cell stabilizers
          • Pediatric Use:
            4 years
          • Supplied:
            10 mL bottle
          • Dosing:
            QID

        • Alomide

          Lodoxamide 0.1%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals mast cell stabilizers
          • Pediatric Use:
            2 years
          • Supplied:
            10 mL
          • Dosing:
            QID

        • Alamast

          Pemirolast 0.1%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals mast cell stabilizers
          • Pediatric Use:
            3 years
          • Supplied:
            10 mL
          • Dosing:
            QID

        • Alocril

          Nedocromil 2%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals mast cell stabilizers
          • Pediatric Use:
            3 years
          • Supplied:
            5 mL
          • Dosing:
            BID
      • 8

        Combination

        • Lastacaft

          Alcaftadine 0.25%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            2 years
          • Supplied:
            3 mL
          • Dosing:
            QD
          • Pregnancy Category:
            Cat B

        • Optivar

          Azelastine 0.05%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            3 years
          • Supplied:
            6 mL
          • Dosing:
            BID

        • Bepreve

          Bepotastine 1.5%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            2 years
          • Supplied:
            5, 10 mL
          • Dosing:
            BID

        • Elestat

          Epinastine 0.05%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            3 years
          • Supplied:
            5 mL
          • Dosing:
            BID

        • Zaditor

          Ketotifen 0.025%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            3 years
          • Supplied:
            5 mL
          • Dosing:
            BID; OTC
          • Pregnancy Category:
            Cat C

        • Patanol

          Olopatadine 0.1%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            3 years
          • Supplied:
            5 mL
          • Dosing:
            BID

        • Pataday

          Olopatadine 0.2%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            3 years
          • Supplied:
            2.5 mL
          • Dosing:
            QD
          • Pregnancy Category:
            Cat C

        • Pazeo

          Olopatadine 0.7%

          • Antihistamines/Anti-Inflammatory/Analgesics topicals combination
          • Pediatric Use:
            2 years
          • Supplied:
            2.5 mL
          • Dosing:
            QD
          • Pregnancy Category:
            Cat C
    • 5

      Orals

      • Zyrtec

        Cetirizine HCl

        • Antihistamines/Anti-Inflammatory/Analgesics orals
        • Uses:
          Allergy related symptoms
        • Dosing and Supply:
          5 mg and 10 mg / Adults 10 mg QD
        • Contraindications and Side Effects:
          Drowsiness; dry mouth; tiredness; sleep disturbances; dry eye
        • Other Pearls:
          N/A

      • Prednisone

        Prednisone

        • Antihistamines/Anti-Inflammatory/Analgesics orals
        • Uses:
          Inflammation not responsive to non-pharm or nonsteroidal therapy
        • Dosing and Supply:
          Ranges from 5 - 100 mg/day depending on severity of disease
        • Contraindications and Side Effects:
          Psychosis; GI ulcers; diabetes; HTN; immunosuppression; chronic renal failure; systemic infection; others - consult reliable reference
        • Other Pearls:
          Requires strict tapering schedule to avoid side effects esp rebound

      • Motrin

        Ibuprofen

        • Antihistamines/Anti-Inflammatory/Analgesics orals
        • Uses:
          Analgesic, anti-pyretic, anti-inflammatory NSAID
        • Dosing and Supply:
          200 - 800 mg caplets; 200 - 400 mg q 4-6 h for antipyretic and analgesia; 600-800 mg q 4-6 h for anti-inflammatory activity
        • Contraindications and Side Effects:
          GI: Gastric ulcer/bleeding. Alert patients to d/c use if GI upset is prolonged or intense. Not recommended in bledding disorders or pts taking Coumadin or similar
        • Other Pearls:
          IBU is available generically or OTC in 200 mg caplets / capsules / gelcaps

      • Tylenol III

        30 mg codeine with 300 mg acetaminophen

        • Antihistamines/Anti-Inflammatory/Analgesics orals
        • Uses:
          Category III scheduled drug (need DEA cetrtification to Rx) for significant pain not otherwise controlled with NSAIDs
        • Dosing and Supply:
          1-2 tabs every 4-6 hours, not to exceed
        • Contraindications and Side Effects:
          Drug dependency or h/o substance abuse; asthma, COPD, liver/kidney dysfunction; can cause nausea, itching/rash, delirium, seizures, cardiotoxicity
        • Other Pearls:
          Several studies show no relative advantage of T-III over 800 mg IBU in pain management. Use only if safer drugs are ineffective

      • Tramadol

        Ultram, others

        • Antihistamines/Anti-Inflammatory/Analgesics orals
        • Uses:
          Non scheduled drug but has risk of dependency due to weak mu-opioid receptor agonist activity
        • Dosing and Supply:
          50-100 mg PO q 4-6 hours PRN; not to exceed 400 mg/day (immediate release, adult dose)
        • Contraindications and Side Effects:
          Drug dependency, allergy or sensitivity to opiates, severe renal/kidney impairment
        • Other Pearls:
          N/A

  • NSAIDs

    • 6

      Topicals

      • Acular LS

        Ketorolac tromethamine 0.4%

        • NSAIDs topicals
        • How Supplied:
          5 mL
        • General Dosing Schedule:
          QID
        • Other Info:
          Pediatric use 3 years
        • Pregnancy Category:
          Cat C

      • Acuvail

        Ketorolac tromethamine 0.45%

        • NSAIDs topicals
        • How Supplied:
          Unit dose
        • General Dosing Schedule:
          BID
        • Other Info:
          N/A (safety and efficacy not established)

      • Ilevro

        Nepafenac 0.3%

        • NSAIDs topicals
        • How Supplied:
          1.7 mL
        • General Dosing Schedule:
          QD
        • Other Info:
          10 years
        • Pregnancy Category:
          Cat C

      • Nevanac

        Nepafenac 0.1%

        • NSAIDs topicals
        • How Supplied:
          3 mL
        • General Dosing Schedule:
          TID
        • Other Info:
          10 years

      • Prolensa

        Bromfenac

        • NSAIDs topicals
        • How Supplied:
          1.6, 3 mL
        • General Dosing Schedule:
          QD
        • Other Info:
          N/A
        • Pregnancy Category:
          Cat C

      • Voltaren

        Diclofenac sodium 0.1%

        • NSAIDs topicals
        • How Supplied:
          2.5, 5 mL
        • General Dosing Schedule:
          QID
        • Other Info:
          N/A

  • Steroids

    • 8

      Topicals

      • Durezol

        Difluprednate 0.05%

        • Steroids topicals
        • How Supplied:
          Emulsion, 5 mL
        • General Dosing Schedule:
          Usually QD - QID
          QID → Uveitis
        • Other Info:
          May cause more rapid and severe IOP spikes
        • Pregnancy Category:
          Cat C

      • Pred Forte

        Prednisone acetate 1%

        • Steroids topicals
        • How Supplied:
          5 - 10 - 15 mL bottle suspension
        • General Dosing Schedule:
          Varies
          Q1H → Uveitis, taper to Q2H to QID over first several days.
          QID → Herpes simplex stromal keratitis
        • Other Info:
          Shake before use! Traditionally 'gold standard' for intraocular inflammation
        • Pregnancy Category:
          Cat C

      • Alrex

        Loteprednol etabonate 0.2%

        • Steroids topicals
        • How Supplied:
          5 - 10 mL
        • General Dosing Schedule:
          Varies, usually BID - QID
        • Other Info:
          N/A

      • Lotemax Gel, Ointment, Suspension

        Loteprednol etabonate 0.5%

        • Steroids topicals
        • How Supplied:
          Drops 5-10-15 mL
          Gel 5g bottle
          Ung 3.5g tube
        • General Dosing Schedule:
          Varies
          QID → Episcleritis/Pingueculitis x 5-7 days
          QID x 2 days, BID x 4 - 8 weeks allergic conjunctivitis
        • Other Info:
          Gel is a 'drop' - don't blink after instillation to allow to 'gel' on surface
          Ung is nonpreserved and ideal for overnight use
        • Pregnancy Category:
          Cat C

      • Inflammase Forte

        Prednisolone sodium phosphate 1%

        • Steroids topicals
        • How Supplied:
          5-10-15 mL
        • General Dosing Schedule:
          Varies
        • Other Info:
          Does not penetrate the cornea as rapidly, best for surface disease

      • Inflammase Mild

        Prednisolone sodium phosphate 0.12%

        • Steroids topicals
        • How Supplied:
          5-10 mL
        • General Dosing Schedule:
          Varies, usually QID or less
        • Other Info:
          Poor penetration

      • FML

        Fluorometholone alcohol 0.1%

        • Steroids topicals
        • How Supplied:
          5-10-15 mL suspension
          3.5g ung
        • General Dosing Schedule:
          Varies
        • Other Info:
          Sometimes used after refractive surgery

      • Pred Mild

        Prednisolone acetate 0.12%

        • Steroids topicals
        • How Supplied:
          5-10 mL
        • General Dosing Schedule:
          Varies, usually QID or less
        • Other Info:
          N/A

  • Glaucoma

    • 4

      Prostaglandins

      • Xalatan

        Latanoprost 0.005%

        • Glaucoma prostaglandins
        • How Supplied:
          2.5 mL
        • Dosing:
          QD HS (once at bedtime)
        • Effective:
          3-5 weeks for full pressire lowering effects
        • Characteristics:
          Mean IOP reduction: 27 - 33.7% (can exceed 50%)

          Only generic PGA

      • Travatan Z

        Travoprost 0.004%

        • Glaucoma prostaglandins
        • How Supplied:
          2.5, 5 mL
        • Dosing:
          QD HS
        • Effective:
          2 weeks for full IOP lowering effect
        • Characteristics:
          Sustained 30% IOP reduction at all times tested

          Preserved w/ Sofzia ⇾ more gentle to ocular surface than BAK

      • Lumigan

        Bimatoprost 0.03% (Latisse) & 0.01%

        • Glaucoma prostaglandins
        • How Supplied:
          2.5, 5, 7.5 mL
        • Dosing:
          QD HS
        • Effective:
          Very fast effects, usually within a few days
        • Characteristics:
          Lumigan 0.01% as efficaceous as Lumigan 0.03% but with lesser hyperemia

          Increased concentration of preservative (BAK) - "roughens up" the epithelium to enhancecorneal penetration

      • Zioptan

        Tafluprost 0.0015%

        • Glaucoma prostaglandins
        • How Supplied:
          Unit dose
        • Dosing:
          QD
        • Effective:
          N/A
        • Characteristics:
          Non preserved

          Niche product, corneal friendly
    • 1

      Miotics

      • Pilocarpine

        • Glaucoma miotics
        • Dosing:
          QID

          Concentrations: 1%, 2%, 4%
        • Effective:
          4 - 8 hours
        • Characteristics:
          Oldest anti-glaucoma medication
    • 3

      Alpha-2 Adrenergic Agonists

      • Propine

        Dipivefrin 0.1%

        • Glaucoma Alpha-2 Adrenergic Agonists
        • Dosing:
          BID
        • Effective:
          Avoid in apakes and pseudophakes due to cystoid macular edema
        • Characteristics:
          Avoided due to weak actions on lowering IOP

          Causes pigment spots in palpebral conj.

      • Apraclonidine 0.5% & 1%

        Iopidine 0.5% & 1%

        • Glaucoma Alpha-2 Adrenergic Agonists
        • Dosing:
          TID
        • Effective:
          Only for short term pressure reduction
        • Characteristics:
          Inhibits release of NE leading to a reduce in sympathetic activity in CB reducing aqueous production

          1% used during laser sx to prevent IOP spike

          0.5% used for POAG management

          Virtually never used in chronic glaucoma therapy

      • Alphagan P & Alphagan 0.2% and 0.15% (generic only)

        Brimonidine tartrate 0.15% & 0.1%

        • Glaucoma Alpha-2 Adrenergic Agonists
        • How Supplied:
          5, 10, 15 mL
        • Dosing:
          TID

          Patients on polytherapy may be able to get away with BID dosing
        • Effective:
          Do not use in smaller patients or children - relative CI
        • Characteristics:
          Alphagan 0.2% ⇾ generic only ⇾ preserved with BAK

          Alphagan P preserved with Purite

          Most significant side effects: drowsiness, fatigue, dry mouth. Can induce fatigue and even coma in children (crosses BBB)

          No lowering effects at night
        • Pregnancy Category:
          Cat B
    • 6

      Beta Blockers

      • Timoptic

        Timolol maleate 0.25% & 0.5%

        • Glaucoma beta blocker beta adrenergic agonist
        • How Supplied:
          5, 10, 15 mL
        • Dosing:
          BID
        • Characteristics:
          Non-selective

          Most popular beta blocker

          Timoptic XE (gel forming solution) designed for QD use

      • Istalol

        Timolol maleate 0.5%

        • Glaucoma beta blocker beta adrenergic agonist
        • How Supplied:
          2.5, 5 mL
        • Dosing:
          QD
        • Characteristics:
          Not generically available

          New and not especially impressive

      • Betimol

        Timolol hemihydrate 0.25% & 0.5%

        • Glaucoma beta blocker beta adrenergic agonist
        • How Supplied:
          5, 10, 15 mL
        • Dosing:
          BID
        • Characteristics:
          N/A

      • Levobunolol 0.25% & 0.5%

        • Glaucoma beta blocker beta adrenergic agonist
        • How Supplied:
          5, 10, 15 mL
        • Dosing:
          BID
        • Characteristics:
          Brand name Betagan no longer available; only available as generic

          Clinically equivalent to Timoptic

      • Betaxolol

        Betoptic S 0.25%

        • Glaucoma beta blocker beta adrenergic agonist
        • How Supplied:
          5, 10, 15 mL
        • Dosing:
          BID
        • Characteristics:
          Beta 1 selective: no pulmonary side effects although may still exacerbate asthma

          Generic

      • Ocupress

        Carteolol 1%

        • Glaucoma beta blocker beta adrenergic agonist
        • Dosing:
          BID
        • Characteristics:
          Intrinsic sympathomimetic activity (ISA) and transient agonist activity

          Least likely to cause bradycardia and bronchospasm

          Generic
    • 4

      Carbonic Anhydrase Inhibitors

      • Acetazolamide

        Diamox

        • Glaucoma Carbonic Anhydrase Inhibitors
        • Description:
          Oral

          1000mg QD po

          Used for short term pressure reduction

      • Methazolamide

        Neptazane

        • Glaucoma Carbonic Anhydrase Inhibitors
        • Description:
          Oral

          25mg BID up to 50mg TID max

          Side effects similar to acetazolamide, but more tolerated

      • Dorzolamide

        Trusopt 2%

        • Glaucoma Carbonic Anhydrase Inhibitors
        • Description:
          Topical

          Stings due to low pH

          TID

          Slightly less effective in dark irides

          Generic
        • How Supplied:
          5, 10 mL

      • Brinzolamide Opthalmic Suspension 1%

        Azopt

        • Glaucoma Carbonic Anhydrase Inhibitors
        • Description:
          Topical

          Closer to physiological pH; less stinging

          TID
        • How Supplied:
          5, 10, 15 mL
    • 2

      Combination agents

      • Cosopt

        Timoptic (Timolol) 0.5% & Trusopt (Dorzolamide) 2%

        • Glaucoma Combination agents
        • How Supplied:
          5, 10 mL
        • Dosing:
          BID
        • Description:
          Topical BB + CAI

          Generic

      • Combigan

        Timoptic (Timolol) 0.5% & Alphagan (Brimonidine) 0.2%

        • Glaucoma Combination agents
        • How Supplied:
          5, 10 mL
        • Dosing:
          BID
        • Description:
          Topical BB + Alpha adrenergic agonist

          Generic and popular

      • Simbrinza

        Azopt (Brinzolamide) 1% & Alphagan (Brimonidine) 0.2%

        • Glaucoma Combination agents
        • How Supplied:
          8 mL
        • Dosing:
          TID
        • Description:
          Alpha adrenergic agonist & CAI

          No beta blocker