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Azopt
Brinzolamide
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Brinzolamide, Timolol
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Azopt (Brinzolamide)

What is Azopt (Brinzolamide)?

Azopt is a prescription medication that consists of a 1% liquid solution of Brinzolamide that comes in either 10mL or 15mL dropper bottle. This means that each mL of solution contains 10mg of the active, generic drug Brinzolamide. This is the only strength available. It is approved by the FDA to treat ocular hypertension and open-angle glaucoma by reducing the pressure inside the eye.

How does it work?

It works by inhibiting carbonic anhydrase, an enzyme that increases secretion by the aqueous humor of the eye. By preventing this enzyme from working, it reduces the amount of fluid produced by the eye and this then reduces the pressure inside the eye. Increased pressure in the eye can cause pain and if left untreated can permanently damage vision.

How to use Azopt

Eye drops can be administered alone or with the help of someone else.

Remove any contact lenses before applying eye drops. A preservative in this medicine can cause staining of soft contact lenses. Any contact lenses can be replaced 15 minutes after administration of medication.

Shake the bottle before use.

  1. Wash your hands and dry thoroughly.
  2. Remove the cap and place in a clean area.
  3. Tilt your head back and gently pull down on the lower lid of the affected eye.
  4. Using your other hand, apply one drop to the space created by pulling down on the lower lid.
  5. Do not touch the eye or the skin with the tip of the dropper. A contaminated dropper could result in an infection of the eye.
  6. Repeat with the other eye if advised to do so by your doctor.
  7. Replace the cap and ensure a tight seal.
  8. Wash your hands again to remove any medication that may have transferred to your hands.

Storage

This medication should be stored at room temperature, between 39°F and 86°F (or between 4°C and 30°C). Keep out of reach of children. Avoid storing in areas that could become damp or wet. Do not ingest this medication orally.

Dosage

The recommended dose is one drop of solution to the affected eye(s), two times daily. Your doctor may prescribe Azopt up to three times per day depending on your situation.

Side Effects

If you experience an allergic reaction,  stop taking the medication immediately and seek medical attention. Signs of a severe allergic reaction can show up in the form of hives, difficulty breathing and/or swelling of the face or throat.

Stop taking the medication immediately and seek medical attention if you experience a skin reaction to this medication. This can include blistering, peeling of the skin, or a rash that covers a large area, spreads quickly or is associated with a fever.

Blurred vision and altered taste are common side effects. These typically affect 5-10% of people using Azopt.

Uncommon side effects, reported in 1-5% of those using Azopt are chest discomfort, cough, diarrhea, dizziness, headache, eye discomfort, dryness, or redness if the eye, nasal or throat discomfort

Rare side effects seen in <1% of people include alopecia, angina, drowsiness, irritability, optic nerve dysfunction, respiratory disorders, blood disorders, and tinnitus.

You may experience side effects other than those listed above. Always check with your doctor if you are concerned.

Warnings and Precautions

It is important to let all of your healthcare providers know all of the medication that you are taking, diagnosed medical conditions and any allergies. Remember to include any over-the-counter medications, vitamins, supplements, herbal medicines, and recreational drugs.

It is advised against using Azopt with patients with hepatic impairment.

Use with caution if patients have renal tubular immaturity or abnormality, due to the risk of metabolic acidosis. This medication should not be used by patients with severe impairment of kidney function. Azopt can lead to systemic sulfonamide-like side effects in very rare cases. This includes lethargy, dizziness, nausea, vomiting, headache, and photosensitivity. Serious skin rashes may also occur such as Steven-Johnson syndrome and toxic epidermal necrolysis. Discontinuation of Azopt may be required if severe side effects occur and consult your physician.

It has not been established if this medication is safe and/or effective when used by children.

Avoid using medication if pregnant since possible side effects are unknown.

Since it is unclear if Azopt is passed through breastmilk, it is best to avoid for breastfeeding mothers.

Interactions

Medications known to interact with Azopt include:

  • Acetazolamide
  • Alpha/Beta-agonists (e.g. epinephrine, norepinephrine)
  • “Azole” antifungals (e.g. itraconazole, ketoconazole, voriconazole)
  • Aspirin
  • Bismuth subsalicylate
  • Boceprovir
  • Choline salicylate
  • Clarithromycin
  • Conivaptan
  • Delavirdine
  • Dichlorphenamide
  • Diflunisal
  • Dorzolamide
  • HIV protease inhibitors (e.g. atazanavir, darunavir, lopinavir, ritonavir)
  • Magnesium salicylate
  • Methazolamide
  • Nelfinavir
  • Telaprevir
  • Salsalate
  • Sodium salicylate
  • Sodium thiosalicylate
  • Topiramate
  • Zonasamide

If you are currently taking any medications mentioned above, consult with your doctor or pharmacist. It may be necessary to stop taking one of the medications; change one of the medications to an alternative; change how or when you take one or both medications, or your healthcare professional may decide it is best to leave all medications as they are.

The list above may not contain all medications known to interact with Azopt. It is important that you inform your doctor of all medications, herbal medications, supplements, over-the-counter medication and recreational drugs that you are taking.

Contraindications

  • Do not use during pregnancy
  • Do not use if you are breastfeeding
  • If you have a known allergy to brinzolamide
  • If you have a known allergy to any drug in the sulfonamides group
  • If you have hyperchloremic acidosis (an increase in the acidity of the blood)
  • If you are taking oral carbonic anhydrase inhibitors – e.g., acetazolamide or methazolamide.
  • Do not use if you have severe kidney disease. This can reduce the ability of the body to process the active ingredient of Azopt.
  • Do not use if you are allergic to any of the listed ingredients in the solution.

Inform your doctor if any of the contraindications mentioned above apply to you.

Frequently Asked Questions

Azopt is a prescribed medication in the form of eye drops. It is used to treat increased pressure in the eye.

Azopt has been shown to be effective in reducing pressure in the eye in clinical studies. One particular study showed a reduction of pressure by 4-5mmHg.

Note: Normal eye pressure is approximately 12-22mmHg.

Azopt is typically prescribed for long-term use to prevent further damage to your eye from increased pressure.

Alternative medications should be discussed with your doctor. Alternative medications to Azopt include:

  • bimatoprost (Lumigan)
  • brimonidine/timolol (Combigan)
  • brinzolamide/brimonidine (Simbrinza)
  • dorzolamide (Trusopt)
  • dorzolamide/timolol (Cosopt)
  • latanoprost (Xalatan)
  • travoprost (Travatan Z)
  • timolol maleate (Timoptic)

Your doctor may prescribe other treatments with Azopt. Other topical treatments for the eye can be used alongside Azopt, but you should leave at least 10 minutes between different eye drops or ointments. This will ensure that you receive the correct amount of each medication and that each medication can work appropriately as intended.

Beta-blockers are a group of drugs that work by slowing the heart rate. They are used to treat heart conditions, high blood pressure and glaucoma. In slowing your heart rate, they reduce the amount of work carried out by your heart and reduce both blood pressure and pressure in your eye. Beta-blocker eye drops can be used to treat increased pressure in the eye however Azopt is not a beta-blocker. Azopt works by inhibiting the action of carbonic anhydrase. It has not been shown to cause any cardiac side effects.

All contact lenses should be removed before the administration of Azopt eye drops. One of the preservatives in the solution can stain soft contact lenses. Contact lenses can be inserted 15 minutes after using Azopt eye drops.

Azopt does not cure glaucoma or ocular hypertension. There is not currently a cure for these conditions. However, Azopt has been proven to be effective at reducing pressure in the eye which will stop your condition from becoming worse.

The effect of Azopt on the developing fetus is unknown. Your doctor will advise whether to use it or not.

It is not known if Azopt passes into breastmilk. Please let your doctor know if you are breastfeeding or donating breastmilk

Azopt eye drops should be used ten minutes before use of any other eye drops that may have been prescribed by your doctor.

Azopt has not been approved as a treatment for children. One study looked at use in children aged between 4 weeks and 5 years and found that it was not an effective treatment for reducing pressure in the eyes of children.

If you miss a dose, use the drops as soon as you remember and continue with the prescribed schedule. If it is almost time for your next scheduled dose, skip the missed dose and continue with the schedule recommended by your doctor. Do not take a double dose if a dose is missed.

It contains Carbomer 974P, edetate disodium, hydrochloric acid and /or sodium hydroxide (to balance the pH), mannitol, purified water, sodium chloride, and tyloxapol. There is also a preservative, Benzalkonium chloride 0.01%. Adjustment of the pH is carried out to 7.5, the pH of natural tears. It is also adjusted to be iso-osmotic to optimize comfort during application.

An overdose of Azopt is not thought to be dangerous. It is advised that you seek immediate medical attention if the medicine is accidentally swallowed.

These eye drops may cause blurred vision and can affect concentration and reaction times. You should avoid driving or any hazardous activity whilst using Azopt until you determine how it will affect you.

Azopt has a long half-life of approximately 111 days in blood. This is due to its extensive distribution in red blood cells.

Azopt will start to work immediately after the administration of the first dose. You may not notice any difference as it cannot repair any damage already done to the eye. It works to reduce the pressure inside the eye and avoid long-term complications.

Yes, the generic form of Azopt can be found under the name Brinzolamide.

Any unused medication can be disposed of safely at a drug-take-back facility. The FDA and DEA websites offer advice and guidance on disposing of drugs safely to avoid accidental ingestion by children or animals; or any harmful effects to the environment.