The FDA has approved Simbrinza (Alcon), an ophthalmic combination of the carbonic anhydrase inhibitor brinzolamide and the selective alpha₂-adrenergic receptor agonist brimonidine, for reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. Simbrinza is the first product to combine drugs from these 2 classes.

Brinzolamide (Azopt - Alcon), a thieno-thiazine-6-sulfonamide carbonic anhydrase inhibitor, has been approved by the FDA in a 1% ophthalmic suspension for treatment of elevated intraocular pressure due to ocular hypertension or open-angle glaucoma. Brinzolamide is the second FDA-approved topical carbonic anhydrase inhibitor. Dorzolamide (Trusopt) was approved earlier (Medical Letter, 37:76, 1995).

The FDA has approved an over-the-counter (OTC) 0.025% ophthalmic formulation of the selective alpha₂-adrenergic agonist brimonidine tartrate (Lumify – Bausch & Lomb) for treatment of ocular redness in adults and children ≥5 years old. Lumify is the first brimonidine product to be approved for OTC use.

The FDA has approved two new ophthalmic drugs for reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension: latanoprostene bunod (Vyzulta – Bausch and Lomb), a modified prostaglandin analog, and netarsudil (VRhopressa – Aerie), the first Rho kinase inhibitor to be approved in the US.

Glaucoma is a progressive optic neuropathy associated with increased intraocular pressure (IOP; normal range 8-22 mm Hg), which is the only disease-related factor that can be modified. Topical drugs that lower IOP are the first line of treatment for open-angle glaucoma.

This issue includes reviews of drugs for glaucoma, age-related macular degeneration (AMD), bacterial conjunctivitis, and dry eye disease. Allergic conjunctivitis is reviewed in a separate issue.

The FDA has approved the selective alpha₂-adrenergic receptor agonist brimonidine as a 0.33% gel (Mirvaso – Galderma) for topical treatment of adults with persistent facial erythema of rosacea. Brimonidine is also available in ophthalmic formulations for treatment of glaucoma.

A reader has questioned why the label for the COX-2 selective NSAID celecoxib (Celebrex, and generics), which contains a sulfonamide moiety, states that it is contraindicated for use in patients with an allergy to sulfonamides, while the labels of some other sulfonamide drugs recommend either caution or no precautions at all. The concept of cross-reactivity among sulfonamide drugs, particularly between antibacterial and nonantibacterial sulfonamides, has been controversial for many years.