Dorzolamide hydrochloride (Trusopt - Merck), a thienothio-pyran-2-sulfonamide carbonic anhydrase inhibitor, was recently approved by the US Food and Drug Administration in a 2% ophthalmic solution for treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma.

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).

Brimonidine tartrate 0.2% ophthalmic solution (Alphagan - Allergan), a selective alpha2-adrenergic agonist, has been approved by the US Food and Drug Administration (FDA) for treatment of increased intraocular pressure due to open-angle glaucoma or ocular hypertension and for its prevention in patients undergoing argon laser trabeculoplasty.

Lantaoprost, a prostaglandin F2-alpha analog, has been approved by the FDA for topical treatment of elevated intraocular pressure in patients with open-angle glaucoma and ocular hypertension refractory to other drugs.

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.

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.

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.

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.