Brinzolamide

Registered South African indications: 

• Open angle glaucoma
• Ocular hypertension

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients 
• Hypersensitivity to sulphonamides 
• Severe renal impairment
• Hyperchloraemic acidosis

Cautions

• Pregnancy
• Breastfeeding
• Hepatic impairment
• Pseudoexfoliative glaucoma
• Pigmentary glaucoma
• Closed angle glaucoma
• Dry eye
• Conditions where the cornea is compromised
• Infants
• Children
• Concomitant use of contact lenses
• May impair ability to drive or operate heavy machinery

Forms avail. in SA and covered in this monograph: opd

Ocular hypertension
Open angle glaucoma

• Ophthalmic (opd): 1 drop, into affected eye(s), 8-12hrly

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If more than one ocular preparation is used, they should be used at least 10mins apart

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When substituting for another antiglaucoma medication, discontinue the agent after a one day of full dosing and start brinzolamide the next day

Not established for use in children

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Caution; not recommended

Renal Impairment

• Severe: Contraindicated

Hepatic Impairment

• Caution; no dose adjustment recommended 

Elderly

• No dose adjustment recommended

Central Nervous System Disorders

• Apathy
• Depression
• Decreased libido
• Nightmare
• Nervousness
• Insomnia
• Motor dysfunction
• Amnesia
• Dizziness
• Paraesthesia
• Headache
• Memory impairment
• Somnolence
• Tremor
• Hypoaesthesia
• Ageusia

Cardiovascular Disorders

• Cardiorespiratory distress
• Bradycardia
• Palpitations
• Angina pectoris
• Arrhythmia
• Tachycardia
• Hypertension
• Hypotension

Respiratory Disorders

• Dyspnoea
• Epistaxis
• Oropharyngeal pain
• Pharyngolaryngeal pain
• Throat irritation
• Upper airway cough syndrome
• Rhinorrhoea
• Sneezing
• Bronchial hyperreactivity
• Upper respiratory tract congestion
• Sinus congestion
• Nasal congestion
• Cough
• Nasal dryness
• Asthma

Gastrointestinal Disorders

• Dysgeusia
• Oesophagitis
• Diarrhoea
• Nausea and vomiting
• Dyspepsia
• Upper abdominal pain
• Abdominal discomfort
• Stomach discomfort
• Flatulence
• Frequent bowel movements
• Gastrointestinal disorder
• Oral hypoaesthesia
• Oral paraesthesia
• Dry mouth

Hepatobiliary Disorders

• Abnormal liver function test

Genitourinary Disorders

• Renal pain
• Pollakiuria
• Erectile dysfunction

Endocrine and Metabolic Disorders

• Decreased appetite

Musculoskeletal Disorders

• Back pain
• Muscle spasms
• Myalgia
• Arthralgia
• Pain in extremity

Skin and Subcutaneous Tissue Disorders

• Maculopapular rash
• Skin tightness
• Urticaria
• Alopecia
• Pruritus
• Dermatitis
• Erythema

Immune, Blood and Lymphatic System Disorders

• Nasopharyngitis
• Pharyngitis
• Sinusitis
• Rhinitis
• Decreased red blood cell count
• Increased blood chloride 
• Hypersensitivity

Sensory Disorders

• Blurred vision
• Eye pain
• Foreign body sensation in eyes
• Ocular hyperaemia
• Corneal erosion
• Keratitis
• Punctate keratitis
• Keratopathy
• Deposits in eye
• Corneal staining
• Corneal epithelium disorder
• Blepharitis
• Eye pruritus
• Conjunctivitis
• Eye swelling
• Meibomianitis
• Photophobia
• Dry eye
• Allergic conjunctivitis
• Pterygium
• Scleral pigmentation
• Asthenopia
• Keratoconjunctivitis sicca
• Subconjunctival cyst
• Conjunctival hyperaemia
• Eyelids pruritus
• Eye discharge
• Eyelid margin crusting
• Corneal oedema
• Diplopia
• Photopsia
• Hypoaesthesia eye
• Periorbital oedema 
• Increased optic nerve cup/disc ratio
• Corneal disorder
• Visual disturbance
• Madarosis
• Erythema of eyelid
• Tinnitus
• Vertigo

• Oral carbonic anhydrase inhibitors
• CYP3A4 inhibitors 

None routine

Brinzolamide is a highly specific, non-competitive, reversible carbonic anhydrase inhibitor. Inhibition of carbonic anhydrase in the ciliary processes of the eye decreases aqueous humor secretion, by slowing the formation of bicarbonate ions with subsequent reduction in sodium and fluid transport. The result is a reduction in intraocular pressure.  

Eye drops (per ml) 10mg

• Azoptic (Novartis South Africa) originator

COMBINATION PREPARATIONS

Brinzolamide/ Timolol

Eye drops (per ml) 10mg/5mg

• Azarga  (Novartis South Africa) originator