Common side effects of glaucoma medications A wide array of topical medications is used to treat the eye disease glaucoma, or high pressure in the eye. The skin covering the outer surface of the eye and inside the eyelids provides a quick and efficient spot for drugs to be absorbed into the eye, so many glaucoma drugs come in the form of eye drops.

Drugs used to treat glaucoma include: beta blockers, miotics, carbonic anhydrase inhibitors, alpha agonists, and prostaglandin analogues.

• Beta blockers (Brand names: Timoptic, Betoptic, Betagan): Worsening of asthma, bradycardia (slow heart rate), congestive heart failure, chronic obstructive pulmonary disease, slowed heart beat, masking signs and symptoms of hypoglycemia (low blood sugar), lethargy, irritability, insomnia, impotence, low blood pressure, reduced exercise tolerance, reduced HDL (good cholesterol)
• Miotics (Brand names: Pilocarpine, Carbochol):  Headaches, excessive salivation and tearing, sweating, nausea, vomiting, diarrhea, pulmonary edema, symptoms of shock, slowed heart beat
• Carbonic Anhydrase Inhibitors (Brand names: Diamox, Neptazane, Trusopt, Azopt):  Paresthesia (unusual sensation such as tingling), lethargy, fatigue, anorexia, kidney stones, skin rash, and rarely, aplastic anemia
• Adrenergic Agents, non-selective (epinephrine, propine):   Headache, anorexia, premature ventricular contractions
• Adrenergic Agents, selective (Brand names: Alphagan, Iopidine):   Nausea, dry mouth, cold extremities (hands and feet), chest tightness, muscular pain, fatigue, and drowsiness
• Hyperosmotics (Brand names: Osmoglyn, Mannitol):  Nausea, vomiting, diarrhea, dehydration, hyperglycemia (high blood sugar), cardiovascular system overload, headache, confusion, disorientation, subdural hematoma, pulmonary edema, congestive heart failure
• Prostaglandin analogues (Brand names: Xalatan, Travatan, Lumigan, Rescula): Discolored skin around the eyeball, flu-like symptoms, muscular pain, fever

It is important to use the medicine as your doctor directs so that a proper eye pressure is maintained. Untreated glaucoma can lead to blindness. However, because many of these side effects can lead to serious health complications, call your doctor immediately if you begin to notice such symptoms.

by Karanjit S. Kooner, M.D., Ph.D.