Metipranolol: a new beta-blocker for glaucoma

Article Abstract:

Metipranolol is a beta-blocker, a drug that blocks the effects of adrenalin and related nerve-secreted hormones at certain sites, particularly the heart and lungs. It has recently been marketed for treatment of elevated pressure within the eye caused by ocular hypertension or chronic open-angle glaucoma. This type of drug is thought to act by decreasing the production of aqueous humor (transparent liquid in the eye). Metipranolol is available as a 0.3 percent solution, is relatively inexpensive, and is apparently effective. However, its long-term effectiveness and safety relative to other ophthalmic beta-blockers remains to be determined. Metipranolol acts within 30 minutes, has a maximum effect at 2 hours; residual effects last for at least 24 hours. Studies have shown that metipranolol is as effective as two other beta-blockers, timolol and levobunolol, in lowering intraocular pressure, but no comparisons with betaxolol, another beta-blocker, are available. Metipranolol has generally been well-tolerated, but stinging with the first few doses has been reported. Other adverse effects have included conjunctivitis, eyelid dermatitis, blurred vision, tearing, photophobia, and swelling in a few patients. Systemic reactions, caused by beta-blocker effects on the cardiovascular or respiratory systems, have been uncommon but included low heart rate, low blood pressure, bronchospasm (spasm of the airways), and fatigue. However, the effects of metipranolol have not been studied in elderly patients or those with cardiac or respiratory diseases. All beta-blockers are contraindicated in patients with heart arrhythmias, including sinus bradycardia (low heart rate) and heart failure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Metipranolol, OptiPranolol (Medication)

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A topical carbonic anhydrase inhibitor for glaucoma

Article Abstract:

Dorzolamide hydrochloride (Trusopt), a recently approved solution for the treatment of glaucoma, may be effective in reducing eye pressure. Dorzolamide hydrochloride is the first carbonic anhydrase inhibitor applied as drops directly to the eyes. A group of 48 patients had an average reduction of eye pressure following a month of treatment with dorzolamide hydrochloride. When combined with beta-blockers, eye pressure decreased even further. Very few adverse drug reactions to Trusopt have been reported, except for eye stinging and a bitter aftertaste. Some patients experience allergic reactions and adverse eye symptoms, including blurred vision. Trusopt solution is more than twice as expensive as beta-blockers.

Dosage and administration, Ophthalmic solutions, Trusopt (Medication)

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A topical prostaglandin for glaucoma

Article Abstract:

Latanoprost (Xalatan), a prostaglandin F analog, has been approved for the topical treatment of eye pressure due to open-angle glaucoma and ocular hypertension. Latanoprost effectively reduces pressure in the eye and may be a viable alternative to beta-blockers or as an adjunct drug in a combination protocol. There are no major adverse effects, except for an increased brown pigmentation of the iris. Latanoprost costs more than other standard glaucoma drugs.

Licensing agreements, Synthetic prostaglandins F, Xalatan (Medication)

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