Dorsopt - instructions for use, analogs, reviews and release forms (eye drops 2%, plus) drugs for the treatment of primary and secondary glaucoma, ophthalmic hypertension in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Dorzopt. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of experts on the use of Dorztop in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues Dorzopta in the presence of existing structural analogs. Use for the treatment of primary and secondary glaucoma, ophthalmic hypertension in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Dorzopt - antiglaucoma preparation, local inhibitor of carbonic anhydrase. Reduces the secretion of the aqueous humor, slowing the formation of bicarbonate, followed by a weakening of the transfer of sodium and water. Does not cause a spasm of accommodation, miosis, gemeralopia.

Dorzopt Plus - a drug for reducing the increased intraocular pressure, contains two active components: dorzolamide and timolol, each of which reduces the increased intraocular pressure by reducing the secretion of intraocular fluid. Joint action of these substances in the combined preparation Dorzopt Plus leads to a more pronounced decrease in intraocular pressure.

Dorzolamide is a selective inhibitor of type II carbonic anhydrase. Inhibition of the carbonic anhydrase of the ciliary body leads to a decrease in the secretion of the aqueous humor, presumably due to a decrease in the formation of bicarbonate ions, which in turn leads to a slowing down of sodium transport and intraocular fluid.

Timolol is a non-selective beta-blocker. Although the exact mechanism of action of Timolol in reducing intraocular pressure has not yet been established, a number of studies have shown a predominant decrease in the formation of intraocular fluid, as well as a slight increase in its outflow.

Composition

Dorzolamide (in the form of hydrochloride) + auxiliary substances (Dorzopt).

Dorzolamide hydrochloride + Timolol maleate + excipients (Dorzopt Plus).

Pharmacokinetics

It penetrates the eye mainly through the cornea (to a lesser extent through the sclera or limbus). Systemic absorption is low. After entering the blood quickly penetrates into the red blood cells containing a significant amount of carbonic anhydrase 2. Binding to plasma proteins - 33%. Transformed into N-dezetilirovanny metabolite is less active against carbonic anhydrase 2 but capable of blocking the carbonic anhydrase 1. With prolonged use accumulated in erythrocytes. It is excreted by the kidneys in the unmodified form and in the form of metabolites. After withdrawal, the rapid phase of withdrawal is replaced by a slow one, caused by the gradual release of the drug from the erythrocytes.

Indications

• open-angle (including secondary) glaucoma;
• pseudoexfoliation glaucoma;
• ophthalmohypertension.

Forms of release

Eye drops 2%.

Instructions for use and how to use them

Dorzopt Drops

Instilled 1 drop into the conjunctival sac of the affected eye 3 times a day.If several local ophthalmic preparations are used in the treatment, then they are administered with an interval of 10 minutes.

Drops Dorzopt Plus

Bury 1 drop in the conjunctival sac 2 times a day.

If several local ophthalmic medicines are used in the treatment, then their administration should occur at an interval of 10 minutes.

The duration of treatment is determined by the doctor depending on the clinical condition of the patient.

Side effect

Dorzolamide

• inflammation of the eyelid;
• lacrimation;
• irritation and peeling of the eyelid;
• iridocyclitis;
• point keratitis;
• transient myopia (passing after withdrawal of the drug);
• headache;
• asthenia / fatigue;
• paresthesia;
• angioedema;
• bronchospasm;
• hives;
• itching;
• nose bleed;
• irritation of pharynx;
• dry mouth;
• rash.

Timolol

• conjunctivitis;
• blepharitis;
• keratitis;
• decreased sensitivity of the cornea;
• dry eye syndrome;
• visual disturbances, including changes in the refractive power of the eye (in some cases due to cancellation of miotics);
• diplopia;
• ptosis;
• tinnitus;
• paresthesia;
• headache;
• asthenia;
• fatigue;
• dizziness;
• depression;
• insomnia;
• nightmares;
• decreased memory;
• increased myasthenia gravis symptoms;
• arrhythmia;
• a decrease in blood pressure;
• fainting;
• rhythm disturbances;
• heart failure;
• edema;
• Raynaud's syndrome;
• decrease in temperature of hands and feet;
• bronchospasm (mainly in patients with previous bronchial obstructive pathology);
• cough;
• chest pain;
• alopecia;
• psoriasis-like rash or exacerbation of psoriasis;
• anaphylaxis;
• angioedema;
• hives;
• local or generalized rash;
• diarrhea;
• dyspepsia;
• dry mouth;
• decreased libido;
• Peyronie's disease;
• systemic lupus erythematosus.

Contraindications

• bronchial asthma (including in the anamnesis);
• severe chronic obstructive pulmonary disease (COPD);
• sinus bradycardia;
• AV-blockade of 2 and 3 degrees;
• severe heart failure;
• cardiogenic shock;
• renal failure of severe degree (QC less than 30 ml / min);
• dystrophic processes in the cornea;
• pregnancy;
• lactation (breastfeeding);
• children and adolescents under 18 years of age (because efficiency and safety have not been adequately studied);
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

The drug Dorzopt and Dorzopt Plus is contraindicated for use during pregnancy and lactation (breastfeeding).

Use in children

Contraindicated in children and adolescents under the age of 18 years.

Application in elderly patients

With caution in old age.

special instructions

Before using Dorsopt Plus, you need to ensure adequate control of the cardiovascular system. Patients with a history of severe cardiac disease and signs of heart failure should be closely monitored.

Contains preservative benzalkonium chloride, which can precipitate in soft contact lenses and have a damaging effect on the eye tissue. Therefore, patients wearing soft contact lenses should remove them before applying drops and install back no earlier than 20 minutes after instillation.

Caution is prescribed to patients with diabetes mellitus, since beta-blockers may mask the symptoms of acute hypoglycemia.

Before the planned surgical operation, the drug should be gradually discontinued 48 hours before the general anesthesia.beta-blockers increase the effect of muscle relaxants and means for general anesthesia.

Impact on the ability to drive vehicles and manage mechanisms

During the period of treatment it is necessary to refrain from driving motor vehicles and practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

Anti-glaucoma drugs (beta-adrenoblockers, pilocarpine, dipivefrin, carbachol) enhance the action of dorzolamide.

With simultaneous use with acetazolamide, the risk of systemic side effects increases.

It is possible to increase toxicity when taking large doses of acetylsalicylic acid.

There were no studies of Dorsopt Plus interaction with other drugs.

Nevertheless, it is possible to intensify the hypotensive effect and / or develop a pronounced bradycardia when the ophthalmic solution of timolol and slow calcium channel blockers, sympatholytics, beta adrenoblockers, antiarrhythmics (including amiodarone), cardiac glycosides, parasympatomimetics, opioid analgesics and MAO inhibitors are combined together. .

When combined with timolol and inhibitors of the CYP2D6 isoenzyme (eg, quinidine or selective serotonin reuptake inhibitors), the potentiated effect of systemic blockade of beta-adrenoceptors (eg, decreased heart rate, depression) was reported.

In spite of the fact that Dorzopt Plus is an inhibitor of carbonic anhydrase, dorzolamide is used locally, it can penetrate into the systemic bloodstream. In clinical studies of the use of an ophthalmic solution of dorzolamide, acid-base balance disorders were not detected. However, with systemic use of carbonic anhydrase inhibitors, these disorders are known, and in some cases they can affect the interaction with other drugs (for example, enhance toxic reactions when using salicylates in high doses).

There is a possibility of amplification, known systemic effects of inhibiting carbonic anhydrase in the combined use of local and systemic inhibitors of carbonic anhydrase. Because there is no data on the use of such a combination, combined use of Dorsopt Plus and systemic inhibitors of carbonic anhydrase is not recommended.

Analogues of drug Dorzopt

Structural analogs for the active substance:

• Dorzolamide hydrochloride;
• Dorzopt Plus;
• Kosopt;
• Trusopt.

Analogues on the curative effect (means for the treatment of glaucoma):

• Azarga;
• Asopt;
• Amylonosar;
• Arutimol;
• Betoptik;
• Betofan;
• Histochrome;
• Dorzopt Plus;
• Irifrin;
• Clopheline;
• Kosopt;
• Xalacom;
• Xalatamax;
• Xalatan;
• Xoneuf;
• Cusimolol;
• Lanotan;
• Mexidol;
• Niolol;
• Okumed;
• Oftan Dipivefrin;
• Oftan Pilocarpine;
• Oftan Timolol;
• Otrensin;
• Pikamilon;
• Pilocarpine;
• Pilotimol;
• Proserin;
• Proxodolol;
• Proksokarpin;
• Proxopheline;
• Retinalamine;
• Strix;
• Strix forte;
• Taflotan;
• Taflotan multi;
• Timolol;
• Timololong;
• Timothy;
• Timpilo;
• Travatane;
• Trusopt;
• Fotil;
• Fotil forte.

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