Dorzopt plus from glaucoma: instructions for use,

Drops for the eyes Dorzopt plus is an antiglaucoma drug.

In the composition, which includes two active components, namely: dorsalamide and timolol, contribute to reducing intraocular pressure, by suppressing the production of intraocular fluid. When these two components interact, the risk of inflammation decreases.

On this page you will find all information about Dorsopt: full instructions for use with this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already applied drops Dorsopt a plus. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is Dorzopt plus? The average price in pharmacies is at the level of700 rubles.

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Form of issue and composition

Dorzopt Plus is produced in the form of eye drops in the form of an almost colorless or colorless, clear and slightly viscous solution (5 ml in a transparent or white polymer bottle-dropper with a polymer lid and safety ring, 1 bottle in a cardboard box pack).

• The main elements: dorzolamide - 20 mg, timolol - 5 mg.

Additional components: benzalkonium chloride, purified water, mannitol, hyetylose, sodium solution hydroxide 1M / hydrochloric acid solution 1M, sodium hydroxide solution 1M, citric acid monohydrate.

Pharmacological effect

The antiglaucoma preparation contains two active components: dorzolamide and timolol, each of which reduces the increased intraocular pressure by decreasing the secretion of the aqueous humor. Joint action of these substances in the combined preparation Dorzopt Plus leads to a more pronounced decrease in intraocular pressure.

1. TimololNon-selective beta-blocker. Although the exact mechanism of action of timolol in reducing intraocular pressure has not yet been established, a number studies showed a predominant decrease in the formation of intraocular fluid, as well as a slight enhancement its outflow.
2. Dorzolamide- selective inhibitor of carbonic anhydrase type II. Inhibition of the carbonic anhydrase of the ciliary body leads to a decrease in the secretion of the intraocular fluid, presumably due to reducing the formation of hydrocarbonate ions, which in turn leads to a slowdown in sodium transport and intraocular liquid.

Decrease in intraocular pressure occurs 20 minutes after instillation, reaches a maximum after 2 hours and lasts at least 24 hours.

Indications for use

Treatment with drops for the eyes only on the recommendation of the ophthalmologist in the following cases:

1. Glaucoma is open-angle.
2. Glaucoma pseudoexfoliation.
3. With glaucoma.

Contraindications

According to the instructions, the following conditions are contraindications for the use of drops in the eye:

1. The patient's age is 18 years;
2. Cardiogenic shock;
3. Bronchial asthma in history;
4. Acute myocardial infarction;
5. Renal failure of severe course;
6. Degenerative changes in the cornea;
7. Individual intolerance to the components of the drug;
8. Violation of cardiac conduction, changes in the rhythm of the heart;
9. Heart failure in the stage of decompensation;
10. Chronic obstructive pulmonary disease of severe course;
11. The period of pregnancy and breastfeeding.

Drops Dorzopt plus with particular caution are prescribed for patients with diabetes mellitus, hepatic insufficiency or persons of retirement age.

Application in pregnancy and lactation

In studies on rats, the teratogenic effect of dorzolamide was established. Whether the substance penetrates into the breast milk of lactating women has not been established, however, in young lactating female rats, a decrease in body weight gain is noted.

Information on the use of timolol during pregnancy is not enough. In the course of epidemiological studies, the effect of beta-adrenoblockers on the formation of congenital malformations of the fetus was not revealed, but intrauterine growth retardation was detected. In addition, in newborns whose mothers received beta-blockers before delivery, the symptoms were diagnosed blockade of beta-adrenoreceptors: hypoglycemia, arterial hypotension, bradycardia, respiratory failure. It is also known that beta-blockers penetrate into breast milk.

In view of the above, during pregnancy and lactation, the use of Dorzopt Plus is contraindicated. If it is necessary to prescribe a drug to a breastfeeding woman, breastfeeding should be stopped.

Instructions for use

In the instructions for use it is indicated that Dorzopt Plus is recommended to instill 1 drop into the conjunctival sac of the eye (or both eyes) 2 times / day.

1. If the drug is prescribed as a replacement for another ophthalmic drug for the treatment of glaucoma, the drug should be discontinued 1 day before the start of therapy with Dorzopt Plus.
2. In the case of joint application with other local ophthalmic preparations, the administration of Dorzopt Plus preparation should be carried out with an interval of 10 minutes.
3. With nasolacrimal occlusion (closure of the eyelids) for 2 min after instillation of the drug, its systemic absorption decreases, which may lead to an increase in local action.
4. The drug Dorzopt Plus is a sterile solution, so patients should be instructed how to properly use the bottle.

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

Side effects

Side effect of the drug Dorzopt plus is composed of the effects of active components.

Timolol:

1. Respiratory system: bronchospasm, chest pain, cough.
2. Skin manifestations: exacerbation of psoriasis, alopecia, psoriasis-like rash.
3. Allergy: Quincke's edema, anaphylaxis, urticaria, rash (local and generalized).
4. Cardiovascular system: hypotension, syncope, arrhythmia, cardiac arrest, Raynaud's syndrome, swelling, lowering the temperature of the legs and hands.
5. Nervous system: paresthesia, ringing in the ears, headache, fatigue, dizziness, asthenia, depression, nightmares, myasthenia gravis symptoms, memory loss, insomnia.
6. Organs of vision: keratitis, decreased sensitivity of the corneal layer, blepharitis, conjunctivitis, dry cider eyes, vision impairment, including those associated with changes in the refractive power of the eye, ptosis, diplopia.
7. Digestive system: dry mouth, diarrhea, indigestion.

Dorzolamide:

1. Nervous system: pain in the head, paresthesia, fatigue and asthenia.
2. Allergies: bronchospasm, pruritus, angioedema, hives.
3. Organs of vision: lacrimation, iridocyclitis, inflammation, ecdysis, eyelid irritation, pinpoint keratitis, temporary myopia, which disappears after drug withdrawal.
4. Other: nosebleed, dry mouth, throat irritation, rash.

Overdose

With prolonged use of the drug or exceeding the dose given in the instruction, the patient develops symptoms overdose, which manifest the intensification of the above-described side effects, as well as oppression of the function of the heart, liver, kidney. Possible cardiac arrest.

Against the background of an overdose of eye drops Dorzopt plus in patients often develop acidosis, a change in the water-salt balance.

The treatment is aimed at eliminating the symptoms and maintaining the normal functioning of the affected organs and body systems. It is necessary to control the concentration of electrolytes (especially sodium) and the pH of the blood plasma. Dialysis is ineffective.

special instructions

Dorzopt Plus, like other ophthalmic drugs for topical use, can penetrate into the systemic bloodstream. Since the drug timolol is a beta-adrenoblocker, undesirable reactions, developing with the systemic application of beta-blockers, can be noted with topical application of the drug Dorzopt Plus.

1. Before using Dorsopt Plus, you need to ensure adequate control of the cardiovascular system.
2. Reported cases of heart failure with a fatal outcome against the background of the use of timolol in the form of eye drops.
3. With the appearance of the first signs or symptoms of heart failure, the drug Dorzopt Plus should be discontinued.
4. Reported cases of bronchospasm with fatal outcome in patients with bronchial asthma on the background of the use of timolol in the form of eye drops.
5. Patients with grade I blockade should be prescribed beta-blockers with caution because of their ability to slow the pulse.
6. The drug should be used with caution in patients with severe impairment of peripheral circulation (severe illness or Raynaud's syndrome).
7. In patients with COPD of mild to moderate severity, Dorsopt Plus should be used with caution and only if the perceived benefit of treatment exceeds the potential risk.
8. The drug should be used with caution in patients with spontaneous hypoglycemia or in patients with diabetes mellitus (especially with labile course) on the background of the use of insulin or oral hypoglycemic drugs, since beta-blockers can mask the symptoms hypoglycemia.
9. The need to abolish beta-blockers in the case of the forthcoming extensive surgical intervention has not been proven. The effects of beta-adrenoblockers during surgery, if necessary, can be eliminated by applying sufficient doses of adrenomimetics.
10. Beta-blockers may mask some clinical signs of hyperthyroidism (eg, tachycardia). If there is a suspected development of hyperthyroidism, patients should be closely monitored. It is necessary to avoid a sharp abolition of beta-blockers due to the risk of thyrotoxic crisis.
11. Like other ophthalmic drugs for topical use, the drug Dorzopt Plus can penetrate into the systemic bloodstream. The dorsolamide included in the preparation is sulfonamide. Undesirable reactions revealed in the systemic application of sulfonamides can be noted with topical application of the drug (Stevens-Johnson syndrome and toxic epidermal necrolysis). If signs of severe hypersensitivity reactions appear, the drug should be discontinued. In the treatment of beta-adrenergic blockers of patients with atopy or severe anaphylactic reactions to various allergens in a history, it is possible to strengthen the response with repeated contact with these allergens. In this group of patients, the use of epinephrine in a standard therapeutic dose to stop allergic reactions may not be effective.
12. Studies of the use of Dorzopt Plus in patients with hepatic insufficiency have not been carried out, so the drug should be used with caution in such patients.
13. Used in ophthalmology, beta-blockers can cause dry eye mucosa. The drug should be used with caution in patients with corneal disorders. In patients with a low number of endothelial cells, there is an increased risk of developing corneal edema.
14. When using Dorzopt Plus in patients taking systemic beta-blockers, it is necessary to take into account the possible mutual enhancement pharmacological action of the drugs both with respect to the known systemic effects of beta-blockers, and in the reduction of intraocular pressure. The combined use of Dorzopt Plus with other beta-blockers is not recommended.
15. If it is necessary to cancel the local administration of timolol, as in the case of abolition of systemic beta-blockers, discontinuation of therapy in patients with IHD should be carried out gradually.
16. In clinical studies, the difference in the efficacy and safety of dorsolamide + timolol combination in patients older than 65 years compared with younger patients was not detected. Nevertheless, the possibility of higher sensitivity to the drug in some elderly patients should not be ruled out.
17. The use of systemic inhibitors of carbonic anhydrase can lead to a violation of acid-base balance and is accompanied by urolithiasis, especially in patients with a history of urolithiasis. The drug Dorzopt Plus contains an inhibitor of carbonic anhydrase, which, when applied topically, can be absorbed and penetrated into the systemic blood flow, therefore the risk of developing urolithiasis in patients with urolithiasis in an anamnesis when treated with Dorzopt Plus can increase.
18. Dorzopt Plus contains a preservative of benzalkonium chloride, which can cause irritation of the eye. Therefore, patients before using the drug should take out soft contact lenses and install them back no earlier than 15 minutes after instillation of the drug. Benzalkonium chloride is capable of discoloring soft contact lenses.

During the period of application of Dorzopt Plus preparation, it is necessary to refrain from controlling vehicles and mechanisms and occupations of potentially hazardous activities requiring an increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

1. With acetazolamide - increased risk of systemic adverse reactions.
2. With high doses of Acetylsalicylic acid - probably an increase in toxicity.
3. Combination with antiglaucoma drugs (β-adrenoblockers, Pilocarpine, Dipivefrin, Carbachol) causes an increase in the action of Dorzolamide.

Reviews

We picked up some of the people's comments about Dorsopt plus:

1. Stas. After taking Dorsopt plus, mixed impressions remained. With its immediate duties the drug coped. The price is relatively inexpensive again. But I had several possible side effects and I did not like it at all!

Consumer feedback on the facility in question is not very much. The advantages of this drug include high efficiency and effectiveness, as well as accessibility (sold in virtually any pharmacy).

Also it should be noted that drops of "Dorzopt Plus" also contain negative responses from patients. Many of them complain that after using a local remedy, local or systemic side reactions often develop. Therefore, experts do not recommend using the above medication alone. To achieve the best therapeutic result, it should be prescribed only by an experienced doctor. Only with a properly selected therapy scheme, side effects can be avoided.

Analogues

Structural analogs for the active substance:

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

Before using analogues, consult your doctor.

Storage conditions and shelf life

Drops should be stored at room temperature out of the reach of children, avoiding heating or freezing. When suspensions or foreign matter appear in the vial, drops should be discarded even if the product has not expired.

After opening the vial can be used for 4 weeks. Provided the integrity of the package - up to 2 years.

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