Brinzolamide - Brand name: Azopt

Brinzolamide is a medicine that treats high pressure inside the eye (ocular hypertension) and helps with glaucoma.

High pressure can happen when too much fluid builds up inside your eye. Brinzolamide helps the eye to produce less fluid.

If not treated, high pressure can damage your optic nerve and cause vision loss or blindness.

Brinzolamide is available on prescription only. It comes as eye drops. It contains a preservative (benzalkonium chloride) to keep it sterile.

Your doctor may also prescribe timolol or brimonidine eye drops to use with brinzolamide.

There are some combined eye drops. The brand Azarga contains brinzolamide and timolol, and Simbrinza contains brinzolamide and brimonidine.

• Usually you use brinzolamide eye drops 2 to 3 times a day.
• It may take up to 4 weeks for brinzolamide eye drops to reach their full effect, when used twice a day.
• If it works for you, you will usually use brinzolamide for the rest of your life.
• It's important to use your eye drops regularly and to go for check-ups, to make sure your vision is not getting worse.
• Common side effects include an itchy or painful eye and a feeling that something's in your eye.

Most adults aged 18 years and over can use brinzolamide eye drops. Children can only use brinzolamide if it's prescribed by a specialist.

Brinzolamide is not suitable for everyone. To make sure it's safe for you, tell your doctor before starting brinzolamide if you:

• have ever had an allergic reaction to brinzolamide or any other medicine
• have liver or kidney problems
• have a condition called hyperchloraemic acidosis (where your blood becomes too acidic)
• have dry eyes or problems with your cornea (the clear outer layer of your eye)
• normally wear contact lenses (you can still use brinzolamide, but you will need to remove the contact lenses before using the eye drops)

It's important to use brinzolamide as your doctor has advised.

Dosage

The usual dose for adults and children is 1 drop into the affected eye or eyes twice a day, in the morning and at night.

Your doctor may increase this to 1 drop into the affected eye or eyes 3 times a day, if needed.

How to use eye drops

Always refer to the patient information leaflet. Instructions can vary between different manufacturers, as some bottles look different and work differently. You may find using a mirror helps.

If you wear contact lenses, make sure you remove them before using your eye drops. Wait 15 minutes before putting your lenses back in.

The drops may make your vision blurred, cause irritation and may change the colour of the contact lenses.

1. Wash your hands.
2. Shake the bottle and twist off the cap. If it does not come with a separate dropper and you have not used these eye drops before, practise gently squeezing the bottle away from your eye first, to get used to the pressure and the time it takes for 1 drop to fall out.
3. Make sure the tip of the bottle does not touch your eye, eyelashes, eyelid, your skin, or any other surface.
4. Tilt your head back. Use your finger to gently pull down your lower eyelid.
5. Hold the dropper over your eye, look up, squeeze gently and allow 1 drop to fall into your lower eyelid. If the drop misses your eye, try again.
6. Close your eye. Gently press your finger over the inside corner of your eye (over the eyelid) for about a minute. This helps to keep the drop in the eye.
7. Wipe away any extra liquid with a clean tissue.
8. Repeat in your other eye if your doctor has told you to do this.
9. Put the cap back on the bottle as soon as you've finished using it.

If you find it hard to use eye drops, ask a pharmacist for advice. They may be able to recommend an eye drop dispenser.

If you use brinzolamide with other eye drops or eye ointment, wait at least 5 minutes before using them. They can wash out the brinzolamide and it may not work as well. It's best to use eye ointments last.

Expiry dates

Use the brinzolamide eye drops within the expiry date on the bottle and within 4 weeks of opening. This will help to prevent the risk of eye infections and the eye drops not working so well.

You could write the date you opened the bottle or packet on the label or the box. This will help you to know when you need to start using a new one.

What if I forget to use it?

If you forget a dose by less than 2 hours, use the eye drops as soon as you remember, then return to your normal routine for your next dose.

If you forget a dose by more than 2 hours, skip the missed dose and use your next dose at the normal time.

Never use 2 doses at the same time. Never use an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember your medicines.

What if I use too much?

Using too many drops can irritate your eye and make it water and turn red. If you get too much brinzolamide in your eye, rinse it all out with water. Do not put any more drops in until it is time for your next dose.

Any irritation, watering or redness should get better, but if you are worried about it ask your doctor or pharmacist for advice.

Contact your doctor if you swallow brinzolamide.

Like all medicines, brinzolamide can cause side effects, but not everyone gets them.

Common side effects

These common side effects happen in more than 1 in 100 people.

Keep using the medicine, but talk to your doctor or pharmacist if these side effects bother you or do not go away:

• an itchy or painful eye and a feeling that something's in your eye, blurred vision, or watery eyes
• your eyes become sensitive to bright light (photophobia)
• a bad or unusual taste in your mouth

Serious side effects

Serious side effects are less common. Do not use any more brinzolamide and call a doctor straight away if you:

• become short of breath
• have asthma or COPD and your breathing gets worse
• get an irregular, slow or fast heart rate (palpitations)

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to brinzolamide.

These are not all the side effects of brinzolamide. For a full list, see the leaflet inside your medicine packet.

What to do about:

• an itchy or painful eye and a feeling that something's in your eye, blurred vision, or watery eyes - this should go away on its own but talk to your doctor or pharmacist if you are concerned about this. If the eye drops irritate your eyes and make them water so much that you think about stopping using the drops, talk to your doctor straight away. They may prescribe something different for you. Do not drive, cycle, use tools or operate heavy machinery until your eyes feel comfortable again and your vision is clear.
• your eyes become sensitive to bright light - wearing sunglasses may help.
• a bad or unusual taste in your mouth - this usually only lasts up to 5 minutes. Drink some water or juice, or chew some sugar-free gum.

It's important that high pressure in your eye or glaucoma is treated while you are pregnant or breastfeeding.

Brinzolamide and pregnancy

Treating high pressure in the eye (glaucoma) is essential and so treatment with brinzolamide should continue in pregnancy.

As it is applied to the eye, very little gets into the bloodstream and to your baby. The small amount that might get to your baby is unlikely to cause harm, however there is not much information on this.

Brinzolamide and breastfeeding

There's not much information on the use of brinzolamide while breastfeeding, but only very small amounts are likely to pass into breast milk.

This is due to how brinzolamide works and because it's used as eye drops, rather than injected or swallowed.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your midwife, health visitor or doctor as soon as possible.

For more information about how brinzolamide can affect you and your baby during pregnancy, read this leaflet about treating glaucoma in pregnancy on the Best Use of Medicines in Pregnancy (BUMPS) website.

There are some medicines that do not mix well with brinzolamide and can affect how well it works.

Tell a doctor or pharmacist if you're taking any of these medicines before you start using brinzolamide:

• other eye drops that work in a similar way to brinzolamide, such as acetazolamide or dorzolamide
• antifungals such as ketoconazole, itraconazole and clotrimazole
• ritonavir (an antiviral medicine)
• metformin (a medicine used for diabetes)

Mixing brinzolamide with herbal remedies or supplements

There's very little information about taking herbal medicines and supplements with brinzolamide.