Glaucoma Medication Preservatives

There is a growing body of literature indicating that higher concentrations of BAK are associated with inflammatory changes in the conjunctiva and even trabecular meshwork.1 If a BAK allergy is suspected, one could consider a provocative test in one eye of a BAK preserved artifical tear to determine if the symptoms of redress and discomfort are re-created i.e. a BAK challenge test.

Preservative

Drug

Trade

timolol maleate

Timoptic (ocu-dose)

pilocarpine 2% & 4%

generic (steri-unit)

0.01%

apraclonidine

Iopidine

0.01%

betaxolol

Betoptic

0.005%

bimatoprost

Lumigan

0.005%

brimonidine

Alphagan

0.01%

brinzolamide

Azopt

carbachol

Isopto Carbachol

0.005%

Carteolol

Carteolol HCl

demecarium bromide

Humorsol

dipivefrin

Propine

0.0075%

dorzolamide

Trusopt

epinephrine

Epifrin

0.02%

latanoprost

Xalatan

0.004%

levobunolol

Benzalkonium chloride (BAK)

Benzodeodecinium bromide Chlorobutanol

Purite (stabilized oxychloro complex)

0.0075%

metipranolol pilocarpine hydrochloride timolol maleate timolol maleate/dorzolamide timolol hemihydrate travoprost timolol maleate echothiophate iodide pilocarpine nitrate brimonidine 0.1%, 0.15%

Optipranolol

Isopto Carpine, Pilocar,

Pilostat, Pilopine HS gel

Timoptic

Cosopt

Betimol

Travatan

Timoptic XE

Phospholine Iodide

Pilagan

Alphagan-P

1 Anwaruddin R et al. Invest Ophthalmol Vis Sci (Suppl) 2002:43:164; Baudouin C et al. Ophthalmology 1999:106:556-563.

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