Narrow Angle Glaucoma
There are a number of narrow angle or “closed angle” glaucoma medications to avoid due to the fact that they block acetylcholine, the chemical that keeps the eye angle open. These medications can cause further narrowing and can lead to blockage of the eye’s drainage system. Here is a list of numerous narrow angle glaucoma medications to avoid:
- Allergy/Cold Remedies: Diphenhydramine, Ephedrine
- Anxiety: Vistaril (hydroxyzine)
- Asthma/COPD: Atrovent (ipratroprium bromide), Spiriva (tiotropium bromide)
- Depression: Prozac (fluoxetine), Paxil (paroxetine), Elavil (amitryptiline), Tofranil (imipramine)
- Gastric Reflux/Nausea: Tagamet (cimetidine), Zantac (ranitidine), Phenergan (promethazine)
- Incontinence/Overactive Bladder: Detrol (tolterodine), Ditropan (oxybutynin)
- Migraines/Muscle Spasms: Topamax (topiramate), Norflex, Artane (trihexyphenidyl)
- Sulfa-Containing Drugs: Topamax (topiramate), Diamox (acetazolamide), Qualaquin (quinine),
- Sumycin (tetracycline), Bactrim (trimethoprim/sulfamethoxazole)
A laser peripheral iridotomy can be very helpful in preventing an angle closure attack. It is important to be examined for narrow angles if you have a family history of glaucoma, experience headaches or if you are developing a cataract.
Steroids are the most important open angle glaucoma medication to avoid. Steroid usages can cause permanent blockage of the eye’s drainage system. Steroids can be given topically, inhaled, intravenously, by mouth or injected into joints. This medication is used for the many conditions listed below:
- Autoimmune diseases: Lupus, Crohn’s Disease, Ulcerative Colitis, Rheumatoid Arthritis, Sarcoid
- Allergies: Hayfever, Poison Ivy, Eczema, Rash
- Osteoarthritis/Carpal Tunnel treated with corticosteroid Injections
- Asthma/COPD Steroid Inhalers: Beclomethasone dipropionate (Qvar), Budesonide (Pulmicort), Budesonide/Formoterol (Symbicort), Fluticasone (Flovent), Fluticasone powder (Arnuity Ellipta), Fluticasone/Salmeterol(Advair), Mometasone (Asmanex), Mometasone/formoterol (Dulera)
Your risk of elevated eye pressure increases if you have underlying open-angle glaucoma. Any steroid use you should discuss with your ophthalmologist. Short courses and lower doses of steroids decrease the risk of increased eye pressure.
Dr. Ninita Brown, of Metrolina Eye Associates has been trained as a glaucoma specialist. To be examined for possible glaucoma due to chronic medication use , please call our contact office today.