Brinzolamide

How it works

It inhibits carbonic anhydrase in the ciliary epithelium, reducing aqueous humour formation and thereby lowering intraocular pressure.

Prescribing in practice

• As a sulfonamide derivative it is contraindicated in patients with known sulfonamide hypersensitivity, and systemic sulfonamide-type reactions can rarely occur.
• Avoid in severe renal impairment because of reduced clearance of the active metabolite.
• Blurred vision on instillation is common owing to the suspension formulation; shake well before use.

Monitoring

Monitor intraocular pressure response and remain alert for ocular discomfort, altered taste and rare systemic sulfonamide-type hypersensitivity reactions.

Counselling the patient

• Shake the bottle well and expect transient blurring after instillation.
• Remove soft contact lenses before use and wait before reinserting them.
• A temporary bitter or unusual taste in the mouth after dosing is common and harmless.

Evidence & guidelines

Topical carbonic anhydrase inhibitors are a well-established treatment option for reducing intraocular pressure, used alone or as adjunctive therapy.