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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIGLAUCOMA PREPARATIONS AND MIOTICS › Carbonic anhydrase inhibitors
diclofenamide
S01EC02
Adult Dosing
- Primary open-angle glaucoma: 50 mg 1 to 3 times daily
- Secondary glaucoma: 50 mg 1 to 3 times daily
- Preoperative control of intraocular pressure: 50 mg to 100 mg 1 to 2 times daily prior to surgery
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Indications
- Adjunctive treatment of chronic simple (open-angle) glaucoma
- Secondary glaucoma
- Preoperative control of intraocular pressure when prior therapy has failed
Mechanism of Action
- Inhibits carbonic anhydrase in the ciliary body of the eye
- Decreases aqueous humor secretion, resulting in a reduction of intraocular pressure
Contraindications
- Hypersensitivity to diclofenamide or other sulfonamides
- Markedly depressed sodium and/or potassium blood serum levels
- Severe pulmonary obstruction or respiratory acidosis
- Adrenocortical insufficiency and Addison's disease
- Severe renal or hepatic impairment
Adverse Reactions
- Gastrointestinal: anorexia, nausea, vomiting, weight loss, taste alteration
- Central nervous system: paresthesias, fatigue, dizziness, headache, depression
- Metabolic: hypokalemia, metabolic acidosis, hyperuricemia
- Hematologic: leukopenia, agranulocytosis, aplastic anemia, thrombocytopenia
- Dermatologic: rash, pruritus, Stevens-Johnson syndrome, toxic epidermal necrolysis
Drug Interactions
- High-dose salicylates: risk of severe metabolic acidosis and CNS toxicity due to additive effects and reduced renal clearance
- Lithium: increased renal excretion of lithium leading to decreased therapeutic efficacy
- Other carbonic anhydrase inhibitors: potential for additive toxicity and adverse metabolic effects
- Potassium-wasting diuretics (e.g., thiazides, loop diuretics): increased risk of severe hypokalemia
Curated Content: Needs Vetting Before Put to Clinical Use