Marketplace

Focus on Glaucoma Medications

TRAVATAN Z AND AZOPT

Alcon

■ Travatan Z solution (travoprost 0.004%) is the only BAK-free prostaglandin analogue available in the United States. Travatan Z solution is formulated without benzalkonium chloride (BAK) and replaces BAK with sofZIA, a robust ionic buffered preservative system that meets all USP preservative-effectiveness standards.

Travatan Z solution is indicated for the reduction of elevated IOP in patients with open-angle glaucoma or ocular hypertension who are intolerant or insufficiently responsive to other IOP-lowering medications.

The most common side effect reported with Travatan Z solution is ocular hyperemia, which was reported in 30% to 50% of patients. The recommended dosage is one drop in the affected eye(s) once daily in the evening.

Azopt suspension is an adjunctive agent for additional IOP lowering. Topical carbonic anhydrase inhibitors, like Azopt suspension, provide consistent IOP control throughout the day and night, without the concern of systemic side effects or peak and trough fluctuations between doses. Azopt suspension is indicated in the treatment of elevated IOP in patients with ocular hypertension or open-angle glaucoma. The recommend dose is one drop in the affected eye(s) t.i.d. The most frequently reported adverse events associated with Azopt suspension were blurred vision and unusual taste reported in 5% to 10% of patients.
Alcon
Phone: (800) 862-5266
www.travatan.com and
www.azopt.com

COMBIGAN, LUMIGAN AND ALPHAGAN P 0.1%

Allergan

■ Combigan (brimonidine tartrate/timolol maleate ophthalmic solution) 0.2%/0.5%, an alpha adrenergic receptor agonist with a beta adrenergic receptor inhibitor, is a b.i.d. prescription eye drop indicated for the reduction of elevated IOP in patients with glaucoma or ocular hypertension who require adjunctive or replacement therapy due to inadequately controlled IOP. The IOP-lowering of Combigan ophthalmic solution dosed b.i.d. was slightly less than that seen with the concomitant administration of timolol maleate ophthalmic solution 0.5% dosed b.i.d. and brimonidine tartrate ophthalmic solution 0.2% dosed t.i.d. Combigan works in two ways to lower IOP with the IOP-lowering efficacy of two proven agents in the convenience of one bottle.

The most common adverse reactions, occurring in approximately 5% to 15% of patients, included allergic conjunctivitis, conjunctival folliculosis, conjunctival hyperemia, eye pruritus and ocular burning and stinging.

Lumigan (bimatoprost 0.03%) is a once-daily prescription eye drop indicated for the reduction of IOP in patients with open-angle glaucoma or ocular hypertension. In 2006, the FDA approved Lumigan as a first-line treatment, in addition to its widely established use by ophthalmologists as a second-line therapy for patients who require additional lowering of IOP.

Patient compliance with treatment has been shown to be vital to reducing the risk of disease progression and vision loss. An extension of Allergan's pivotal trials concludes that bimatoprost continues to be well tolerated and effectively sustained lower IOP in patients over 4 years of continuous treatment. (Williams RD, et al. Long-term efficacy and safety of bimatoprost for IOP lowering in glaucoma and ocular hypertension: results from the extension of the pivotal trials through year 4. Poster presented at: AGS; March 3-6, 2005; Snowbird, Utah.)

Lumigan has been reported to cause changes to pigmented tissues, including the eyelashes, iris and eyelid. These changes may be permanent. Allergan says patients using Lumigan may also experience some usually tolerable side effects, including eye redness (hyperemia), increased eyelash growth or itchy eyes.

Alphagan P (brimonidine tartrate 0.1%) is a new formulation of the original Alphagan 0.2% and Alphagan P 0.15%. Alphagan P 0.1% is indicated for lowering IOP in patients with open-angle glaucoma or ocular hypertension.

Alphagan P offers a dual mechanism of action for treatment flexibility. The new formulation is designed to ensure that patients receive maximal therapeutic efficacy while reducing drug exposure. Patients using Alphagan P 0.1% may experience some usually tolerable side effects, including allergic conjunctivitis, conjunctival hyperemia and eye pruritus. Alphagan P 0.1% is contraindicated in patients receiving monoamine oxidase inhibitor therapy.
Allergan, Inc.
Phone: (800) 347-4500
www.allergan.com

ISTALOL

Ista Pharmaceuticals

■ Istalol (timolol maleate 0.5%) is a once-daily beta-blocker topical solution that helps lower IOP. Clinical studies show that Istalol, which is a q.d. solution, lowers IOP as well as other b.i.d. beta-blocker drops. The difference between other beta-blocker medications and Istalol lies in the unique formulation of Istalol, says ISTA. Istalol is the only beta-blocker solution indicated for once-daily dosing that has 75% less systemic absorption compared to generic timolol and contains 50% less BAK preservative than other solution formulations. Additionally, unlike other betablockers, Istalol does not contain a gel base, which means that there is no gel-induced blur. Istalol has shown to have less effect on heart rate compared with timolol maleate in the phase 3 trials, which was statistically significant through the 12 month period. (Mundorf TK, Ogawa T, Naka H, et al. A 12-month, multicenter, randomized, double-masked, parallel-group comparison of timolol-LA once a daily and timolol maleate ophthalmic solution twice daily in the treatment of adults with glaucoma or ocular hypertension. Clin Ther. 2004;26:541-551)
Ista Pharmaceuticals
Phone: (949) 788-6000
www.istavision.com

XALATAN

Pfizer Ophthalmics

■ Xalatan (latanoprost ophthalmic solution) is the number one prescribed IOP-lowering agent, and is indicated first-line for the reduction of elevated IOP in patients with open-angle glaucoma or ocular hypertension. With more than a decade of clinical experience, Xalatan provides the powerful IOP lowering expected from a prostoglandin, and proven tolerability with the lowest incidence of hyperemia in its class. Xalatan is the only PG with published 5-year efficacy and safety data. Studies demonstrate that Xalatan is the proven PG therapy that patients can stay on longer (Reardon G et al. Patient persistency with topical ocular hypotensive therapy in a managed care population. Am J Ophthalmol. 2004;137(suppl):S3-S12.)
Pfizer Ophthalmics
Phone: (888) 691-6813
www.xalatan.com

BETIMOL

Vistakon Pharmaceuticals, LLC

■ Betimol (timolol 0.25%, 0.5%) is a patent-protected, branded beta-blocker currently marketed in the United States by Vistakon Pharmaceuticals, LLC. Clinical studies have demonstrated the efficacy and safety of Betimol as statistically equivalent to that of timolol maleate (Timoptic). The most common ocular adverse events reported in using Betimol include foreign body sensation (2%), burning/stinging (1%), dry eye (1%) and ocular discomfort (1%).
Vistakon Pharmaceuticals, LLC
Phone: (800) 523-6225
www.vistakonpharmaceuticals.com