Cosopt (Dorzolamide Hydrochloride / Timolol Maleate Ophthalmic) - Summary

COSOPT SUMMARY

What is COSOPT?

COSOPT (dorzolamide hydrochloride-timolol maleate ophthalmic solution) is the combination of a topical carbonic anhydrase inhibitor and a topical beta-adrenergic receptor blocking agent.

COSOPT is indicated for the reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to beta-blockers (failed to achieve target IOP determined after multiple measurements over time). The IOP-lowering of COSOPT b.i.d. was slightly less than that seen with the concomitant administration of 0.5% timolol b.i.d. and 2.0% dorzolamide t.i.d. (see CLINICAL PHARMACOLOGY, Clinical Studies).

See all Cosopt indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Cosopt (Dorzolamide / Timolol Ophthalmic)

[Comparative study of the pressure lowering efficacy and variations in the ocular pulse amplitude between fixed combinations of dorzolamide/timolol and brinzolamide/timolol]. [2011.05]
OBJECTIVE: To determine possible differences in the intraocular pressure (IOP) and ocular pulse amplitude (OPA) lowering capacity of the fixed drug combinations dorzolamide/timolol and brinzolamide/timolol... CONCLUSIONS: Both fixed combinations were similarly effective in reducing intraocular pressure and ocular pulse amplitude. Adverse effects related to both treatments were mild and well-tolerated, though itching occurred most frequently in the eyes treated with dorzolamide/timolol. Copyright (c) 2011 Sociedad Espanola de Oftalmologia. Published by Elsevier Espana. All rights reserved.

Comparison of the efficacy and tolerability of preservative-free and preservative-containing formulations of the dorzolamide/timolol fixed combination (COSOPT) in patients with elevated intraocular pressure in a randomized clinical trial. [2010.12]
BACKGROUND: The aim of this study was to compare the efficacy and tolerability of preservative-free (PF) and preservative-containing (PC) formulations of the dorzolamide/timolol fixed combination (COSOPT) in patients with elevated intraocular pressure (IOP)... CONCLUSIONS: In patients with elevated IOP, PF and PC dorzolamide/timolol were equivalent in efficacy for change in trough and peak IOP, and had generally similar tolerability.

Comparison of ocular hypotensive actions of fixed combinations of brimonidine/timolol and dorzolamide/timolol. [2010.07]
OBJECTIVE: To compare brimonidine/timolol fixed combination (BrTFC; Combigan *) with dorzolamide/timolol fixed combination (DTFC; Cosopt dagger) in terms of ability to lower intraocular pressure (IOP) in primary open-angle glaucoma (POAG)... CONCLUSION: Reductions from baseline in mean diurnal IOP and morning IOP were greater with BrTFC than with DTFC.

Efficacy and safety of fixed combinations of latanoprost/timolol and dorzolamide/timolol in open-angle glaucoma or ocular hypertension. [2010.07]
AIMS: To compare intraocular pressure (IOP) reductions with fixed-combination (FC) latanoprost/timolol once daily in the evening vsFC dorzolamide/timolol twice daily... CONCLUSIONS: When beta-blocker therapy is inadequate, either FC may achieve the desired IOP level, but FC latanoprost/timolol more often achieves a pressure of <or=16 mm Hg. Both FCs were well tolerated.

Additive intraocular pressure reduction effect of fixed combination of maleate timolol 0.5%/dorzolamide 2% (Cosopt) on monotherapy with latanoprost (Xalatan) in patients with elevated intraocular pressure: a prospective, 4-week, open-label, randomized, controlled clinical trial. [2010.06]
PURPOSE: To evaluate the additive effect of dorzolamide/timolol fixed combination in patients under monotherapy with latanoprost... CONCLUSIONS: In our sample, dorzolamide 2%/timolol 0.5% fixed combination as add-on therapy in patients with open-angle glaucoma or ocular hypertension under monotherapy with latanoprost with IOP already in mid-teens levels may further enhance pressure reduction.

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Clinical Trials Related to Cosopt (Dorzolamide / Timolol Ophthalmic)

Effects of Cosopt on IOP and on Ocular Diastolic Perfusion Pressure [Not yet recruiting]
Hypothesis: Studies suggest that patients with low diastolic velocity and high resistivity index in the ophthalmic artery had more progressive visual fields, the investigators hypothesize therefore that addition of Cosopt to Latanoprost could improve ocular diastolic perfusion pressure (ODPP).

Objective: To evaluate the effects of Cosopt on ODPP in patients not adequately controlled with latanoprost alone.

The Effects of Cosopt® Vs Xalacom® on Ocular Hemodynamics and Intraocular Pressure (IOP) in Primary Open-angle Glaucoma (POAG) [Recruiting]
Both Cosopt® and Xalatan® plus Timoptic® will significantly lower IOP, however only Cosopt® will demonstrate positive hemodynamic effects. The clinical significance of this will be investigated by examining the ophthalmic and short posterior ciliary arteries to determine the blood supply to the optic nerve head, the site of damage in glaucoma

Intraocular Pressure and Ocular Perfusion Pressure of Cosopt in Normal Tension Glaucoma [Recruiting]
To prove the non-inferiority of the fixed timolol-dorzolamide combination (Cosopt) compared to 0. 005% latanoprost (Xalatan) in the aspects of intraocular pressure (IOP) and ocular perfusion pressure (OPP) in subjects with normal tension glaucoma (NTG)

Clinical hypotheses. Primary hypothesis

- Cosopt group is non-inferior to Xalatan group in diurnal IOP reduction.

Secondary hypothesis

- Cosopt group is non-inferior to Xalatan group in diurnal diastolic and systolic OPP.

Patient Preference Comparison of AZARGA Versus COSOPT [Recruiting]
The purpose of this study is to assess patient preference of AZARGA® compared to COSOPT® after one week instillation of each study medication is administered to both eyes in patients with open-angle glaucoma or ocular hypertension.

Comparison of Efficacy of Two Groups of Glaucoma Drops (Xalatan vs.Cosopt) in Reducing Eye Pressure Following Laser (SLT)Treatment in the Management of Glaucoma. [Recruiting]
WHAT IS THIS STUDY ABOUT? Glaucoma and ocular hypertension are chronic eye diseases that can damage the optic nerve and lead to vision loss or blindness. The optic nerve acts like an electric cable with over a million wires. This nerve is responsible for carrying images from the eye to the brain. The way glaucoma and ocular hypertension cause blindness depends on many factors, but the most important factor is the increased pressure inside the eye (intraocular pressure).

There is no cure for glaucoma or ocular hypertension. However, lowering the pressure inside the eye has been shown to slow the progression of disease. Intraocular pressure can be lowered by glaucoma medication, laser treatment, or surgery.

You have open angle glaucoma, pseudoexfoliative glaucoma, or ocular hypertension. Researchers want to find out more about how 2 drugs called Cosopt (dorzolamide hydrochloride and timolol maleate) and Xalatan (latanoprost) can help people with these conditions.

Cosopt and Xalatan are both eye drops that are approved by the U. S. Food and Drug Administration (FDA) to reduce intraocular pressure in people with open angle glaucoma and ocular hypertension.

The study doctor will do a laser procedure called Selective Laser Trabeculoplasty (SLT) on people in this study to help lower their intraocular pressure. The FDA has approved SLT to treat open angle glaucoma and ocular hypertension.

Then the study doctor will ask some participants to use either Cosopt or Xalatan, if their intraocular pressure is still too high 4 to 6 weeks after the SLT procedure. The study doctor wants to see which of the 2 study drugs (Cosopt or Xalatan) is better at reducing intraocular pressure after SLT.

It is planned that about 30 people with glaucoma or ocular hypertension who are at least 18 years old will be in this study. Out of the participants whose intraocular pressure is still too high after SLT, half will use Cosopt and half will use Xalatan. You do not have to be in this study to have SLT or to use Cosopt or Xalatan.

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Reports of Suspected Cosopt (Dorzolamide / Timolol Ophthalmic) Side Effects

Ocular Hyperaemia (12),  Loss of Consciousness (6),  Cough (6),  Drug Ineffective (5),  Intraocular Pressure Increased (5),  Headache (5),  Dizziness (5),  Heart Rate Irregular (5),  Fear (4),  Feeling Cold (4), more >>

PATIENT REVIEWS / RATINGS / COMMENTS

Cosopt review by 62 year old female patient
		Rating
Overall rating:
Effectiveness:		Considerably Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		glaucoma
Dosage & duration:		1 drop each eye (dosage frequency: twice a day) for the period of 2years
Other conditions:		none
Other drugs taken:		none
		Reported Results
Benefits:		The pressure in my eyes decreased with use over a period of four months.
Side effects:		There is a mild burning in my eyes for a couple of minutes after the drops are out in.
Comments:		The drops are administered twice a day approximately 12 hours apart. It is usually necessary to keep eyes closed for a minute or two until the burning subsides.

Cosopt review by 53 year old male patient
		Rating
Overall rating:
Effectiveness:		Considerably Effective
Side effects:		Mild Side Effects
		Treatment Info
Condition / reason:		High interoccular pressure
Dosage & duration:		One drop each in each eye twice daily (dosage frequency: twice daily) for the period of About 3 years
Other conditions:		none
Other drugs taken:		none
		Reported Results
Benefits:		Cosopt reduced my occular pressure in both eyes by nearly one third which pleased my eye doctor. The treatment benefits are long term. Reducing occular pressure will prolong eyesight by preserving the optical nerves. Sorry not 50 words.
Side effects:		I suspect it caused increased hair loss (thining) which I became aware of after about two - two and a half years of using the medication. I had hair loss before ever starting medications but it seems like this medicine began increasing the problem. Cosopt burned initially on application and turned the eyes red which cleared up fairly quickly. I am not aware of any other side effect. I switched medications and further explanation is below. If I knew these drugs do cause hair loss it might affect its rating,... but then again it does save the eyes.
Comments:		I had elevated occular pressure that needed to be reduced and my doctor put me on xalatan which caused my eyelashes to begin to thicken and become dark in a couple of months so I had him put me on something else so we went to cosopt. After a time I felt like this was causing increased hair loss so I looked up drug side effects and cosopt was listed as causing hair loss so I had him change it again then I started alphagan p and azopt. My eyes after nearly two months time turned red and never cleared up so the doctor dropped the alphagan p and replaced it with timilol 0.25 percent. The redness quickly went away. Now with azopt in each eye once in the morning and once at bedtime and timilol 0.25 in both in the mornings only my occular pressures have been reduced one to two points lower in each eye than what the cosopt did when taken in the morning and at bedtime. These changes have not stopped the hair loss from occuring even though timilol 0.25 percent has half the timilol in it as the cosopt and is used only once a day in each eye vs cosopts twice a day in each eye. Azopt is reported to cause hair loss and is very similar to the second ingredient in cosopt.