Dorzolamide Eye Drops Uses, Dosage, Side Effects & Price | DrugsAtlas
Authoritative Clinical Reference
Navigation
DRUG NAME: Dorzolamide
Therapeutic Class: Antiglaucoma Agent
Subclass: Carbonic Anhydrase Inhibitor (Topical)
Speciality: Ophthalmology
Schedule (India): H
Route(s): Ophthalmic (topical)
Formulations Available in India:
| Formulation | Strength | Availability |
| Ophthalmic solution (eye drops) | 2% w/v (20 mg/mL) | 5 mL bottle |
| Fixed-Dose Combination with Timolol | Dorzolamide 2% + Timolol 0.5% | 5 mL bottle |
INDICATIONS + DOSING — FOR CLINICIAN USE ONLY
Primary Indications (Approved / Standard in India):
▶️ Open-Angle Glaucoma & Ocular Hypertension
Reduces intraocular pressure (IOP) by inhibiting carbonic anhydrase in ciliary processes, decreasing aqueous humor production.
| Parameter | Recommendation |
|
Starting dose
|
1 drop in affected eye(s) three times daily |
|
Titration
|
Not applicable |
|
Usual maintenance dose
|
1 drop three times daily (monotherapy); may reduce to twice daily when combined with β-blockers |
|
Maximum dose
|
1 drop three times daily |
|
Clinical notes
|
Assess IOP response at 2–4 weeks; may be used as monotherapy or adjunct therapy |
▶️ Secondary Glaucomas (Pseudoexfoliative, Pigmentary Glaucoma)
| Parameter | Recommendation |
|
Starting dose
|
1 drop in affected eye(s) three times daily |
|
Titration
|
Not applicable |
|
Usual maintenance dose
|
1 drop three times daily |
|
Maximum dose
|
1 drop three times daily |
|
Clinical notes
|
Dosing same as primary open-angle glaucoma; titrate based on IOP response |
Secondary Indications — Adults Only (Off-label):
| Indication | Dose | Duration | Notes |
| Pre-operative IOP lowering in acute angle-closure crisis | 1 drop once or twice pre-procedure | Single or short-term use |
OFF-LABEL; Specialist only; Evidence: Indian ophthalmology practice protocols for acute angle-closure management
|
PAEDIATRIC DOSING (Specialist Only)
Primary Indications (Approved / Standard in India):
▶️ Paediatric Glaucoma (Congenital, Juvenile Open-Angle Glaucoma)
| Age Group | Dose | Maximum | Clinical Notes |
|
>2 years
|
1 drop in affected eye(s) three times daily | 1 drop three times daily | Titrate based on IOP response |
Safety Monitoring:
- Weight and growth monitoring
- Acid-base status (risk of metabolic acidosis with systemic absorption)
- Use only when surgery or systemic carbonic anhydrase inhibitors are not preferred or are contraindicated
Secondary Indications — Paediatrics (Off-label):
| Indication | Dose | Duration | Notes |
| Adjunct in refractory paediatric glaucoma | 1 drop in affected eye(s) three times daily | As clinically required |
OFF-LABEL; Specialist only; Evidence: Tertiary Indian paediatric ophthalmology centre practice
|
⚠️ Not recommended in children <2 years except under specialist supervision with close monitoring.
RENAL ADJUSTMENT
| Renal Function | Recommendation |
| Mild to moderate impairment (CrCl ≥30 mL/min) | No adjustment required |
| Severe impairment (CrCl <30 mL/min) | Avoid or use with caution; risk of systemic accumulation and metabolic acidosis |
| Haemodialysis | Not established; avoid use |
HEPATIC ADJUSTMENT
| Hepatic Function | Recommendation |
| Mild impairment | No dosage adjustment required |
| Moderate impairment | No dosage adjustment required; monitor for systemic effects |
| Severe impairment | Use with caution; limited systemic absorption expected but no formal studies available |
CONTRAINDICATIONS
- Known hypersensitivity to dorzolamide or any sulfonamide-derived agents
- Severe renal impairment (CrCl <30 mL/min)
- Pre-existing hyperchloraemic metabolic acidosis
CAUTIONS
- History of sulfonamide allergy (potential cross-reactivity, though rare with topical use)
- Pre-existing corneal endothelial disorders (risk of corneal oedema and decompensation)
- Angle-closure glaucoma (use as adjunct only; does not replace definitive treatment)
- Low corneal endothelial cell count
- Contact lens wearers: remove lenses before instillation; wait ≥15 minutes before reinsertion (preservative benzalkonium chloride may be absorbed)
- Concurrent use of systemic carbonic anhydrase inhibitors
PREGNANCY
| Parameter | Recommendation |
|
Risk category
|
Use only if potential benefit justifies potential risk; no adequate human data |
|
Preferred alternatives
|
Topical β-blockers (e.g., timolol) generally preferred in Indian obstetric practice if no contraindication |
|
When may be used
|
Under specialist guidance when β-blockers are not tolerated or contraindicated |
|
Monitoring
|
Fetal growth assessment if prolonged use; monitor for signs of metabolic disturbance |
LACTATION
| Parameter | Recommendation |
|
Compatibility
|
Likely compatible; minimal systemic absorption |
|
Preferred alternatives
|
Topical β-blockers (e.g., timolol) also considered compatible |
|
Drug levels in milk
|
Low to undetectable |
|
Infant monitoring
|
Observe for feeding difficulties, irritability, vomiting (rare) |
ELDERLY
- Dosage adjustment: Not required
- Considerations:
-
- Higher incidence of local ocular irritation and dry eye symptoms
- Ensure proper instillation technique; supervise if manual dexterity is impaired
- Monitor IOP response closely, particularly if on multiple antiglaucoma agents
- Assess for corneal endothelial health before initiating therapy
MAJOR DRUG INTERACTIONS
| Interacting Drug | Effect | Recommendation |
| Systemic carbonic anhydrase inhibitors (acetazolamide, methazolamide) | Additive systemic carbonic anhydrase inhibition; increased risk of metabolic acidosis, hypokalaemia | Avoid concurrent use unless under specialist supervision |
| High-dose salicylates (aspirin >3 g/day) | Increased risk of salicylate toxicity due to altered renal excretion | Avoid concurrent use |
MODERATE DRUG INTERACTIONS
| Interacting Drug | Effect | Recommendation |
| Other topical antiglaucoma agents (β-blockers, prostaglandin analogues, α-agonists) | Additive IOP-lowering effect; potential for increased local irritation | Generally safe to combine; allow ≥10-minute interval between different eye drops |
| Topical ocular corticosteroids | May mask signs of ocular infection | Monitor closely for infection if used long-term together |
| Other topical ocular medications | Drug interaction at ocular surface; altered absorption | Allow ≥10-minute interval between instillations |
COMMON ADVERSE EFFECTS
- Ocular burning or stinging upon instillation
- Transient blurred vision
- Bitter or unusual taste (dysgeusia)
- Superficial punctate keratitis
- Conjunctival hyperaemia
- Eyelid irritation or dermatitis
- Dry eye sensation
- Foreign body sensation
- Tearing
SERIOUS ADVERSE EFFECTS
| Adverse Effect | Action Required |
| Stevens-Johnson syndrome / Toxic epidermal necrolysis | Discontinue immediately; urgent dermatology referral |
| Corneal oedema / decompensation | Discontinue; ophthalmology evaluation |
| Systemic metabolic acidosis | Discontinue; evaluate renal function and acid-base status |
| Severe allergic reactions (angioedema, anaphylaxis) | Discontinue immediately; emergency management |
| Irreversible corneal endothelial damage | Discontinue; specialist assessment |
MONITORING REQUIREMENTS
| Phase | Parameters |
|
Baseline
|
IOP measurement; slit-lamp examination (cornea, anterior chamber); baseline renal function if systemic carbonic anhydrase inhibitor co-prescribed |
|
After initiation
|
IOP at 2–4 weeks; assess tolerability and local side effects |
|
Long-term
|
Periodic IOP monitoring; visual field assessment; corneal endothelial evaluation (especially with prolonged use); slit-lamp examination |
|
Paediatrics
|
Growth parameters; acid-base status if prolonged therapy |
BRANDS AVAILABLE IN INDIA
Single-ingredient (Dorzolamide 2%):
- Dorzox (Cipla)
- Dorzid (Ajanta Pharma)
- Dorzol (Alcon)
- Dortas (Sun Pharma)
Fixed-Dose Combination (Dorzolamide 2% + Timolol 0.5%):
- Dorzox-T (Cipla)
- Dorzid-T (Ajanta Pharma)
- Cosopt (MSD; imported)
PRICE RANGE (INR)
| Formulation | Pack Size | Approximate Price Range |
| Dorzolamide 2% eye drops | 5 mL | ₹130–₹280 |
| Dorzolamide + Timolol FDC eye drops | 5 mL | ₹180–₹320 |
- FDC formulations may fall under NPPA price control if included in NLEM as combination
- Prices may vary based on brand and region
CLINICAL PEARLS
- Dorzolamide is a sulfonamide derivative; obtain history of sulfa allergy before prescribing, though topical cross-reactivity is uncommon
- Transient stinging on instillation is very common; counsel patients that it typically resolves within minutes
- FDC with timolol improves adherence and provides additive IOP reduction; preferred when dual therapy is indicated
- Avoid dropper tip contact with eye or eyelid to prevent contamination
- Evaluate corneal endothelial health (specular microscopy if available) before initiating long-term therapy; avoid in patients with pre-existing endothelial compromise
- In paediatric glaucoma, use only under ophthalmology supervision; monitor for systemic effects including metabolic acidosis
- Wait at least 10 minutes between instillation of different eye drops to maximise absorption and minimise wash-out effect
TAGS
dorzolamide; glaucoma; carbonic anhydrase inhibitor; antiglaucoma; eye drops; ocular hypertension; sulfonamide; paediatric glaucoma; IOP; topical ophthalmic
VERSION
RxIndia v1.1 — 14 Feb 2026
REFERENCES
- CDSCO (Central Drugs Standard Control Organisation) approved product information
- Indian Pharmacopoeia / National Formulary of India
- AIIMS Ophthalmology department protocols
- API Textbook of Medicine
- Indian Journal of Ophthalmology — clinical practice articles
- Goodman & Gilman’s The Pharmacological Basis of Therapeutics
- WHO Essential Medicines List (supportive reference for paediatric use)
- Manufacturer prescribing information (Cipla, Alcon)
⚖️
Clinical Responsibility
This platform is designed strictly for healthcare professionals. Data provided is synthesized from authoritative pharmacological sources and clinical registries. Do not use for consumer medical decisions. Always verify critical dosing and contraindications with official institutional protocols and peer-reviewed journals.
Content Feedback
Is this information helpful?
Help us improve our clinical database for the medical community.