The Status of Dorzolamide: Brand vs. Generic
The most prominent source of confusion regarding the status of dorzolamide stems from the discontinuation of its original brand-name version, Trusopt. The manufacturer, Merck, discontinued Trusopt, making it no longer available for new prescriptions or refills. However, this does not mean the generic equivalent, dorzolamide ophthalmic solution, has been completely withdrawn from the market. As long as the generic remains profitable, multiple manufacturers can continue to produce and sell it.
Intermittent Shortages and Supply Issues
Despite the continued availability of the generic, dorzolamide has been subject to recurring supply chain disruptions. In fact, a report from the American Society of Health-System Pharmacists (ASHP) noted a shortage impacting specific manufacturers in 2025, with one estimating a relaunch date of September 2025. Similar issues have arisen in previous years as well. The reasons for these shortages are often complex, ranging from manufacturing issues to business decisions by individual pharmaceutical companies. Patients need to be aware that while the drug is not permanently discontinued, its supply can be unpredictable.
Generic Dorzolamide and Its Role in Glaucoma Treatment
Dorzolamide belongs to a class of drugs known as carbonic anhydrase inhibitors (CAIs). These medications work by decreasing the production of aqueous humor, the fluid inside the eye, which in turn lowers intraocular pressure. This is a crucial step in managing conditions like glaucoma and ocular hypertension, which can cause vision loss if left untreated. For many patients, dorzolamide is a highly effective treatment, either alone or in combination with other drops.
Alternatives to Dorzolamide
In the event of a shortage or if dorzolamide is unsuitable for a patient, several alternative treatments are available. These can be grouped into different classes of eye drops that lower intraocular pressure through various mechanisms.
- Other Carbonic Anhydrase Inhibitors (CAIs): Brinzolamide (Azopt) is another topical CAI. Oral CAIs like acetazolamide (Diamox) may also be used in more severe cases.
- Prostaglandin Analogues: These are often a first-line treatment due to their effectiveness and convenient once-daily dosing. Examples include latanoprost (Xalatan) and bimatoprost (Lumigan).
- Beta-Blockers: These drugs, such as timolol, also reduce aqueous humor production and are a common alternative.
- Alpha Adrenergic Agonists: Examples include brimonidine (Alphagan), which works by both reducing fluid production and increasing drainage.
Combination Products
For patients requiring multiple medications, combination products can simplify treatment. Cosopt is a well-known example that contains a fixed combination of dorzolamide and timolol. This can be a useful alternative, although patients should be aware that it also contains dorzolamide and has faced its own shortage issues. Preservative-free versions of combination therapies like dorzolamide/timolol are also available for patients who react to preservatives.
Comparison of Dorzolamide and Alternatives
| Feature | Dorzolamide (Generic) | Brinzolamide (Azopt/Generic) | Latanoprost (Xalatan/Generic) |
|---|---|---|---|
| Drug Class | Carbonic Anhydrase Inhibitor (CAI) | Carbonic Anhydrase Inhibitor (CAI) | Prostaglandin Analogue |
| Dosing Frequency | Three times daily | Three times daily | Once daily (evening) |
| Common Side Effects | Burning/stinging, bitter taste | Blurred vision, unusual taste | Changes in eye color, eyelash growth |
| Sulfa Allergy Risk | Yes | Yes | No |
| Corneal Concerns | Risk of corneal edema | Risk of corneal edema | Macular edema, uveitis |
| Typical Cost | Generally affordable | More expensive than dorzolamide | Affordable (generic) |
What to Do During a Dorzolamide Shortage
- Contact your pharmacy. Ask if they have dorzolamide from other manufacturers. Supply can vary depending on the producer.
- Speak with your doctor. They may need to switch you to an alternative medication. Your doctor will assess your specific needs and decide on the best course of action.
- Explore combination products. If you also use a beta-blocker, switching to a combination product like Cosopt might be a simple solution.
- Do not stop treatment. Abruptly stopping medication for glaucoma can lead to a dangerous increase in intraocular pressure and cause vision damage.
- Use authoritative sources. For up-to-date information on drug shortages, patients and professionals can check resources like the American Society of Health-System Pharmacists (ASHP) drug shortage bulletins.
Conclusion: No Widespread Discontinuation, But Patient Vigilance is Key
In summary, the specific concern about whether they are discontinuing dorzolamide is primarily a misunderstanding related to the withdrawal of the brand-name product, Trusopt. The generic medication remains available, though its supply can be unreliable due to manufacturer-specific production and distribution issues. Patients managing glaucoma should maintain open communication with their pharmacist and eye care professional to stay informed about the status of their medication and to prepare for potential shortages by discussing suitable alternatives. The medication class as a whole is not being phased out, and other effective options are widely accessible, ensuring that patients can continue their vital treatment. For more information on carbonic anhydrase inhibitors, a valuable resource is the NCBI Bookshelf.
Disclaimer: This article is for informational purposes only and is not medical advice. Consult with a healthcare professional before making any changes to your medication or treatment plan.
