Brinzolamide

AZOPT

What it isTopical carbonic anhydrase inhibitor; open-angle glaucoma.

Why this oneA suspension rather than a solution, so it stings far less than dorzolamide, which improves adherence.

What limits itTransient blurred vision after instillation. It is a sulfonamide; corneal decompensation in a compromised endothelium.

FDA-approved for

FDA dosing	Population	Start	Target	Max
Elevated IOP in open-angle glaucoma or ocular hypertension	Adults	1 drop TID	1 drop TID

Renal Not recommended if CrCl <30 mL/min (severe impairment); not studied

Hepatic Undefined

Instill in affected eye(s) three times daily
If using more than one topical ophthalmic drug, administer at least 10 minutes apart
Remove contact lenses before instillation; reinsert 15 minutes after
Avoid dropper tip contact to prevent contamination

Sulfonamide hypersensitivity reactions (rare fatalities: SJS, TEN, hepatic necrosis, blood dyscrasias)
Corneal edema risk in patients with low endothelial cell counts
Not studied in acute angle-closure glaucoma
Benzalkonium chloride may be absorbed by soft contact lenses

Pregnancy No adequate human data; fetal toxicity in rats at high oral (systemic) doses

Lactation No human data; detected in milk of lactating rats

NO BOXED WARNINGS

Principal riskTransient blurred vision; sulfonamide cross-reactivity

Cost, est. cash$10–$400/month

Generic entry2020

Therapeutic safety burden0 / 4

Overdose danger0 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.