Any sort of medication comes with potential side effects, but did you know that many well-known  medications can potentially make glaucoma worse? Here, Dr. Audrey Tai, a cataract and refractive surgeon, ophthalmologist, and cornea specialist discusses common prescription and over-the-counter drugs that can further harm your vision–and even cause a medical emergency–if you have glaucoma.*

The First Thing You Need to Know

The first thing you need to know, says Tai, is that “medications may be safe for one type of glaucoma but risky for another,” so it’s important to know what type of glaucoma you have.

The most common type of glaucoma in the U.S. is open-angle glaucoma (OAG). With OAG, a slow-progressing type, blind spots that you won’t even be aware of begin to develop in your peripheral (side) vision over the course of years, even decades.

Angle-closure glaucoma (ACG), also called narrow-angle glaucoma, “is less common, but more likely to be symptomatic.” Tai explains that ACG occurs “when the iris, the eye muscle that determines our eye color, is very close to the drainage angle,” and completely blocks off fluid drainage. When this happens, eye pressure increases very quickly, causing an acute angle-closure attack, which is a medical emergency. If not treated immediately, you could lose your sight within hours or days.

Medications to Avoid With Open-Angle Glaucoma

“Steroids are the main medication that can raise eye pressure for patients with open-angle glaucoma,” Tai says. “Taking steroids in any form: orally, topically on the skin, through an inhaler or IV, can all worsen glaucoma,” especially those applied near or in the eye. 

She recommends letting your eye doctor know if you are taking any form of steroid, whether for:

• Allergies
• Asthma
• Autoimmune disorders
• Irritable bowel syndrome
• Joint disease, or any other condition

Medications to Avoid With Angle-Closure Glaucoma

Most people, Tai explains, aren’t aware that they have ACG until they have an acute attack in which they may experience:

• Sudden eye pain
• Rapid vision loss or foggy vision
• Headache
• Nausea and vomiting
• Seeing halos or rainbows around light sources

If you experience any of these symptoms, especially in combination, contact your ophthalmologist immediately or go to the nearest emergency room.

“Many common medications can be dangerous” for people with ACG, she says, and trigger an acute attack. These include:

• Atrovent and Spiriva (for asthma or COPD)
• Botox (especially if injected near the eye)
• DayQuil, NyQuil, and Alka-Seltzer Plus (along with other cold or flu remedies that contain antihistamines or decongestants)
• Detrol and Oxybutynin (for urinary incontinence or overactive bladder)
• Dilating eye drops used during eye exams
• Benadryl, Claritin, Allegra, and Zyrtec (for allergy relief and nasal congestion)
• Imitrex (for migraine)
• Norflex (for muscle spasm)
• Artane (for Parkinson’s disease)
• Scopolamine patches (for motion sickness)
• Tagamet and Zantac (for heartburn)
• Drugs used to treat psychiatric disorders, such as:
  • Prozac
  • Paxil
  • Elavil
  • Tofranil
  • Cymbalta
• Sulfa containing medications such as Topamax, Diamox, and Bactrim

This is a partial list. Be aware that the active ingredients in many of the drugs on this list can be sold under more than one brand name. It’s a good idea to familiarize yourself with the generic names of your medications.

ACG can be diagnosed during an eye examination using a variety of tests. If you know that you have ACG, and have a question about a particular medication, whether prescription or over-the-counter, consult your eye doctor before taking it.

*Tai, A. [Eye Channel by Eye Surgeon Dr. Audrey Tai]. (2024, March 2). Warning! Avoid These Medications If You Have Glaucoma | Eye Surgeon Explains [Video file]. https://www.youtube.com/watch?v=20kZ5i1sAMU

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