Glaucoma can be treated with a variety of eye drop medications to lower your intraocular (internal eye) pressure and protect the optic nerve. You may be prescribed one or more types of drops, and your prescription may change over time. Here, the Glaucoma Research Foundation (GRF) outlines some commonly prescribed medications and some common side effects.*

Eye drop action, categories

Eye drops lower eye pressure by promoting drainage of excess eye fluid and/or decreasing eye fluid production. Named after their active ingredient, there are five general types of eye drops:

• Alpha agonists
• Beta blockers
• Carbonic anhydrase inhibitors (CAIs)
• Prostaglandin analogs (PGs)
• Rho kinase inhibitors (ROCK inhibitors or RKIs)

Combination drops may be a more convenient and cost-effective option for people in need of more than one medication.

Alpha agonists

Alpha agonists both increase eye fluid drainage and decrease fluid production.

• A common example is Alphagan® P (brimonidine tartrate 0.1%, 0.15%), and brimonidine is also available in generic form.
• Side effects may include: 
  • Burning or stinging during application
  • Drowsiness or fatigue
  • Headache
  • Dry nose or mouth

GRF notes that the preservative in Alphagan® P decomposes into natural tear components, which may be better if you’re allergic to the preservatives in other eye drops.

Beta blockers

Beta blockers only decrease eye fluid production. They come in generic forms, so are fairly inexpensive.

• Common examples are: 
  • Betagan® (levobunolol HCI 0.25%, 0.5%)
  • Betoptic® S (betaxolol HCI 0.25%, 0.5%)
  • Timolol Maleate (timolol maleate 0.5%)
  • Timoptic (timolol maleate ophthalmic solution 0.25%, 0.5% in Ocudose dispenser)
  • Betimol® (timolol ophthalmic solution 0.25%, 0.5%)

• Side effects may include:
  • Llow blood pressure, decreased pulse rate, and slower heart rate response during exercise
  • Breathlessness in people with asthma or other respiratory conditions
  • Fatigue

Closing the eyes or blocking the tear ducts after applying beta blockers can help prevent the drug from entering general circulation and causing body-wide side effects.

Carbonic anhydrase inhibitors (CAIs)

CAIs decrease eye fluid production and come in both drops and pills—the latter an alternative for those whose glaucoma isn’t responsive to drops.

• Common examples are: 
  • Diamox (acetazolamide) 
  • Neptazane® (methazolamide)
  • Trusopt® (dorzolamide HCI 2%)

• Side effects of the eye drops may include burning and stinging for example, while the pills may lead to more extensive impacts, such as:
  • Tingling or weakness in hands and feet
  • Mental “fuzziness” and impaired memory
  • Frequent urination
  • Kidney stones
  • Nausea

Prostaglandin analogs (PGs)

PGs help fluid drain from the eye and are especially effective for open-angle glaucoma. 

• Common examples are:
  • Durysta™ (bimatoprost 10 mcg implant)
  • Lumigan® (bimatoprost 0.01%, 0.03%)
  • Travatan® Z (travoprost 0.004%)
  • Vyzulta™ (latanoprostene bunod 0.024%)
  • Xalatan® (latanoprost 0.005%)

• Side effects may include:
• • Eye color change
  • Eyelash growth
  • Sunken eyes
  • Droopy, darkened eyelids
  • Stinging

PGs come in eye drops, except for Durysta, which is implanted in the eye. Latanoprost and some bimatoprost and travoprost formulations come in generic form. Another PG, Zioptan™ (tafluprost ophthalmic solution 0.0015%) is preservative-free.

Rho kinase inhibitors (ROCK inhibitors or RKIs)

RKIs increase fluid drainage by acting on the trabecular meshwork drainage system.

• A common example is Rhopressa® (netarsudil 0.02%).
• Side effects can involve:
  • Stinging
  • Redness
  • Minor bleeding on the sclera (white part of the eye)
  • Deposits in the cornea (the clear dome-like covering over the iris and pupil)

Combined medications

Combination eye drops increase eye fluid drainage.

• Common examples are:
  • Combigan® (brimonidine tartrate plus timolol maleate ophthalmic solution 0.2%/0.5%)
  • Cosopt® (dorzolamide HCI plus timolol maleate)
  • Cosopt® PF (preservative-free) (dorzolamide HCI plus timolol maleate)
  • Rocklatan® (netarsudil plus latanoprost ophthalmic solution 0.02%/0.005%)
  • Simbrinza® (brinzolamide plus brimonidine tartrate 1%/0.2%)

• Side effects can include:
  • Combigan. Similar adverse effects as from alpha agonists and beta blockers
  • Cosopt. Burning and/or stinging, as well as changes in taste
  • Rocklatan. Redness and stinging
  • Simbrinza. Blurry vision, irritation, eye allergy, bad taste, dry mouth

Speak with your doctor about any allergies or sensitivities you may have to ingredients in your glaucoma medications.

*Glaucoma Research Foundation. (2023, March 17). “A Guide to Glaucoma Medications” and “Glaucoma Medications and Their Side Effects“.

The information provided by The Glaucoma Community is for educational purposes only and does not replace professional medical advice. Always talk with your healthcare provider before making changes to your treatment or care. The Glaucoma Community does not endorse specific treatments, providers, or products.