Nodom (Dorzolamide Hydrochloride)

Dorzolamide Hydrochloride is indicated for ocular conditions where reduction of intra‑ocular pressure is required.

• Open‑angle glaucoma: lowers intra‑ocular pressure to help prevent optic nerve damage.
• Ocular hypertension: reduces elevated eye pressure to decrease risk of progression to glaucoma.
• Secondary glaucoma (adjunct therapy): contributes to pressure control when used with other antiglaucoma agents.

• Dorzolamide inhibits the enzyme carbonic anhydrase located in the ciliary body epithelium. By blocking this enzyme, the production of aqueous humor is reduced, leading to a decrease in intra‑ocular pressure. The effect is localized to the eye because the drug is applied topically as an ophthalmic solution, limiting systemic exposure. The inhibition is reversible and selective for the isoforms present in ocular tissue, providing sustained pressure control with minimal systemic activity.

Topical dorzolamide may cause ocular and systemic adverse reactions, most of which are mild and transient.

Common Side Effects

• Blurred vision: temporary difficulty focusing after instillation.
• Eye irritation: burning or stinging sensation.
• Bitter taste: metallic taste after drainage through the nasolacrimal duct.

Serious or Rare Side Effects

• Allergic reaction: swelling, rash, or itching around the eye.
• Severe eye pain: may indicate corneal edema.
• Stevens‑Johnson syndrome: rare systemic skin reaction.

When prescribing dorzolamide eye drops, clinicians should consider several safety measures to minimize risks.

• Monitor intra‑ocular pressure: schedule regular IOP assessments.
• Assess sulfonamide allergy: avoid use in patients with known sulfa hypersensitivity.
• Remove contact lenses: advise patients to take out lenses before instillation.
• Avoid concurrent carbonic anhydrase inhibitors: risk of excessive pressure reduction.
• Store at room temperature: keep in the original container, protect from light and moisture.

Dorzolamide can interact with other ophthalmic or systemic agents, affecting efficacy or safety.

Major Interactions (Avoid)

• Concurrent use of other topical carbonic anhydrase inhibitors: may cause excessive intra‑ocular pressure lowering.
• Systemic sulfonamide drugs in sulfa‑allergic patients: increase risk of hypersensitivity reactions.

Moderate Interactions (Monitor Closely)

• Beta‑blocker eye drops: additive IOP‑lowering effect, monitor pressure.
• Prostaglandin analogues: combined therapy may require IOP monitoring.
• Oral carbonic anhydrase inhibitors (e.g., acetazolamide): may increase systemic exposure and side effects.