Preparat: Cosopt, Cosopt sine, Cosopt®, Costad, Dorzolamid Mylan, Dorzolamid Orifarm, Dorzolamid Sandoz, Dorzolamid Stada, Dorzolamid/Timolol Actavis, Dorzolamid/Timolol Sandoz, Dorzolamide/Timolol Teva, Duokopt, Trusopt, Trusopt®
ATC kod: S01EC03, S01ED51
Substanser: dorzolamid, dorzolamidhydroklorid
Det saknas kontrollerade studier om skillnader mellan könen avseende effekt för dorzolamid ögondroppar.
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.
A pharmacokinetic study of 1 mg daily in 20 healthy volunteers showed that steady state concentrations of dorzolamide were slightly higher in women than in men (4.10 μg/ml vs 3.95 μg/ml) . However, no sex differentiation in dosing has been recommended .
No studies with a clinically relevant sex analysis regarding the effects of dorzolamide eyedrops have been found.
In a randomized study, patients with risk factors for glaucoma received double-blinded treatment with dorzolamide or placebo. In a subgroup, measurements of central corneal thickness at 5 year follow-up (394 men, 460 women) showed 8.6 μm greater thickness in men than in women (576.8 μm and 569.2 μm, respectively) [12,13].
Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).
In a population-based survey study including a medical examination in 4744 Australians, 2.3% were previously diagnosed with ocular hypertension or open angle glaucoma (52 male, 56 female). The proportion reporting a history of glaucoma surgery or treatment with glaucoma medication was similar in men and women .
In a study from the US nearly half of the individuals who had filled one glaucoma prescription discontinued the treatment within six months. Among glaucoma patients aged 40-49 years, living in the Southeast region of the US and being a woman were factors associated with discontinuation .
General differences between men and women with glaucomaIn a randomized clinical trial of normal-tension glaucoma patients, an untreated subset of patients (61 men, 99 women) was analyzed regarding risk factors for (a high) progression rate of visual field loss. The time to measurable decrease in visual field was shorter in women than in men (1849 vs. 2356 days and the speed of deterioration was higher in women than in men (0.47 vs. 0.23 decibels per year). Migraine and optic disk hemorrhage were other risk factors for an increased progression rate (OR 2.58 and 2.72, respectively). According to the authors, it could be wise to treat women with migraine or optic disk hemorrhage aggressively as they are at a higher risk of faster progression than others .An eye examination of a West Greenland Eskimos population > 40 years old (162 men, 182 women) aimed at detecting primary angle-closure glaucoma (PACG) showed a higher prevalence in women than in men (age-group 60-69: 5% in men, 15% in women and age-group 70+: 3% in men, 27% in women) . Measurements of the right eyes (155 men, 156 women) showed that the limbal chamber depth (LCD), as well as the axial chamber depth (ACD) was lower in women than in men .In a population based study in the Netherlands it was noted that women who were postmenopausal before the age of 45 had a higher risk of open-angle glaucoma (odds ratio 2.6) compared to those who were older at menopause (odds ratio for open angle glaucoma of 1.1) . A study of endothelial nitric oxide synthase gene variants found an association with open angle glaucoma which might explain this . Studies on the effect of hormonal replacement therapy (HRT) are lacking .In a retrospective study, glaucoma patients (64 men, 59 women) underwent selective laser trabeculoplasty (SLT). The intra ocular pressure (IOP) lowering efficacy of SLT was equal in men and women and regardless of type, or absence of glaucoma medication at 6 months post-laser .
Fler kvinnor än män hämtade ut ögondroppar innehållande dorzolamid (ATC-kod S01EC03) på recept i Sverige år 2015, totalt 4 376 kvinnor och 2 928 män. Det motsvarar 0,9 respektive 0,6 patienter per tusen invånare. Andelen som hämtat ut läkemedel ökade med stigande ålder hos båda könen. Totalt sett var ögondroppar innehållande dorzolamid 1,5 gånger vanligare hos kvinnor .
Fler kvinnor än män hämtade ut ögondroppar innehållande timolol i kombination (ATC-kod S01ED51) på recept i Sverige år 2015, totalt 38 434 kvinnor och 33 818 män. Det motsvarar 7,9 respektive 6,9 personer per tusen invånare. Andelen som hämtat ut läkemedel ökade med stigande ålder hos båda könen . ATC-koden innehåller timololkombinationer med bimatoprost, brinzolamid, brimonidin, dorzolamid, latanoprost, pilokarpin, travoprost, tafluprost. Kombinationen timolol/dorzolamid utgör 32 % av den totala försäljningen i denna ATC-kod .
Faktagranskat av: Mia von Euler
Godkänt av: Karin Schenck-Gustafsson