Drug products: Cosopt, Cosopt sine, Cosopt®, Costad, Dorzolamid Mylan, Dorzolamid Orifarm, Dorzolamid Sandoz, Dorzolamid Stada, Dorzolamid/Timolol Actavis, Dorzolamid/Timolol Ebb, Dorzolamid/Timolol Sandoz, Dorzolamide/Timolol Teva, Duokopt, Trusopt, Trusopt®
ATC code: S01EC03, S01ED51
Substances: dorzolamide, dorzolamide hydrochloride
Controlled studies on differences between men and women regarding efficacy of dorzolamide eyedrops are lacking.
The present evidence concerning differences between men and women is limited and do not motivate differentiation in dosing or treatment.
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 .
Date of litterature search: 2015-12-02
Reviewed by: Mia von Euler
Approved by: Karin Schenck-Gustafsson