From the Guidelines
Dorzolamide can result in electrolyte abnormalities, although the specific details of these abnormalities are not explicitly stated in the provided evidence. According to the study published in Ophthalmology in 2021 1, dorzolamide is a topical carbonic anhydrase inhibitor used to decrease aqueous production in the treatment of glaucoma. While the study does not directly mention dorzolamide causing electrolyte abnormalities, it does list "Serum electrolyte imbalance" as a potential side effect of oral carbonic anhydrase inhibitors, such as acetazolamide.
Given the mechanism of action of carbonic anhydrase inhibitors, it is plausible that dorzolamide could cause electrolyte abnormalities, particularly if there is significant systemic absorption. However, the provided evidence does not specify the extent to which dorzolamide is associated with electrolyte disturbances.
Some key points to consider when evaluating the potential for dorzolamide to cause electrolyte abnormalities include:
- The mechanism of action of dorzolamide as a carbonic anhydrase inhibitor
- The potential for systemic absorption of dorzolamide after ocular administration
- The presence of any underlying medical conditions that may increase the risk of electrolyte disturbances, such as renal impairment
- The importance of monitoring patients on dorzolamide for signs of electrolyte abnormalities, such as unexplained fatigue, confusion, or respiratory changes.
In clinical practice, it is essential to be aware of the potential for dorzolamide to cause electrolyte abnormalities and to monitor patients accordingly, particularly those with underlying medical conditions that may increase their risk. However, the exact nature and frequency of these abnormalities are not clearly stated in the provided evidence 1.
From the FDA Drug Label
Although acid-base and electrolyte disturbances were not reported in the clinical trials with Dorzolamide HCl Ophthalmic Solution, these disturbances have been reported with oral carbonic anhydrase inhibitors and have, in some instances, resulted in drug interactions (e.g., toxicity associated with high-dose salicylate therapy). Dorzolamide may result in electrolyte abnormalities as it is a carbonic anhydrase inhibitor, and such disturbances have been reported with oral carbonic anhydrase inhibitors 2.
From the Research
Dorzolamide and Electrolyte Abnormalities
- Dorzolamide is a carbonic anhydrase inhibitor used in the treatment of glaucoma to lower intraocular pressure 3, 4, 5, 6.
- Studies in humans have shown that dorzolamide does not appear to produce acid-base or electrolyte disturbances 4, 5.
- However, a study in cats found that administration of dorzolamide 2% ophthalmic solution can result in hypokalemia (low potassium levels) 7.
- The study in cats also found that chloride values were significantly greater in the treatment group compared to the placebo group 7.
- It is worth noting that the studies in humans did not report any significant electrolyte abnormalities, but the study in cats suggests that dorzolamide may have a measurable effect on serum potassium levels in felines 3, 4, 5, 6, 7.
Key Findings
- Dorzolamide is generally well-tolerated in humans and does not appear to cause significant electrolyte disturbances 4, 5.
- However, the study in cats suggests that dorzolamide may cause hypokalemia and alterations in chloride levels 7.
- Further studies are needed to fully understand the effects of dorzolamide on electrolyte levels in different species 7.