From the FDA Drug Label
Dorzolamide HCl Ophthalmic Solution has not been studied in patients with severe renal impairment (CrCl < 30 mL/min) Because Dorzolamide HCl Ophthalmic Solution and its metabolite are excreted predominantly by the kidney, Dorzolamide HCl Ophthalmic Solution is not recommended in such patients. Dorzolamide HCl-Timolol Mal Ophthalmic Solution 2-0.5 % is not recommended for patients with severe renal impairment (CrCl < 30 mL/min) due to the lack of studies and the fact that the drug and its metabolite are excreted predominantly by the kidney 1.
From the Research
Dorzolamide HCl-Timolol Mal ophthalmic solution 2%-0.5% should be used with caution in patients with kidney disease. This medication is a combination eye drop containing dorzolamide (a carbonic anhydrase inhibitor) and timolol (a beta-blocker) used to treat glaucoma and ocular hypertension. While primarily applied topically to the eye, some systemic absorption can occur, particularly with the dorzolamide component. In patients with significant kidney impairment (especially those with creatinine clearance less than 30 mL/min), dorzolamide may accumulate in the body since it is primarily eliminated by the kidneys 2. This accumulation could potentially lead to metabolic acidosis or other systemic side effects. Additionally, patients with kidney disease may experience more pronounced systemic effects from the timolol component. If you have kidney disease, inform your ophthalmologist before starting this medication. Your doctor may recommend more frequent monitoring of kidney function, electrolytes, or possibly adjust the frequency of administration. Alternative glaucoma medications with less potential impact on kidney function might be considered for patients with severe kidney impairment. Despite these concerns, the overall systemic absorption from eye drops is generally low compared to oral medications, making them relatively safer even for patients with kidney disease. The most recent study on the safety and efficacy of fixed combination therapy with dorzolamide hydrochloride 2% and timolol maleate 0.5% found that it is well tolerated and effective in lowering intraocular pressure in patients with glaucoma and ocular hypertension 3. However, it is essential to weigh the benefits and risks of using this medication in patients with kidney disease, considering the potential for systemic absorption and accumulation of dorzolamide. In general, the use of dorzolamide and timolol in patients with kidney disease requires careful consideration and monitoring by an ophthalmologist.
Some key points to consider when using Dorzolamide HCl-Timolol Mal ophthalmic solution 2%-0.5% in patients with kidney disease include:
- The potential for systemic absorption and accumulation of dorzolamide in patients with significant kidney impairment
- The need for careful monitoring of kidney function, electrolytes, and potential systemic side effects
- The consideration of alternative glaucoma medications with less potential impact on kidney function for patients with severe kidney impairment
- The importance of weighing the benefits and risks of using this medication in patients with kidney disease.
It is crucial to follow the most recent and highest quality study, which is 3, to ensure the best possible outcome for patients with kidney disease using Dorzolamide HCl-Timolol Mal ophthalmic solution 2%-0.5%.