What is the role of moxonidine in the treatment of glaucoma?

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Last updated: April 15, 2025 • View editorial policy

From the Research

Moxonidine is not currently recommended for glaucoma treatment. Moxonidine is primarily used as an antihypertensive medication that works as a centrally-acting imidazoline receptor agonist, reducing sympathetic nervous system activity. While some research has explored the potential of imidazoline receptor agonists to reduce intraocular pressure (IOP), moxonidine has not been established as a standard treatment for glaucoma in clinical practice.

The first-line medications for glaucoma typically include:

  • Prostaglandin analogs (like latanoprost, travoprost)
  • Beta-blockers (like timolol)
  • Alpha-2 agonists (like brimonidine)
  • Carbonic anhydrase inhibitors (like dorzolamide) These medications work through different mechanisms to either decrease aqueous humor production or increase its outflow, thereby reducing IOP.

According to a recent study 1, the combination of Brinzolamide-Brimonidine (BB) and Latanoprost-Timolol (LT) are effective in treating primary open-angle glaucoma (POAG) and ocular hypertension (OHT), with LT showing slightly better and sustained IOP reduction. However, moxonidine was not mentioned as a treatment option in this study.

If a patient with glaucoma also has hypertension requiring treatment, their ophthalmologist and primary care physician should coordinate care, as some antihypertensive medications may have effects on IOP. However, moxonidine would not be selected specifically for its effects on glaucoma management, as its primary use is for hypertension, and its efficacy in reducing IOP is not well established in clinical practice, as noted in studies 2, 3, 4, 5.

References

Research

Moxonidine: some controversy.

Expert opinion on pharmacotherapy, 2001

Research

Perspectives in the medical treatment of glaucoma.

Current opinion in ophthalmology, 1999

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