Eye Drops With Preservatives Avoid & Eye Drops... - Glaucoma UK

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Eye Drops With Preservatives Avoid & Eye Drops Information

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Preser­v­a­tives are increas­ing­ly recog­nised as hav­ing a neg­a­tive impact on ocu­lar struc­tures even in con­cen­tra­tions as low as 0.005%¹. Patients with Dry Eye Dis­ease (DED), par­tic­u­lar­ly those who require fre­quent use of lubri­cants or oth­er top­i­cal ther­a­pies, should avoid ocu­lar lubri­cants that con­tain Ben­za­lko­ni­um chlo­ride (BAK)².

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I use monoprost that is preservative free in the uk it is called lantaprost

However, they gave me alphagan and two other kind of drops in the last 3 months azarga being one of them, that was hell...

They had preservatives in them and in france they did not give me another choice. fortunately I have been able to stop taking them due to having SLT. The worry of what it could do to my eyes gave me severe anxiety....

I tried to get alphagan p (purite) that is preservative free. I even wrote to the manufacturer allergan in france and india to buy them myself... I did not even get a reply from france.... just incase I have to go back on that drug... I am still struggling to get it here I have to get my opthalmogist to complete a special form to the government... it must be pricey I don't know.

The reason for telling you all this is I do know what drops you are all taking, if they have preservatives. If so try and get an alternative to what you are taking. They are simply harmful to your eyes if they have preservatives and dry out your eyes. And that goes for dry eye drops for dry eye, choose preservative free. I use Thea preservative free eye drops for dry eyes.

Here is an excellent link for the uk with all the eye drops for glaucoma


below i have cut and pasted the list of eye drops. i have gone through the whole list and checked which ones have preservatives... i have written beside each eye drop....


The medication used in this category of eye drops work by improving drainage of fluid from the eye to specifically to reduce high eye pressure (ocular hypertension).

Some primary examples of these include:

Latanoprost (Xalatan) (PRESERVATIVE FREE)




Latanoprostene Bunod (Vyzulta) PRESERVATIVES

Some of these medications may cause certain changes to the eye, such as slight redness of the eye, changes to the iris colour, and darkening and/or lengthening of the eyelashes.1 These eye drops should be used once a day, usually at night.

Prostaglandins are generally considered to be effective in managing open-angle glaucoma (the most common form of glaucoma).2


This class of glaucoma eye drops works by reducing the production of fluid in the eye, and a commonly used medication that does this is Timolol (Timoptic).

Other examples of beta blockers include:


Carteolol (Ocupress) PRESERVATIVE IN THIS

Betaxolol (Betoptic) PRESERVATIVE IN THIS

Metipranolol (OptiPranolol) PRESERVATIVE IN THIS

It is worth noting that beta blockers can cause some systemic (whole body) side effects such as slow pulse, asthma, dizziness, and fatigue.1 Your ophthalmologist can help you with some techniques to minimise these risks2.

These eye drops are generally used once or twice a day. They can also be prescribed in combination with other types of medication for best results.

Alpha-adrenergic agonists

Alpha agonists are a class of glaucoma eye drops that both decrease fluid production and increase fluid outflow. Examples of these include:



Generally, allergic reactions are the most common side effects of glaucoma eye drops. This can be due to a common type of preservative used in the production of certain eye drops.

However, the preservative used in Alphagan-P actually breaks down into natural tear components, and is, therefore, better tolerated by people who are allergic to glaucoma eye drops (either the preservative in the drug or the drug itself).2 This type of glaucoma eye drop usually needs to be put in the eyes 2-3 times a day.

Carbonic anhydrase inhibitors

This group of glaucoma eye drops works by reducing the amount of fluid that is produced in the eye. Examples include:

Dorzolamide (Trusopt) PRESERVATIVE FREE

Brinzolamide (Azopt) PRESERVATIVE IN THIS

Carbonic anhydrase inhibitors are also available in pill form. Some people find that they have some problematic side effects when taking these, but your doctor will talk them through with you.

Carbonic anhydrase inhibitors are typically used 2-3 times a day, sometimes alone, but usually in combination with another anti-glaucoma eye drop.

Combination eye drops

Some people need more than one type of medication in order to control their intraocular pressure, which is where combination eye drops can help. They also reduce exposure to preservatives and potential allergic reactions.2 If you are prescribed a combination eye drop, your ophthalmologist will go into detail as to why and how they fit into your treatment plan.

Common combinations include:

Cosopt – a combination of timolol (beta blocker) and dorzolamide (carbonic anhydrase inhibitor). Cosopt PF is the preservative-free version. The drug is also available in generic form COSPOST PF IS THE PRESERVATIVE FREE VERSION

Combigan – a combination of brimonidine (alpha agonist) and timolol (beta blocker)


Xalacom – a combination of latanoprost (prostaglandin) and timolol (beta blocker)


Simbrinza – a combination of brinzolamide (carbonic anhydrase inhibitor) and brimonidine (alpha agonist). This combination is free of beta blocker and may be suitable for people who cannot take beta blockers.


this sounds interesting...

A new class of anti-glaucoma medication called Rho Kinase (ROCK) inhibitors has passed clinical trials in the UK, and this group of medications works by increasing the drainage of fluid from the eye.2

This new medication is the first of its kind in over 20 years and represents a huge leap forward in the science behind how certain drugs can manage glaucoma symptoms. To find out more, talk to your ophthalmologist.

Hope this helps. valfrance

2 Replies

Hello Valfrance. Thank you for sharing this information with everyone.

Its important to remember however that everyone who is diagnosed with glaucoma is different.

The first type of drop normally prescribed for glaucoma is a prostaglandin as these work quickly and well in bringing the eye pressure down. The most commonly used drops to be prescribed that do not contain preservative are Monopost, Saflutan and Lumigan.

Lumigan is available with preservative as well but doesn't tend to be prescribed as often as it used to be.

Sometimes just prescribing one drop may not be deemed strong enough by the consultant to treat the patients glaucoma on its own and they have to prescribe additional drops. They would always look to try to offer an additional drop that is preservative free but it may not be possible. It is true that long term use of these drops can affect the cornea but it depends very much on how often the drops are put in each day and the strength of them. For a small minority of people, although they are prescribed preservative free drops, they still experience side effects.

Hi Trish thank you for your response. I appreciate what you have said, however initially unless you try non preservative drops first how would you know. I was given preservative drops, and there is a preservative free choice for the same drug. I was not given that I think this is due to cost. I just read the research about preservative drops and I just think it is better for the patient to be given them. kind regards valfrance

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