Brinzolamide and Monopost: timing the drops

[haraba]

Hi,

I am on brinzolamide and monopost drops.

My consultant today advised that my twice a day brinzolamide must be administered 12 hourly and the closer to this the better to maintain a dosage profile that prevents any rises in intraocular pressure. I was sometimes an hour out and this was considered to be sub-optimal.

The pressures today were both 16mm. I have "normal tension glaucoma". I was told last year that we should aim for about 12mm. I have been 18-20mm.

Additionally, to use the once in the evening monopost ( latanoprost preservative free) about 15 mins after the evening brinzolamide.

Have any of you found that an extremely strict regime or particular timing has made a significant difference in your IOP control ?

Thank you.

[Beecalmed]

I was told to keep my twice daily drops treatment 12 hrs apart early on in my treatment and to stick to it and try to keep within a hour if I had an unavoidable delay.

But then I’ve lost vision and had progression so I’m happy to be rigorous to stop any more. I was also younger than average at diagnosis so my consultant said I had a longer glaucoma journey than most and we needed to optimise treatment early on.

In the same vein, I can understand why those who haven’t lost vision or progressed can feel they can afford to be more laid back about their drop timings and application. So I’d follow your consultants advice on this. But yes it can be very inconvenient and you can feel your drops rule your life.

I find people around me find it hard to believe I have to be be quite so exact with drop timing, particularly as it seems everyone has a elderly friend or relative with glaucoma who “doesn’t have a problem and just does the drops anytime ”. I usually have to point out I’ve already lost vision and maybe their friend hasn’t and therefore can afford to be more laissez faire. 🙄

My mom is in that category so my relatives insist on assuming my glaucoma is the same as hers. It’s not, and never had been, Mom was diagnosed in her 70s, has closed angle, on drops for 15yrs and no sight loss. She’s missed drops for whole weekends because she lost her drops on holiday with no impact. I have open angle, diagnosed in 50s with sight loss and 4 yrs on still struggle to keep IOPs down. I’ve had SLT and am diligent in drop timings and procedure. So frustrating to be told I’m worrying unduly when I have to do my drops in the restaurant toilets at a family dinner! 😩

[haraba in reply to Beecalmed]

Thank you for your reply and description of how the timings are important. I share your many of your feelings and will follow your advice.

[PeterRabbit62]

Hi I also used Brinzolamide and I also used Brimonodine with them and Timolol and Brimoprost (Ganfort) at bedtime, it does say in the instructions so it 12 hourly apart, I do try to stick to it myself, I have been on them for at least two years now and I was diagnosed 10 years ago. I have primary open angle glaucoma, I tend to put them very early in the morning whilst I am in bed between 6 and 7 and then I will do the same early evening. I was using Simzbrina which is a mixture of the two but because my local pharmacists could not get it so my consultant move me on to them that also said 12 hourly, but was much easier because you only have one bottle to use, now have 2, so that means await of about 5 to 10 mins before I put the next one in. Best wishes

[haraba in reply to PeterRabbit62]

Thank you for your help. I will figure out what time is best for me. Probably 06:30-07:00 then 18:30-19:00 with Monopost 10- 15 mins later after the PM Brinzolamide dose.

[Peg99]

Hello haraba

Whether your glaucoma journey is long or short, taking medication responsibly is vital to the preservation of your eye sight. Eye drops may seem to be bothersome but you have to remember that they are as important a medication to the likes of us as the administration - on time - of insulin to diabetics.

The importance of putting in the drops at 12 hourly intervals was impressed on me when I was first diagnosed. In fact, I was told that I would be blind in 5 years as the glaucoma was so advanced when it was eventually diagnosed and that taking all the drops (there were 4 at that time as well as Diamox capsules) might give me a little extra time.

I was assiduous in my drops timings, as anyone would have been, with the result that I can still see. You may not see the daily effect of drops (what can one little drop every 12 hours achieve is what many folk think) but they can make the world of difference to us glaucoma sufferers.

Find a time that suits you, personally I use the noon and midnight times as I am usually at home at those times, but think about it and choose what suits you best. After a while, it becomes very easy to put the drops in, after 38 years, I no longer need a mirror and can put them in wherever I am!

Take care and best of luck to you

[haraba in reply to Peg99]

I have no doubt that using the drops is of the utmost importance to preserve one’s sight. I have not missed any drops since they were started. I am interested in how we all approach the “strict adherence” to the 12 hourly interval. Thank you Peg99 for your advice.

[haraba]

I have received a reply today from the consultant (via the Opthalmology secretaries) regarding whether I change my Monopost timing in relation to the 12 hourly Brinzolamide dosing.

“10pm for Monopost is perfectly fine”.