Jennifer A. Palombi, OD
Reviewers
Kristy E. Chmielewski, OD
Anders S. Hansson, OD
William S. Hileman, OD
Jennifer L. Schmelzer, OD
Residents at the Chillicothe/Columbus VA Medical Facilities residency program, which is affiliated with The Ohio State University College of Optometry.
The Top 100—Drug Interactions & Side-Effects for Optometrists
Jennifer A. Palombi, OD
PUBLISHER’S NOTE
The Top 100—Drug Interactions & Side-Effects for Optometrists is based upon information believed to be reliable. In developing The Top 100—Drug Interactions & Side-Effects for Optometrists, the publisher and authors have made substantial efforts to make sure the drugs and information about them are correct and are in accordance with currently accepted standards.
Readers are cautioned to use their own judgment in making clinical decisions and, when appropriate, consult and compare information from other resources, since ongoing research and clinical experience yield new information and since there is the possibility of human error in developing such a comprehensive resource as this.
When prescribing or administering drugs, attention should be paid to checking the product information supplied by the drug manufacturer. The publisher, authors, reviewers and editors disclaim any liability, loss or damage as a result, directly or indirectly, of using or applying any of the contents of The Top 100—Drug Interactions & Side-Effects for Optometrists.
Copyright © 2008 by Anadem Publishing, Inc. All rights reserved, including translation. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, electronic or mechanical, including photocopying, or by any information storage and retrieval system, without prior written permission from the copyright owner.
The Top 100 Drug Interactions & Side-Effects for Optometrists
________________________________________________________________________________
8-Mop, Oxsoralen, Uvadex
Generic: Methoxsalen
Class: Photosensitizers, Psoralens
Common Indications: Psoriasis, vitiligo
Ocular Side Effects: Cataracts (Note: the amount of Methoxsalen in the lens is directly proportional to the serum levels. If the lens is exposed to UV light while lenticular Methoxsalen levels are high, cataractogenicity is most likely. Patients should be advised to wear UV protective lenses for a 24-hour period after ingestion of Methoxsalen. After 24 hours, the drug will have largely diffused out of the lens)
Warnings & Ocular Drug Interactions: The drug may inhibit caffeine metabolism. Contraindicated in aphakic patients
Abilify
Generic: Aripiprazole
Class: Psychotropic agents
Common Indications: Schizophrenia, bipolar disorder in remission
Ocular Side Effects: Frequent: conjunctivitis; Infrequent: eye pain, dry eye, cataracts, blepharitis, eye hemorrhage; Rare: diplopia, ptosis, photophobia, amblyopia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Accutane
Generic: Isotretinoin
Class: Retinoids
Common Indications: Severe recalcitrant nodular acne
Ocular Side Effects: According to the World Health Organization, Ocular Side Effects and their probability are as follows: Certain: abnormal meibomian gland secretion, blepharoconjunctivitis, corneal opacities, decreased dark adaptation, decreased contact lens tolerance, decreased vision, increased tear osmolarity, keratitis, meibomian gland atrophy, myopia, ocular discomfort, intracranial hypertension, photophobia, ocular sicca, teratogenic ocular abnormalities; Probable/Likely: reversible decrease in color vision, permanent loss of dark adaptation; Possible: corneal ulcers, diplopia, eyelid edema, optic neuritis, permanent sicca-like syndrome, subconjunctival heme
Warnings & Ocular Drug Interactions: Retinoids in combination with Tetracycline may increase risk for intra-cranial hypertension
Aciphex
Generic: Rabeprazole sodium
Class: Gastric acid secretion inhibitors
Common Indications: GERD, duodenal ulcers
Ocular Side Effects: Cataracts, amblyopia, dry eyes, glaucoma, abnormal vision; Rare: corneal opacity, diplopia, strabismus, retinal degeneration, eye pain.
Warnings & Ocular Drug Interactions: Clarithromycin and Amoxicillin can increase plasma concentrations of Rabeprazole sodium.
Actonel
Generic: Risedronate sodium
Class: Bone resorption inhibitors
Common Indications: Osteoporosis, Paget’s disease
Ocular Side Effects: Ocular inflammation (including nonspecific conjunctivitis and scleritis), abnormal or blurred vision, cataracts, amblyopia and dry eye (Note: cataracts were reported to be higher in daily dosing than in weekly dosing)
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Altocor, Mevacor
Generic: Lovastatin
Class: Antihyperlipidemics
Common Indications: Hypercholesterolemia, primary prevention of coronary heart disease
Ocular Side Effects: Progression of cataracts; Rare: ophthalmoplegia
Warnings & Ocular Drug Interactions: Concomitant use of Cyclosporine, Erythromycin, immunosuppressants or Niacin increases the risk of acute renal failure
Ambien
Generic: Zolpidem tartrate
Class: Nonbenzodiazepine hypnotics
Common Indications: Insomnia
Ocular Side Effects: Frequent: diplopia, abnormal vision; Infrequent: eye irritation, eye pain, scleritis; Rare: corneal ulceration, photopsia, conjunctivitis, abnormal lacrimation
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Aralen phosphate
Generic: Chloroquine/Chloroquine phosphate
Class: Antiprotozoals
Common Indications: Malaria. Off-label uses include treatment of juvenile arthritis, rheumatoid arthritis and systemic lupus erythematosus
Ocular Side Effects: Visual disturbances, irreversible retinal damage (with high dose and/or long-term use), scotoma
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Aredia
Generic: Pamidronate
Class: Bone resorption inhibitors
Common Indications: Hypercalcemia of malignancy, Paget’s disease, bone metastases of breast cancer
Ocular Side Effects: Ocular inflammation (including non- specific conjunctivitis, episcleritis, uveitis and scleritis), abnormal or blurred vision, ocular pain, photophobia
Warnings & Ocular Drug Interactions: Caution should be used when using Aredia with other potentially nephrotoxic drugs
Aricept
Generic: Donepezil hydrochloride
Class: Acetylcholinesterase inhibitors
Common Indications: Dementia, Alzheimer’s disease
Ocular Side Effects: Frequent: cataracts, eye irritation, blurred vision; Infrequent: dry eyes, glaucoma, blepharitis, retinal hemorrhage, conjunctival hemorrhage
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Avapro
Generic: Irbesartan
Class: Angiotensin II receptor antagonists
Common Indications: Hypertension, diabetic nephropathy
Ocular Side Effects: Infrequent: blurred vision, conjunctivitis, eyelid abnormality
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Benadryl
Generic: Diphenhydramine
Class: Antihistamines, H1
Common Indications: Allergic conjunctivitis, allergic rhinitis, motion sickness, insomnia
Ocular Side Effects: Photosensitivity, mydriasis, cycloplegia, dry eye, exacerbation of narrow angle glaucoma
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Calm-X, Dimetabs, Dramamine (Adult & Children’s)
Generic: Dimenhydrinate
Class: Anticholinergic agents
Common Indications: Motion sickness, nausea, vomiting
Ocular Side Effects: Exacerbation of narrow angle glaucoma, blurred vision, diplopia, impaired night vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Carbatrol
Generic: Carbamazepine
Class: Anticonvulsants, analgesics
Common Indications: Epilepsy, trigeminal neuralgia
Ocular Side Effects: Diplopia, gaze-evoked nystagmus, punctate corneal opacities, blurred vision, conjunctivitis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Cardene, Cardene IV, Cardene SR
Generic: Nicardipine hydrochloride
Class: Calcium channel blockers
Common Indications: Chronic angina, essential hypertension
Ocular Side Effects: Blurred vision
Warnings & Ocular Drug Interactions: Concomitant Cyclosporine therapy increases Cyclosporine levels. Patients treated with Nicardipine and Cyclosporine should have their plasma Cyclosporine levels monitored regularly. Nicardipine may also have an additive effect with beta blockers
Celexa
Generic: Citalopram hydrobromide
Class: Antidepressants
Common Indications: Depression
Ocular Side Effects: Abnormal accommodation, conjunctivitis, ocular pain; Rare: photophobia, diplopia, mydriasis
Warnings & Ocular Drug Interactions: Macrolide antibiotics may increase serum levels of Celexa
Cenestin, Enjuvia, Premarin
Generic: Estrogens, conjugated
Class: Hormones
Common Indications: Symptoms of menopause
Ocular Side Effects: Steepening of corneal curvature, contact lens intolerance
Warnings & Ocular Drug Interactions: May increase blood Cyclosporine levels and increase risk of hepatotoxicity and nephrotoxicity
Chlor-Trimeton
Generic: Chlorpheniramine
Class: Antihistamines, H1
Common Indications: Allergic rhinitis, common cold
Ocular Side Effects: Dry eye, mydriasis, cycloplegia, photosensitivity
Warnings & Ocular Drug Interactions: Doxycycline, Erythromycin, Ciprofloxacin may increase the levels/effects of Chlorpheniramine
Cialis
Generic: Tadalafil
Class: Impotence agents, phosphodiesterase inhibitors
Common Indications: Erectile dysfunction
Ocular Side Effects: Changes in color perception (blue-tinged vision), decreased color vision, blurred vision, changes in light perception, ERG changes, conjunctival hyperemia, ocular pain, photophobia, ischemic optic neuropathy
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Claritin
Generic: Loratadine
Class: Antihistamines, H1
Common Indications: Allergic rhinitis; off-label: urticaria
Ocular Side Effects: Increased corneal and conjunctival staining, decreased tear flow and volume, contact lens discomfort; Rare: photosensitivity
Warnings & Ocular Drug Interactions: Erythromycin may increase blood concentrations of Loratadine
Concerta
Generic: Methylphenidate hydrochloride
Class: CNS stimulants
Common Indications: ADHD
Ocular Side Effects: Blurred vision, accommodative problems
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Cordarone, Pacerone
Generic: Amiodarone hydrochloride
Class: Class 3 antiarrhythmics
Common Indications: Recurrent ventricular fibrillation, unstable ventricular tachycardia
Ocular Side Effects: Corneal deposits (whorl keratopathy) can be expected in most patients after 6 months of use; this may lead to blurry vision. Photosensitivity: Rare: vision loss and blindness (<1%), usually associated with optic neuritis or optic neuropathy
Warnings & Ocular Drug Interactions: May increase the effects of beta blockers
Coreg
Generic: Carvedilol
Class: Antiadrenergics, beta blockers
Common Indications: Hypertension, CHF
Ocular Side Effects: Contact lens wearers may experience decreased lacrimation
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Coumadin
Generic: Warfarin
Class: Anticoagulant agents
Common Indications: Thromboembolic disorder
Ocular Side Effects: Ocular hemorrhage, most commonly subconjunctival hemes
Warnings & Ocular Drug Interactions: The following agents may potentiate the effects of Warfarin: Acetaminophen, Ciprofloxacin, Erythromycin, Amoxicillin, Azythromycin, Levofloxacin, Tetracycline, Gatifloxacin, Norfloxacin, Ofloxacin, topical salicylates. The following agents may inhibit the effects of Warfarin: Difloxacin, supplements containing high amounts of vitamin K, Cyclosporine
Cozaar, Hyzaar
Generic: Losartan potassium
Class: Angiotensin II receptor antagonists
Common Indications: Hypertension, diabetic nephropathy
Ocular Side Effects: Blurred vision, ocular burning/stinging, conjunctivitis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Cutivate,Flonase, Flovent
Generic: Fluticasone propionate
Class: Inhaled corticosteroids
Common Indications: Allergic rhinitis, asthma
Ocular Side Effects: Ocular dryness and irritation, conjunctivitis, blurred vision; Rare: glaucoma, increased IOP, cataracts
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Cymbalta
Generic: Duloxetine hydrochloride
Class: Antidepressants, serotonin and norepinephrine reuptake inhibitors
Common Indications: Major depressive disorder, diabetic peripheral neuropathic pain, generalized anxiety disorder
Ocular Side Effects: Frequent: blurred vision; Infrequent: conjunctivitis, diplopia; Rare: glaucoma, macular degeneration, maculopathy, photopsia, retinal detachment
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Deltasone, Liquid Pred, Meticorten, Prednicen-M, Prednicot, Sterapred, Sterapred DS
Generic: Prednisone
Class: Corticosteroids
Common Indications: Endocrine disorders, rheumatic disorders, collagen diseases, dermatologic diseases, allergic rhinitis, respiratory diseases, GI diseases
Ocular Side Effects: Delayed wound healing, increased susceptibility to infection, posterior subcapsular cataracts, glaucoma
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Depakote
Generic: Divalproex sodium
Class: Antipsychotics
Common Indications: Acute, manic or mixed episodes associated with bipolar disorder
Ocular Side Effects: Amblyopia, conjunctivitis, deafness, dry eyes, eye pain, nystagmus
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Detrol LA
Generic: Tolterodine
Class: Muscarinic receptor agonists
Common Indications: Overactive bladder, urinary incontinence
Ocular Side Effects: Elevated IOP/glaucoma, blurred vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Dexedrine, Dextrostat
Generic: Dextroamphetamine sulfate
Class: Adrenergic agonists, amphetamines, stimulants
Common Indications: Narcolepsy, ADHD
Ocular Side Effects: Mydriasis, reduction in IOP
Warnings & Ocular Drug Interactions: May increase the risk of bradycardia, hypertension and heart block in combination with beta blockers
DiaBeta, Glycron, Glynase PresTab, Micronase
Generic: Glyburide
Class: Antidiabetic agents, second generation sulfonylureas
Common Indications: Type 2 diabetes mellitus
Ocular Side Effects: Changes in accommodation or blurred vision have been reported. Patients should be taught that these symptoms are likely related to changing blood sugar levels
Warnings & Ocular Drug Interactions: Beta blockers may increase the effects of Glyburide; Ciprofloxacin may increase the effects of Glyburide
Didronel
Generic: Etidronate disodium
Class: Bone metabolism regulators
Common Indications: Paget’s disease
Ocular Side Effects: Abnormal or blurred vision, nonspecific conjunctivitis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Dilantin
Generic: Phenytoin
Class: Antiepileptic agents
Common Indications: Epilepsy
Ocular Side Effects: Diplopia, gaze-evoked nystagmus
Warnings & Ocular Drug Interactions: Salicylates may increase serum Phenytoin levels; additionally, Doxycycline and corticosteroids may have their efficacy decreased by Phenytoin therapy
Dimetabs, Calm-X, Dramamine (Adult & Children)
Generic: Dimenhydrinate
Class: Anticholinergic agents
Common Indications: Motion sickness, nausea, vomiting
Ocular Side Effects: Exacerbation of narrow angle glaucoma, blurred vision, diplopia, impaired night vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Ditropan
Generic: Oxybutynin
Class: Antispasmodics, anticholinergics
Common Indications: Overactive bladder, urinary incontinence
Ocular Side Effects: Elevated IOP/glaucoma, dry eyes, blurred vision
Warnings & Ocular Drug Interactions:No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Dramamine (Adult & Children’s), Calm-X, Dimetabs
Generic: Dimenhydrinate
Class: Anticholinergic agents
Common Indications: Motion sickness, nausea, vomiting
Ocular Side Effects: Exacerbation of narrow angle glaucoma, blurred vision, diplopia, impaired night vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Effexor, Effexor XR
Generic: Venlafaxine
Class: Antidepressants, serotonin and norepinephrine reuptake inhibitors
Common Indications: Depression. Off-label: anxiety disorder
Ocular Side Effects: Mydriasis, abnormal accommodation, cataracts, conjunctivitis, corneal lesion, diplopia, dry eyes, exophthalmos, eye pain, visual field defects, blepharitis, conjunctival edema, retinal hemorrhage, glaucoma, subconjunctival hemorrhage, keratitis, papilledema, scleritis, uveitis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Elavil, Endep, Vanatrip
Generic: Amitriptyline hydrochloride
Class: Tricyclic antidepressants
Common Indications: Depression. Off-label: neuropathic pain
Ocular Side Effects: Blurred vision, eye pain, photosensitivity, cycloplegia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Elocon, Nasonex (inhaled)
Generic: Mometasone topical
Class: Topical corticosteroids
Common Indications: Allergic rhinitis
Ocular Side Effects: Glaucoma, cataracts
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Endep, Elavil, Vanatrip
Generic: Amitriptyline hydrochloride
Class: Tricyclic antidepressants
Common Indications: Depression. Off-label: neuropathic pain
Ocular Side Effects: Blurred vision, eye pain, photosensitivity, cycloplegia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Estrostep
Generic: Norethindrone acetate/Ethinyl estradiol
Class: Oral contraceptives
Common Indications: Pregnancy contraception
Ocular Side Effects: Retinal thrombosis, steepening of corneal curvature, contact lens intolerance, cataracts
Warnings & Ocular Drug Interactions: Oral antibiotics may reduce the effectiveness of oral contraceptives
Flexeril
Generic: Cyclobenzaprine hydrochloride
Class: Musculoskeletal agents, relaxants
Common Indications: Muscle spasm. Off-label: fibromyalgia
Ocular Side Effects: Increased IOP, worsening of narrow angle glaucoma, blurred vision, diplopia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Flomax
Generic: Tamsulosin hydrochloride
Class: Antiadrenergics, alpha blockers
Common Indications: BPH
Ocular Side Effects: Intraoperative Floppy Eyelid Syndrome: this drug should be discontinued several weeks before cataract surgery. Amblyopia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Fosamax
Generic: Alendronate sodium
Class: Bone resorption inhibitors
Common Indications: Osteoporosis
Ocular Side Effects: Blurred vision, nonspecific conjunctivitis, ocular pain, uveitis, scleritis
Warnings & Ocular Drug Interactions: Caution should be used when prescribing concomitant NSAIDS since this increases the risk of GI irritation
Imitrex
Generic: Sumatriptan succinate
Class: Selective 5-hydroxytryptamine receptor subtype agonists
Common Indications: Migraine
Ocular Side Effects: Rare: disorders of sclera, mydriasis, blindness and low vision, visual disturbances, eye edema and swelling, eye irritation and itching, accommodation disorders, external ocular muscle disorders, eye hemorrhage, eye pain, keratitis, conjunctivitis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Inversine
Generic: Mecamylamine
Class: Antiadrenergics
Common Indications: Hypertension. Off-label: smoking cessation
Ocular Side Effects: Mydriasis, blurred vision, increase in IOP (contraindicated in all glaucoma patients)
Warnings & Ocular Drug Interactions: Sulfonamides and antibiotics may increase the effects of Mecamylamine
Isoniazid
Generic: Nydrazid
Class: Antibacterial agents
Common Indications: Tuberculosis
Ocular Side Effects: Optic neuropathy
Warnings & Ocular Drug Interactions: Acetaminophen concomitant with Isoniazid therapy may heighten Acetaminophen toxicity
Klonopin
Generic: Clonazepam
Class: Anxiolytics, benzodiazepines
Common Indications: Petit mal seizures, panic disorder
Ocular Side Effects: Worsening of narrow angle glaucoma (contraindicated in narrow angle patients), ocular irritation, blurred vision, diplopia, nystagmus, visual field defect, eye twitching, styes
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Lamictal
Generic: Lamotrigine
Class: Antiepilepsy agents
Common Indications: Epilepsy, seizures
Ocular Side Effects: Off-label: bipolar disorder. Frequent: diplopia, blurred vision, amblyopia; Infrequent: abnormal accommodation, conjunctivitis, dry eyes, photophobia; Rare: ptosis, strabismus, uveitis, visual field loss, nystagmus
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Lasix
Generic: Furosemide
Class: Loop diuretics
Common Indications: Edema, hypertension
Ocular Side Effects: Blurred vision, yellow-tinged vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Lescol
Generic: Fluvastatin
Class: Antihyperlipidemics
Common Indications: Hyperlipidemia
Ocular Side Effects: Progression of cataracts, ocular hemorrhage, ophthalmoplegia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Levitra
Generic: Vardenafil
Class: Impotence agents, phosphodiesterase inhibitors
Common Indications: Erectile dysfunction
Ocular Side Effects: Changes in color perception (blue-tinged vision), decreased color vision, blurred vision, changes in light perception, ERG changes, conjunctival hyperemia, ocular pain, photophobia, ischemic optic neuropathy
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Lexapro
Generic: Escitalopram oxalate
Class: Antidepressants, serotonin-specific reuptake inhibitors
Common Indications: Major depressive disorder, generalized anxiety disorder
Ocular Side Effects: Frequent: blurred vision. Infrequent: conjunctivitis, dry eyes, eye irritation, mydriasis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Lipitor
Generic: Atorvastatin calcium
Class: Antihyperlipidemic agents
Common Indications: Hyperlipidemia
Ocular Side Effects: Amblyopia, dry eyes, ocular hemorrhage, glaucoma
Warnings & Ocular Drug Interactions: Erythromycin can increase plasma concentrations of Lipitor by up to 40%
Luminal
Generic: Phenobarbital
Class: Anticonvulsants, barbiturates, preanesthetics, sedatives/hypnotics
Common Indications: Seizure disorders, sedation, insomnia
Ocular Side Effects: May effect the function of the extraocular muscles
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Lunesta
Generic: Eszopiclone
Class: Nonbenzodiazepine hypnotics
Common Indications: Insomnia
Ocular Side Effects: Infrequent: conjunctivitis, dry eyes. Rare: iritis, photophobia, mydriasis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Lyrica
Generic: Pregabalin
Class: Analgesics
Common Indications: Diabetic peripheral neuropathy. Off-label: neuropathic pain
Ocular Side Effects: Frequent: blurred vision, diplopia, conjunctivitis; Infrequent: abnormal accommo-dation, dry eyes, blepharitis, eye hemorrhage, photophobia, retinal edema; Rare: anisocoria, blindness, corneal ulcer, exophthalmos, extraocular palsy, iritis, keratitis, keratoconjunctivitis, miosis, mydriasis, night blindness, ophthalmoplegia, optic atrophy, papilledema, ptosis uveitis
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Mellaril
Generic: Thioridazine hydrochloride
Class: Antipsychotics
Common Indications: Schizophrenia
Ocular Side Effects: Pigmentary retinopathy characterized by diminished visual acuity, brownish tinge to vision, impaired night vision and the presence of pigmentary deposits in the retina. This is seen most commonly in patients exceeding recommended dosages of the drug
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Mexitil
Generic: Mexiletine hydrochloride
Class: Antiarrhythmic agents, sodium channel blockers
Common Indications: Ventricular arrhythmias
Ocular Side Effects: Reversible nystagmus, blurred vision, diplopia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Myambutol
Generic: Ethambutol
Class: Oral chemotherapeutic agents
Common Indications: Pulmonary tuberculosis
Ocular Side Effects: Optic neuritis with associated loss in visual acuity, scotoma, color blindness or visual defect
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Namenda
Generic: Memantine hydrochloride
Class: NMDA receptor antagonists
Common Indications: Dementia, Alzheimer’s disease
Ocular Side Effects: Frequent: cataracts, conjunctivitis. Infrequent: macula lutea degeneration, decreased visual acuity, blepharitis, blurred vision, corneal opacity, glaucoma, conjunctival hemorrhage, eye pain, retinal hemorrhage, xerophthalmia, diplopia, abnormal lacrimation, myopia, retinal detachment
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Nexium
Generic: Esomeprazole magnesium
Class: Gastric acid secretion inhibitors
Common Indications: GERD, duodenal ulcers
Ocular Side Effects: Conjunctivitis, abnormal vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Niaspan
Generic: Niacin
Class: Antihyperlipidemic agents
Common Indications: Hyperlipidemia
Ocular Side Effects: Sicca syndromes, blurred vision, eyelid edema, cystoid macular edema, toxic amblyopia
Warnings & Ocular Drug Interactions: Nutritional supplements containing large doses of Niacin may potentiate side effects of this drug
Nolvadex
Generic: Tamoxifen citrate
Class: Antineoplastics, antiestrogens, estrogen receptor modulators, hormone modifiers
Common Indications: Breast carcinoma, metastatic breast carcinoma, prevention of breast carcinoma
Ocular Side Effects: Corneal changes, cataracts, diminished color vision, retinal vein thrombosis, retinopathy
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Norvasc
Generic: Amlodipine besylate
Class: Calcium channel blockers
Common Indications: CAD
Ocular Side Effects: Off-label: angina. Abnormal vision, conjunctivitis, diplopia, eye pain
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
NuvaRing
Generic: Etonogestrel/Ethinyl estradiol
Class: Contraceptives
Common Indications: Pregnancy contraception
Ocular Side Effects: Retinal thrombosis, steepening of corneal curvature, contact lens intolerance, cataracts
Warnings & Ocular Drug Interactions: Oral antibiotics may reduce the effectiveness of oral contraceptives
Nydrazid
Generic: Isoniazid
Class: Antibacterial agents
Common Indications: Tuberculosis
Ocular Side Effects: Optic neuropathy
Warnings & Ocular Drug Interactions: Acetaminophen concomitant with Isoniazid therapy may heighten Acetaminophen toxicity
Ortho Evra
Generic: Norelgestromin/Ethinyl estradiol
Class: Contraceptives, patch
Common Indications: Pregnancy contraception
Ocular Side Effects: Retinal thrombosis, steepening of corneal curvature, contact lens intolerance, cataracts
Warnings & Ocular Drug Interactions: Oral antibiotics may reduce the effectiveness of oral contraceptives
Ortho Tri-Cyclen
Generic: Norgestimate/Ethinyl estradiol
Class: Oral contraceptives
Common Indications: Pregnancy contraception
Ocular Side Effects: Retinal thrombosis, steepening of corneal curvature, contact lens intolerance, cataracts
Warnings & Ocular Drug Interactions: Oral antibiotics may reduce the effectiveness of oral contraceptives
Paxil, Paxil CR
Generic: Pexeva, Paroxetine hydrochloride
Class: Antidepressants, serotonin-specific reuptake inhibitors
Common Indications: Depression, generalized anxiety disorder, obsessive compulsive disorder, panic disorder. Off-label: social anxiety disorder, premenstrual dysphoric disorder
Ocular Side Effects: Conjunctivitis, eye hemorrhage, keratoconjunctivitis, mydriasis, amblyopia, anisocoria, blepharitis, blurred vision, cataracts, conjunctival edema, corneal ulcer, exophthalmos, eye pain, glaucoma, night blindness, photophobia, ptosis, retinal hemorrhage, visual field defect, abnormality of accommodation
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Plavix
Generic: Clopidogrel bisulfate
Class: Platelet aggregation inhibitors
Common Indications: Recent MI, recent CVA, peripheral artery disease, acute coronary syndrome
Ocular Side Effects: Cataracts, conjunctivitis. Note: in combination with aspirin, patients may suffer intraocular hemorrhage with significant vision loss
Warnings & Ocular Drug Interactions: Aspirin exacerbates effects; NSAIDS may increase risk for gastric bleeds
Pravachol
Generic: Pravastatin
Class: Antihyperlipidemics
Common Indications: Hyperlipidemia
Ocular Side Effects: Blurred vision, diplopia, cataract progression, ocular hemorrhage
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Premphase, Prempro
Generic: Estrogens, conjugated/ Medroxyprogesterone acetate
Class: Hormones
Common Indications: Symptoms of menopause
Ocular Side Effects: Retinal thrombosis, optic neuritis, steepening of corneal curvature and contact lens intolerance
Warnings & Ocular Drug Interactions: May increase blood Cyclosporine levels and increase risk of hepatotoxicity and nephrotoxicity
Prevacid
Generic: Lansoprazole
Class: Gastric acid secretion inhibitors
Common Indications: GERD, duodenal ulcers
Ocular Side Effects: Blurred vision, conjunctivitis, dry eyes, eye pain, photophobia, visual field defect, retinal degeneration
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Prometrium
Generic: Progesterone
Class: Hormones
Common Indications: Endometrial hyperplasia in postmenopausal women
Ocular Side Effects: Blurred vision, diplopia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Protonix
Generic: Pantoprazole sodium
Class: Gastric acid secretion inhibitors
Common Indications: GERD
Ocular Side Effects: Abnormal vision, amblyopia, cataracts, diplopia, glaucoma, extraocular palsy
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Provigil
Generic: Modafinil
Class: Wakefulness promoting agents
Common Indications: Narcolepsy, obstructive sleep apnea
Ocular Side Effects: Amblyopia, blurred vision, eye pain
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
QM-260
Generic: Quinine
Class: Antiprotozoals
Common Indications: Malaria. Off-label: nocturnal leg cramps
Ocular Side Effects: Visual disturbances, scotoma, photophobia, diplopia, restriction of visual field, disturbances of color vision
Warnings & Ocular Drug Interactions: Concomitant therapy with beta blockers may increase bradycardia
Reclast, Zometa
Generic: Zoledronic acid
Class: Bone resorption inhibitors
Common Indications: Hypercalcemia of malignancy, bone metastases of cancer
Ocular Side Effects: Nonspecific inflammation including conjunctivitis, iritis, iridocyclitis, scleritis
Warnings & Ocular Drug Interactions: Aminoglycosides may have an additive effect to the serum calcium lowering effects of Zoledronic acid
Requip
Generic: Ropinirole hydrochloride
Class: Dopamine agonists
Common Indications: Parkinson’s disease, restless legs syndrome
Ocular Side Effects: Infrequent: abnormal lacrimation, conjunctivitis, blepharitis, glaucoma, abnormal accommodation, bleph-arospasm, eye pain, photophobia; Rare: scotoma
Warnings & Ocular Drug Interactions: Ciprofloxacin may increase blood concentrations of Ropinirole hydrochloride
Ridaura
Generic: Auranofin Aurothioglucose
Class: Antirheumatic agents
Common Indications: Rheumatoid arthritis
Ocular Side Effects: Common: conjunctivitis; Rare: gold deposits in the lens or cornea
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Risperdal, Risperdal Consta, Risperdal M-Tab
Generic: Risperidone
Class: Antipsychotics
Common Indications: Acute manic or mixed episodes associated with bipolar I disorder, schizophrenia
Ocular Side Effects: Abnormal accommodation, diplopia, eye pain, blepharitis, photopsia, photophobia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Seroquel
Generic: Quetiapine fumarate
Class: Psychotropic agents
Common Indications: Depressive episodes associated with bipolar disorder, acute manic episodes associated with bipolar I disorder, schizophrenia
Ocular Side Effects: Frequent: amblyopia; Infrequent: conjunctivitis, dry eyes, blepharitis, eye pain; Rare: abnormal accommodation, glaucoma
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Symmetrel
Generic: Amantadine
Class: Anti-Parkinsonians, antivirals
Common Indications: Influenza A (treatment and prophylaxis), Parkinson’s disease
Ocular Side Effects: Corneal deposits, keratitis, corneal edema, decreased visual acuity, photophobia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Synthroid
Generic: Levothyroxine sodium
Class: Synthetic hormones
Common Indications: Hypothyroidism
Ocular Side Effects: Pseudotumor cerebri has been reported in children undergoing Synthroid therapy
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Talwin NX
Generic: Pentazocine hydrochloride/ Naloxone hydrochloride
Class: Analgesics, narcotic agonists/antagonists
Common Indications: Pain, moderate to severe
Ocular Side Effects: Visual blurring and focusing difficulty, visual hallucinations
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic
Genericmedications (does not imply a total absence of drug interactions)
Thorazine
Generic: Chlorpromazine
Class: Antipsychotics, antiemetics
Common Indications: Schizophrenia, nausea, vomiting
Ocular Side Effects: Conjunctival pigmentation, epithelial keratopathy, yellow/white streaks on the corneal endothelium, corneal edema, pigmented lens deposits, reduced visual acuity, constricted or dilated pupils; >Rare: chorioretinopathy
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Topamax
Generic: Topiramate
Class: Carbonic anhydrase inhibitors
Common Indications: Epilepsy, migraine
Ocular Side Effects: Acute onset glaucoma, blurred vision, acute myopia (up to 8.75 diopters), diplopia (at high doses), nystagmus (at high does), shallow anterior chamber angle and angle closure, blepharospasm, myokymia, oculogyric crisis, diplopia
Warnings & Ocular Drug Interactions: Caution should be used in prescribing concomitant carbonic anhydrase inhibitors since this may increase the risk of renal stone formation
Tricor
Generic: Fenofibrate
Class: Antihyperlipidemics
Common Indications: Hyperlipidemia
Ocular Side Effects: Conjunctivitis, abnormal vision, cataract progression
Warnings & Ocular Drug Interactions: Should not be taken concomitantly with Cyclosporine due to increased risk for nephrotoxicity
Trileptal
Generic: Oxcarbazepine
Class: Antiepilepsy agents
Common Indications: Epilepsy
Ocular Side Effects: Diplopia, abnormal accommodation, blurred vision, conjunctival hemorrhage, ocular edema, mydriasis, photophobia, scotoma, involuntary eye movements
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Viagra
Generic: Sildenafil citrate
Class: Impotence agents, phosphodiesterase inhibitors
Common Indications: Erectile dysfunction
Ocular Side Effects: Changes in color perception (blue-tinged vision), decreased color vision, blurred vision, changes in light perception, ERG changes, conjunctival hyperemia, ocular pain, photophobia, ischemic optic neuropathy
Warnings & Ocular Drug Interactions: Erythromycin may increase plasma concentrations of Viagra
Vytorin
Generic: Ezetimibe/Simvastatin
Class: Antihyperlipidemics
Common Indications: Hyperlipidemia
Ocular Side Effects: Cataract progression; Rare: ophthalmoplegia
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Wellbutrin SR
Generic: Bupropion hydrochloride
Class: Antidepressants
Common Indications: Depression
Ocular Side Effects: Off-label: smoking cessation. Accommodation abnormality, dry eye, diplopia, mydriasis, amblyopia, blurred vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Xanax, Xanax XR
Generic: Alprazolam
Class: Anxiolytics, benzodiazepines, sedatives/hypnotics
Common Indications: Anxiety disorder, panic disorder
Ocular Side Effects: Worsening of narrow angle glaucoma (contraindicated in narrow angle patients), blurred vision
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Yasmin
Generic: Drospirenone/Ethinyl estradiol
Class: Oral contraceptives
Common Indications: Pregnancy contraception
Ocular Side Effects: Retinal thrombosis, contact lens intolerance, corneal steepening/edema, cataracts, visual disturbances
Warnings & Ocular Drug Interactions: Oral antibiotics may reduce the effectiveness of oral contraceptives
Zocor
Generic: Simvastatin
Class: Antihyperlipidemics
Common Indications: Hyperlipidemia
Ocular Side Effects: Ocular hemorrhage, progression of cataracts
Warnings & Ocular Drug Interactions: Concomitant use with Cyclosporine or Erythromycin may cause myopathy/rhabdomyolysis
Zoloft
Generic: Sertraline
Class: Antidepressants, serotonin-specific reuptake inhibitors
Common Indications: Depression, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, social phobia, premenstrual dysphoric disorder
Ocular Side Effects: Conjunctivitis, eye pain, abnormal accommodation, photophobia, diplopia, scotoma, visual field defect; Rare: glaucoma, cataracts, dry eyes
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
Zyprexa
Generic: Olanzapine
Class: Antipsychotics
Common Indications: Schizophrenia, acute mixed or manic episodes of bipolar disorder
Ocular Side Effects: Frequent: blurred vision, conjunctivitis; Infrequent: abnormality of accommodation, blepharitis, cataracts, diplopia, dry eyes, eye hemorrhage, eye inflammation, eye pain, ocular muscle abnormality; Rare: corneal lesion, glaucoma, keratoconjunctivitis, macular hypopigmentation, miosis, mydriasis, and pigment deposits on the lens
Warnings & Ocular Drug Interactions: Ciprofloxacin may increase blood concentrations of Olanzapine
Zyrtec
Generic: Cetirizine hydrochloride
Class: Antihistamines, H1
Common Indications: Allergic rhinitis; Off-label: urticaria
Ocular Side Effects: Photosensitivity, contact lens discomfort; ***Nine cases of oculogyric crisis associated with Zyrtec have been reported. Eight of those were pediatric patients.***
Warnings & Ocular Drug Interactions: No reactions to commonly prescribed ophthalmic medications (does not imply a total absence of drug interactions)
