Are There Any Other Alternative Drugs to Substitute for Azopt Drops?

Published April 24, 2014

Question by : Are there any other alternative drugs to substitute for Azopt drops?
The drops are actually not for my own use, but were prescribed by my local veterinarian for my dog who has glaucoma, but the prescription costs $ 175! I love my animal but simply cannot afford to pay this much for one medication for her every month. Are there any drugs that are similar that I could possibly suggest that might be less expensive?
Thank you so much for your detailed answer! Very informative and really does help. Yes the drops have been a pain. Right now she is also on Neo/Poly/Dex and she is getting 2 drops FOUR times per day. It’s next to impossible to get one drop in her, much less remembering to do it four times per day. =/ I will definitely ask about the drug you suggested. Also to be fair my dog is 10 years old so I don’t expect her to live forever and I just don’t feel comfortable throwing out tons of cash for treatments that might not even help. Apparently the glaucoma is only affecting one eye at the moment and I guess the idea is to keep it from spreading? Unfortunately my vet is not very familiar with optometry and I am being sent to a specialist on veterinary optometry this Friday, perhaps I should ask him about trying the alternative drug?

But anyway thank you so much. This has been very very helpful.

Best answer:

Answer by princeidoc
ok I am not a vet. but I am a glaucoma specialist (for humans lol)

the bad news:
glaucoma is usually diagnosed very late in dogs, b/c vets dont check iop (intraocular pressure) very much. i wouldn’t, either…dont want to tackle the dog & fight them for a pressure reading unless you have to. so i am in no way implying vets are negligent or anything. but usually the vet diagnoses canine glaucoma by noting pallor (pale optic nerve) or significant differences in optic nerve “cupping”, (edit: or even red eye/cloudy cornea in extreme high pressure). by the time a dog has pallor or cupping, they’ve already lost some vision.

the good news:
glaucoma usually takes years & years to totally blind a person. well most dogs don’t have “years & years”. they’re not on the Earth but what? 15 years? 20 years at the max. so IMO (and the opinion of most vets) you dont have to be very aggressive in the treatment. all you’re trying to do is prevent major vision loss before the end of the dog’s life. unlike in humans where you could diagnose them with glaucoma at 40 and have to prevent vision loss for another maybe forty five or fifty years. in a dog you’re usually not concerned with getting the pressure really low for a really long time.

ok so back to your question. Azopt is expensive & there is no generic. azopt is also a strange choice IMO for 1st line therapy. its recommended for THREE times a day…well thats a pain when you’re having to tackle your dog & put it in. heck thats a pain for anyone.

MOST vets start with TIMOLOL. its a “beta-blocker” and it works awesome & its been around forever so it comes in a generic, and its only recommended twice a day, which is better than three times a day. a bottle of generic timolol is like $ 14. it is not the same mechanism of action as azopt, but who cares? I doubt your vet is going to be that picky. if it were me i’d go back & ask for a prescription for generic timolol twice a day instead. i bet the vet would be okay with that. i would.

sorry that ended up being longer than i intended

edit: wonder what the neo/poly/dex is for? thats antibiotic & steroid combo. that means the vet thinks it could be bacterial? dexamethasone (the “dex” of neo/poly/dex) can actually CAUSE glaucoma & INCREASE intraocular pressure, so thats certainly weird.

glaucoma does not “spread”. but what we always say about it is…”glaucoma is bilateral but asymmetric”. that means it almost ALWAYS occurs in both eyes. almost no one (or no dog) has glaucoma in ONE EYE. they all have it in BOTH eyes, but 1 eye is affected more severely or more quickly. almost all people with glaucoma end up with drops in both eyes. not b/c its “spreading” but b/c they really have it in both eyes, even if its only super obvious in 1.

for the record its next to impossible to get drops into a person’s eye as well if they’re not cooperating lol. i would assume most dogs would not cooperate. when my dog had an eye problem & i put her on Rx eyedrops (prednosone)…i treated her the same way i treat a screaming toddler: hold them down (gently lol) pry the eye open (also gently haha) and squirt away. 1 drop, 2 drops, 5 drops, steady stream…who cares?? especially if you can get your dog on the cheaper timolol, just squirt it in there. you can’t OD on timolol eye drops. extra drops fall out. i obviously wouldnt “squirt away” on $ 175 azopt tho haha

and yes, i’d ask the specialist if timolol would be ok.

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