salicylates and Glaucoma

We studied the effect of diflunisal on intraocular pressure in patients with glaucoma who were receiving maximally tolerated therapy. Diflunisal therapy, 500 mg twice daily, was started in 48 patients for one week. No changes were made in their regular antiglaucoma medications. Intraocular pressure was reduced an additional 3.8 +/- 3.1 mm Hg (+/- S.D.) in the acetazolamide-treated patients (P less than .0001) and 1.6 +/- 1.5 mm Hg in methazolamide-treated patients (P less than .02), while no significant reduction in intraocular pressure was found in patients receiving topical medications alone. In 15 acetazolamide-treated patients, total plasma concentrations of acetazolamide after diflunisal therapy were significantly higher than the prediflunisal levels, suggesting a modest decrease in renal excretion. In seven acetazolamide-treated patients, free plasma concentrations of acetazolamide were found to increase 5.6-fold after diflunisal therapy. We concluded that diflunisal potentiated the ocular hypotensive effect of acetazolamide by increasing its free plasma level.

Topics: Acetazolamide; Aged; Blood Proteins; Clinical Trials as Topic; Diflunisal; Drug Synergism; Female; Glaucoma; Humans; Intraocular Pressure; Male; Methazolamide; Middle Aged; Osmolar Concentration; Salicylates

Topics: Acetazolamide; Acidosis, Lactic; Aged; Anorexia; Confusion; Coronary Disease; Diabetes Mellitus, Type 2; Drug Interactions; Drug Therapy, Combination; Glaucoma; Humans; Joint Diseases; Male; Salicylates; Urinary Incontinence

Two young patients with unimpaired renal and hepatic function were found to have developed metabolic acidosis after treatment for glaucoma and joint pain with a combination of salicylates and carbonic anhydrase inhibitors in normal doses. Carbonic anhydrase inhibitors appear to interact with salicylates to produce serious metabolic acidosis in patients without the predisposing factors generally considered to constitute risks. It is recommended that treatment combining salicylates and carbonic anhydrase inhibitors is either kept to a minimum or avoided.

Topics: Acetazolamide; Acidosis; Adult; Arthritis; Aspirin; Carbonic Anhydrase Inhibitors; Child; Dichlorphenamide; Drug Interactions; Drug Therapy, Combination; Female; Glaucoma; Humans; Male; Salicylates

Topics: Adult; Aged; Arthritis, Rheumatoid; Female; Glaucoma; Humans; Indomethacin; Intraocular Pressure; Male; Middle Aged; Pilocarpine; Salicylates; Tonometry, Ocular

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Blindness; Cataract; Conjunctivitis; Diplopia; Drug Therapy; Edema; Eye Diseases; Eye Manifestations; Glaucoma; Gold; Humans; Iatrogenic Disease; Intraocular Pressure; Iridocyclitis; Iritis; Keratitis; Lupus Erythematosus, Systemic; Myopia; Rheumatic Diseases; Salicylates; Spondylitis; Spondylitis, Ankylosing; Toxicology; Uveitis

Topics: Glaucoma; Humans; Retinal Detachment; Salicylates; Toluene

Topics: Caffeine; Diuretics; Glaucoma; Salicylates

Topics: Adrenochrome; Diabetes Complications; Diabetic Retinopathy; Disease; Glaucoma; Humans; Retina; Retinal Diseases; Salicylates