Peak Trough

□ Dorzolamide-timolo fixed combination BID 0 Timolol BID

■ Dorzolamide TID

Figure 7.1. Dorzolamide-timolol fixed combination versus components at 3 months. Adapted from Boyle JE, et al. A randomized trial comparing the dorzolamide-timolol combination given twice daily to monotherapy with timolol and dorzolamide. Dorzolamide-Timolol Study Group. Ophthalmology. 1998;105(10):1945-1951. Adapted from reference 16.

Three published studies have demonstrated a potentially greater IOP-lowering effect from the fixed combination compared to concomitant therapy.18-20 In these studies, patients receiving concomitant therapy with dorzolamide and a beta blocker were switched to the fixed combination. Each of the three studies showed a statistically significant IOP reduction after the switch to the fixed combination, ranging from 1.3 to 1.5 mm Hg. This likely represents improved compliance associated with reduction in both bottles and drops per day, as well as elimination of the washout effect.

In head-to-head comparisons with contemporary drugs, the timolol-dorzolamide fixed combination has been shown to be equal in efficacy to latanoprost mono-therapy,21-25 timolol and unoprostone concomitant therapy,26 and timolol and brimonidine concomitant therapy.27 Concomitant therapy with latanoprost and brimonidine has been shown to provide greater IOP reduction than the fixed combination of timolol and dorzolamide.28

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