Want this list as a cheat sheet? Download it here!
Download the cheat sheet
Prostaglandins
Brand Name | Generic Name | Washout Period |
---|---|---|
Lumigan 0.01% | Bimatoprost soln | 4.5 weeks |
Lumigan 0.03% | Bimatoprost soln | 4.5 weeks |
Travatan 0.004% | Travoprost soln | 4.5 weeks |
Travatan Z 0.004% | Travoprost soln | 4.5 weeks |
Zioptan 0.0015% | Tafluprost soln | 4.5 weeks |
Xalatan 0.005% | Latanoprost | 4.5 weeks |
Rescula 0.15% | Unoprostone soln | 4 weeks |
Vyzulta 0.024% | Latanoprostene Bunod soln | 4.5 weeks |
Beta-Blockers
Brand Name | Generic Name | Washout Period |
---|---|---|
Timoptic 0.25% | Timolol soln | 4 weeks |
Timoptic 0.5% | Timolol soln | 4 weeks |
Timoptic XE 0.25% | Timolol Gel-Forming soln | 4 weeks |
Timoptic XE 0.5% | Timolol Gel-Forming soln | 4 weeks |
Timoptic Ocudose PF 0.25% | Timolol soln | 4 weeks |
Timoptic Ocudose PF 0.5% | Timolol soln | 4 weeks |
Betoptic 0.5% | Betaxolol soln | 4 weeks |
Betoptic S 0.25% | Betaxolol soln | 4 weeks |
Betagan 0.25% | Levobunolol soln | 4 weeks |
Betagan 0.5% | Levobunolol soln | 4 weeks |
Optipranolol 0.3% | Metipranolol soln | 4 weeks |
Alpha-Agonists
Brand Name | Generic Name | Washout Period |
---|---|---|
Alphagan 0.15% | Brimonidine soln | 5 weeks |
Alphagan P 0.15% | Brimonidine soln | 5 weeks |
Alphagan 0.2% | Brimonidine soln | 5 weeks |
Iopidine 0.5% | Apraclonidine soln | 5 weeks |
Iopidine 1% | Apraclonidine soln | 5 weeks |
Muscarinic Agonists
Brand Name | Generic Name | Washout Period |
---|---|---|
Isopto Carpine 1% | Pilocarpine soln | 3 days |
Isopto Carpine 2% | Pilocarpine soln | 3 days |
Isopto Carpine 4% | Pilocarpine soln | 3 days |
Rho-Kinase Inhibitors
Brand Name | Generic Name | Washout Period |
---|---|---|
Rhopressa 0.02% | Netarsudil soln | 4 weeks |
Carbonic Anhydrase Inhibitors
Brand Name | Generic Name | Washout Period |
---|---|---|
Azopt 1% | Brinzolamide susp | 1 week |
Trusopt 2% | Dorzolamide soln | 1 week |
Trusopt PF 2% | Dorzolamide soln | 1 week |
Diamox Sequels 500mg | Acetazolamide ER tablet | 1 week |
Osmotic Diuretics
Brand Name | Generic Name | Washout Period |
---|---|---|
Osmitrol 20% | Mannitol soln (oral or IV) | 1 week |
Cannabinoids
Brand Name | Generic Name | Washout Period |
---|---|---|
THC | Tetrahydrocannabinol (THC) | 4 days |
Marinol | Dronabinol (synthetic THC) | 4 days |
- Note: CBD (Cannabidiol) raises IOP even higher, so CBD does not treat glaucoma.
Fixed-Combination Medications
Brand Name | Generic Name | Washout Period |
---|---|---|
Cosopt | Timolol + Dorzolamide soln | 4 weeks |
Cosopt PF | Timolol + Dorzolamide soln | 4 weeks |
Combigan | Timolol + Brimonidine soln | 5 weeks |
Simbrinza | Brimonidine + Brinzolamide susp | 5 weeks |
DuoTrav | Timolol + Travoprost | 4.5 weeks |
Xalacom | Timolol + Latanoprost | 4.5 weeks |
Rocklatan | Netarsudil + Latanoprost | 4.5 weeks |
- They will still need to be treated with IOP medications afterward.
- Even though a high IOP can cause vision loss long-term, the brief timeline of the washout period should not cause any vision loss.
- During the washout period, if they experience any discomfort or change in vision they should return to the clinic immediately.
References:
- Diaconita V, Quinn M, Jamal D, Dishan B, Malvankar-Mehta MS, Hutnik C. Washout Duration of Prostaglandin Analogues: A Systematic Review and Meta-analysis. J Ophthalmol. 2018 Sep 27;2018:3190684. doi: 10.1155/2018/3190684. PMID: 30363694; PMCID: PMC6180964.
- Leary KA, Lin KT, Steibel JP, Harman CD, Komáromy AM. Safety and efficacy of topically administered netarsudil (Rhopressa™) in normal and glaucomatous dogs with ADAMTS10-open-angle glaucoma (ADAMTS10-OAG). Vet Ophthalmol. 2021 Mar;24 Suppl 1(Suppl 1):75-86. doi: 10.1111/vop.12734. Epub 2019 Dec 24. PMID: 31872953; PMCID: PMC7755039.
- Stewart WC, Holmes KT, Johnson MA. Washout periods for brimonidine 0.2% and latanoprost 0.005%. Am J Ophthalmol. 2001 Jun;131(6):798-9. doi: 10.1016/s0002-9394(00)00930-2. PMID: 11384581.
- Diaconita V, Quinn M, Jamal D, Dishan B, Malvankar-Mehta MS, Hutnik C. Washout Duration of Prostaglandin Analogues: A Systematic Review and Meta-analysis. J Ophthalmol. 2018 Sep 27;2018:3190684. doi: 10.1155/2018/3190684. PMID: 30363694; PMCID: PMC6180964.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636120/
- Huestis MA. Human cannabinoid pharmacokinetics. Chem Biodivers. 2007;4(8):1770-1804. doi:10.1002/cbdv.200790152https://iovs.arvojournals.org/article.aspx?articleid=2420676
- Weinreb, Robert N. et al. 24-Hour Intraocular Pressure Control with Fixed-dose Combination Brinzolamide 1%/Brimonidine 0.2%. Ophthalmology, Volume 126, Issue 8, 1095 - 1104.
- 21214 Rescula Medical Review Part 1 (US Food and Drug Administration).
- Konstas, A., Katsimpris, I., Kaltsos, K. et al. Twenty-four-hour efficacy of the brimonidine/timolol fixed combination versus therapy with the unfixed components. Eye 22, 1391–1397 (2008). https://doi.org/10.1038/sj.eye.6702906
- Improved near visual acuity in presbyopes using carbachol and brimonidine eye drops. Trial registered on ANZCTR.