This page shows what was measured, who it was measured in, and what that does not settle.
What Brinzolamide does in the body
Rather than dissolving the drug in acid to keep it in solution, brinzolamide is supplied as fine particles floating in a near-neutral liquid.
It jams the same enzyme dorzolamide jams, in the same tissue, so less fluid is pumped into the eye and pressure falls. The difference is how it is delivered. The eye does not object to the acidity because there is none. The particles do briefly blur vision as they dissolve.
Why people take it. Used to lower pressure inside the eye.
What happened in people
It lowered pressure about as much as dorzolamide and caused far less burning when applied.
✓ Reviewed first-read answer
Where this came from
A person wrote this and a reviewer approved it against this exact record. It carries no effect size.
A reviewer approved this against this record. The reviewed-claim record carrying the exact population and effect size does not exist yet.
No source is stored against this line.
The limit that matters most
Greater comfort was shown, but better long-term use and preserved vision were not.
Where it acts
Ciliary process epithelium, reached as suspended drug particles that dissolve slowly on the ocular surface
Kind of result
The kind of result is not recorded
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · 9451Z89515 · read 2026-08-29
Its recorded molecular formula is C12H21N3O5S3, weighing 383.5 g/mol.
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-30
Where each sentence above came from
A person wrote this explanation into the record, with the studies named in the path below.
A reviewer approved this sentence against this exact record and its sources.
The limit a reviewer approved as the one that matters most here.
The four opening statements run to 95 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Placebo
A placebo is a dummy treatment given so the real one can be compared with it.
A picture of it, and where the picture fails
A placebo is like a blank control in an experiment.
Where that stops being true. A blank does nothing. People given a placebo often do get better.
What people get wrong. A placebo effect is read as imaginary. The improvement is measured and real.
An inactive intervention matched in appearance to the test intervention, used to control for non-specific effects.
Comparator
A comparator is whatever the treatment was measured against.
A picture of it, and where the picture fails
It is like the other runner in a race.
Where that stops being true. A race has one winner. A study can show both arms improved.
What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.
The control condition against which the experimental intervention is assessed.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Diurnally corrected intraocular pressure reduction from baseline at peak and trough over 3 months
Brinzolamide twice daily -3.8 to -5.7 mmHg and three times daily -4.2 to -5.6, statistically equivalent to each other and to dorzolamide -4.3 to -5.9 (equivalence limit ≤1.5 mmHg); ocular discomfort 1.8% and 3.0% against dorzolamide 16.4%, P = .000
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Conducted by Alcon, whose drug it was, against the incumbent competitor. The efficacy result is equivalence, so the entire case for the product rests on the tolerability endpoint, which is the one the sponsor was best positioned to define and detect.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical ophthalmic suspension 1%, instilled three times daily
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Intraocular pressure reduction at one year for the class, dorzolamide against timolol and betaxolol
✓ The study showed what it set out to show
Who was studied
International Dorzolamide Study (Strahlman 1995)
How many people
523
Study design
Double-masked, randomised, parallel comparison at 34 international sites
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Dorzolamide approximately 23% peak and 17% trough reduction, comparable with betaxolol and below timolol
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Cited here for the class rather than for brinzolamide, which did not exist when it ran. It is the source of the one-year durability evidence brinzolamide inherits by equivalence.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical ophthalmic suspension 1%, instilled three times daily
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Dorzolamide significant against baseline at all eight measurement times and superior to timolol at midnight and 3 AM (P = 0.05)
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Tested dorzolamide, not brinzolamide. The overnight advantage often attributed to brinzolamide is inherited from this study by analogy of mechanism, not measured on this molecule.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical ophthalmic suspension 1%, instilled three times daily
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 3 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Brinzolamide
What a person takes: Topical ophthalmic suspension 1%, instilled three times daily.
The measurement behind this step
A near-neutral aqueous suspension of milled drug particles rather than a solution, which is what removes the acidic sting and what makes shaking before every dose mandatory. Particles dissolve on the tear film over minutes, transiently blurring vision, before the dissolved fraction crosses the cornea. If more than one topical eye product is used, the label directs at least ten minutes between them.
Getting in
A cloudy drop of suspended particles, not a solution
The bottle contains solid drug floating in liquid rather than dissolved in it. That is why it looks milky and why it has to be shaken before every single use.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Brinzolamide 1% is an ophthalmic suspension at near-neutral pH. The compound’s aqueous solubility is too low to formulate as a solution at a therapeutic concentration without an acidic buffer, so the drug is milled to a controlled particle size and suspended. The label instructs "Shake well before use" in its dosage section, because the particles settle and an unshaken bottle delivers an inconsistent dose.
The particles dissolve on the eye and briefly blur vision
The solid particles sit on the tear film and dissolve over the following minutes. While they are there they scatter light, which is why vision goes soft for a short time after each drop.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Dissolution from the suspended solid into the tear film is an additional rate-limiting step absent from solution formulations. Undissolved particles scatter incident light, producing the transient blurred vision the label lists among its most frequent adverse reactions at 5% to 10% incidence.
Dissolved drug crosses the cornea to the ciliary body
Once dissolved, the drug passes through the front of the eye to reach the tissue that makes the fluid. Some also drains into the nose, which is what causes the bitter taste.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The dissolved fraction partitions across the corneal epithelium and stroma into the aqueous humour, reaching the ciliary process epithelium. Nasolacrimal drainage carries a portion to the pharynx, producing the bitter, sour or unusual taste the label records at 5% to 10%. Systemically absorbed drug and its active N-desethyl metabolite bind carbonic anhydrase in erythrocytes and accumulate there.
The sulfonamide group locks onto the enzyme’s zinc
One end of the molecule clamps onto the single zinc atom at the heart of the enzyme, which is where all its chemistry happens. The enzyme stops working.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The unsubstituted primary sulfonamide deprotonates and coordinates the catalytic zinc of carbonic anhydrase II, displacing the zinc-bound hydroxide that performs the hydration of carbon dioxide. This is the identical binding mode used by dorzolamide and acetazolamide, which is why the two topical drugs are equipotent in the eye despite differing in the ring system around the warhead.
Bicarbonate production slows and so does the fluid pump
The cells cannot make the salt that pulls fluid into the eye. Sodium and water follow the salt, so less of both moves, and pressure falls.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Inhibition of carbonic anhydrase II in the ciliary processes slows bicarbonate formation and the sodium and fluid transport coupled to it, reducing the rate of aqueous humour secretion. Measured reduction is 2.42 mmHg (95% credible interval 1.62 to 3.23) at three months in the pooled network, statistically indistinguishable from dorzolamide’s 2.49.
Making the drop comfortable did nothing about the two things on the label that actually matter: severe sulfa reactions, and corneal swelling in eyes whose cornea is already fragile.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Both labelled Warnings and Precautions are consequences of the mechanism rather than the vehicle. Sulfonamide hypersensitivity follows from systemic absorption of a sulfonamide, and the label lists Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis and aplastic anaemia among rarely fatal reactions. Corneal oedema in patients with low endothelial cell counts follows from inhibiting the carbonic anhydrase the corneal endothelial pump depends on.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Adults with open-angle glaucoma or ocular hypertension, usually as an added agent. Like dorzolamide it is one of the options where beta-blockade is contraindicated.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “A 3-month controlled clinical study was conducted in which brinzolamide ophthalmic suspension was dosed only twice a day in pediatric patients 4 weeks to 5 years of age.”
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-30
On older people, the label states: “No overall differences in safety or effectiveness have been observed between elderly and younger patients.”
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary There are no adequate and well-controlled studies in pregnant women to inform drug-associated risk.”
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary There are no data on the presence of brinzolamide in human milk, the effects on the breastfed infant, or the effects on milk production.”
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-30
Where the result stopped carrying
The comfort was bought rather than gained: blurred vision and bitter taste replaced stinging, each at 5% to 10%
The suspension requires shaking before every dose, a step no other drop in this batch needs and a new way for a dose to go wrong
Three-times-daily dosing was carried over from dorzolamide despite the trial finding twice daily equivalent
The class sits near the bottom of the pooled efficacy ranking, at roughly half the effect of a prostaglandin analogue
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (11)
It was studied for a different goal
The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Prescription only
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Topical ophthalmic suspension 1%, instilled three times daily
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
RNAWiki has not recorded a supervision or regulatory status for this substance.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
No register row and no identity class settled the question.
No source is stored against this line.
What is in the pack
A near-neutral aqueous suspension of milled drug particles rather than a solution, which is what removes the acidic sting and what makes shaking before every dose mandatory. Particles dissolve on the tear film over minutes, transiently blurring vision, before the dissolved fraction crosses the cornea. If more than one topical eye product is used, the label directs at least ten minutes between them.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Two labelled Warnings and Precautions: sulfonamide hypersensitivity reactions, with rare fatalities from Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anaemia and other blood dyscrasias, and recurrence of sensitisation on readministration by any route; and corneal oedema in patients with low endothelial cell counts. Most frequent adverse reactions at 5% to 10% are blurred vision and bitter, sour or unusual taste. Blepharitis, dermatitis, dry eye, foreign body sensation, headache, hyperemia, ocular discharge and ocular discomfort at 1% to 5%. No beta-blockade, so no respiratory or cardiac contraindications.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Topical ophthalmic suspension 1%, instilled three times daily
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
Particles dissolve on the tear film over minutes, transiently blurring vision, before the dissolved fraction crosses the cornea. If more than one topical eye product is used, the label directs at least ten minutes between them.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
21 products list this as an active ingredient in the United States drug directory. 20 of them contain it and nothing else.
FDA National Drug Code directory · 58032-2023 · read 2026-08-29
They are sold as powder and suspension/ drops, taken ophthalmic.
FDA National Drug Code directory · 58032-2023 · read 2026-08-29
The regulator's established pharmacologic class for it is carbonic anhydrase inhibitor [epc] and carbonic anhydrase inhibitors [moa].
FDA National Drug Code directory · 58032-2023 · read 2026-08-29
7 published labels name it as an active ingredient. 6 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-29
BRINZOLAMIDE is ophthalmic at 3 DOSAGE FORMS AND STRENGTHS Ophthalmic suspension containing brinzolamide 1% (10 mg/mL)., recorded as fda label in effect 2024-07-10 in the United States.
US prescribing information · 37b19837-fcab-4536-abad-6f4f92dfe794 · read 2026-08-30
Recorded price in US: 9.48925–10.0787 USD per one millilitre, across 8 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.
Questions worth asking
Which of the trials of Brinzolamide studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That better instillation comfort produces better adherence and better preserved vision — never measured in any randomised comparison of these two drugs
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That brinzolamide shares dorzolamide’s overnight advantage; that finding comes from a 20-patient study of dorzolamide and is transferred by mechanism
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the eleven-fold acquisition cost difference against dorzolamide reflects anything about the drugs rather than the number of listed manufacturers
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That a gentler formulation is a safer drug, when both labelled warnings arise from the mechanism and are carried over unchanged
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Brinzolamide are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
Statistically equivalent to dorzolamide, and to itself at two doses
In plain words
The trial that got this drug approved put 572 patients on brinzolamide twice daily, brinzolamide three times daily, dorzolamide three times daily or timolol. The three carbonic anhydrase arms were indistinguishable from one another.
What was measured
Diurnally corrected intraocular pressure reduction at peak and trough over 3 months
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
In a multicentre, double-masked, prospective, parallel-group study of 572 patients with primary open-angle glaucoma or ocular hypertension, mean intraocular pressure changes with brinzolamide 1.0% twice daily (-3.8 to -5.7 mmHg) and three times daily (-4.2 to -5.6 mmHg) were statistically equivalent to each other and to dorzolamide 2.0% three times daily (-4.3 to -5.9 mmHg), with an equivalence confidence limit of 1.5 mmHg or less. Timolol 0.5% twice daily ranged from -5.2 to -6.3 mmHg. Clinically relevant pressure change, defined as a reduction of at least 5 mmHg or a pressure of 21 mmHg or less, was reached in up to 75.7% of patients on brinzolamide twice daily and 80.1% three times daily. The primary endpoint was diurnally corrected pressure reduction at peak and trough over 3 months.
Written into the record, not signed off as a reviewed claim
Nine times less stinging than the drug it replaced
In plain words
This is the number the drug exists for. Fewer than two patients in a hundred found brinzolamide uncomfortable to put in. On dorzolamide it was sixteen in a hundred.
What was measured
Incidence of ocular burning and stinging on instillation, brinzolamide against dorzolamide
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
In the same 572-patient trial, the incidence of ocular discomfort — burning and stinging on instillation — was 1.8% with brinzolamide twice daily and 3.0% three times daily, against 16.4% with dorzolamide (P = .000). The mechanistic explanation is formulation rather than molecule: dorzolamide is a solution buffered to roughly pH 5.6 because that is where it stays dissolved, while brinzolamide is a suspension at near-neutral pH and the eye has no acid to object to. The trade-off appears in the label’s adverse reactions section, where blurred vision and bitter, sour or unusual taste are the most frequent reactions at 5% to 10%.
Written into the record, not signed off as a reviewed claim
Twelfth of fourteen first-line drops on pressure lowering
In plain words
Pooling 114 trials, brinzolamide lowers pressure by 2.42 millimetres of mercury. Only betaxolol and unoprostone do less. It is roughly half as effective as the prostaglandin analogues.
What was measured
Mean intraocular pressure reduction at 3 months, pooled across 114 randomised trials
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
In the Bayesian network meta-analysis of 114 randomised trials in 20,275 participants, brinzolamide reduced intraocular pressure at 3 months by 2.42 mmHg (95% credible interval 1.62 to 3.23), ranking twelfth of fourteen first-line agents. Bimatoprost at 5.61, latanoprost at 4.85 and travoprost at 4.83 are roughly double. Dorzolamide at 2.49 (1.85 to 3.13) is indistinguishable from brinzolamide. The credible interval on brinzolamide is wider than dorzolamide’s, reflecting fewer contributing trials. This is not a defect in the drug — the class is genuinely weaker — but a page that reports the equivalence with dorzolamide without reporting where the pair sits in the field has told half the story.
Written into the record, not signed off as a reviewed claim
Comfort was traded for blurring, and the label says so
In plain words
Removing the sting did not remove the side effects, it changed them. The most common complaints in the trials were blurred vision and a bitter taste, each in five to ten patients in a hundred.
What was measured
Labelled adverse reaction incidence bands from the clinical trial programme
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
The FDA label lists blurred vision and bitter, sour or unusual taste as the most frequently reported adverse reactions, at an incidence of 5% to 10%. Reactions occurring in 1% to 5% include blepharitis, dermatitis, dry eye, foreign body sensation, headache, hyperemia, ocular discharge and ocular discomfort. Transient blurring is a direct consequence of the suspension: undissolved drug particles scatter light on the tear film until they dissolve. The bitter taste is nasolacrimal drainage carrying drug to the pharynx, which is shared with dorzolamide. So the comparison is not comfort against discomfort but stinging against blurring plus a required shaking step, in a drug taken three times a day for decades.
Source
AZOPT (brinzolamide ophthalmic suspension) 1% US prescribing information, Adverse Reactions 6.1 and Dosage and Administration 2 (NDA 020816)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
Better tolerated is not the same as better taken, and nobody measured the second
In plain words
The commercial case for this drug is that a comfortable drop gets used more reliably, and reliable use preserves more sight. The comfort was measured. The chain from comfort to adherence to vision was not.
What was measured
That reduced instillation discomfort produces better adherence and therefore better preserved vision — plausible, commercially decisive, and unmeasured in any randomised comparison of these two drugs
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The registration trial measured pressure and it measured instillation discomfort, and it found equivalence on the first and a nine-fold difference on the second. What it did not measure — and what no randomised comparison of brinzolamide against dorzolamide has since measured — is persistence on therapy, adherence, or any visual outcome. The inference is reasonable: glaucoma treatment is lifelong, non-adherence is the commonest reason it fails, and drop discomfort is a documented reason people stop. It remains an inference. On the available evidence the two drugs lower pressure identically, one costs eleven times the other per millilitre in the same acquisition survey, and the case for the difference rests on an endpoint nobody has collected.
Written into the record, not signed off as a reviewed claim
The sulfonamide and corneal warnings followed the class, not the molecule
In plain words
Brinzolamide inherited both of dorzolamide’s serious warnings unchanged, because they come from the mechanism rather than the formulation. Making the drop comfortable did nothing about either.
What was measured
That a better-tolerated formulation of the same mechanism is a safer drug — true for the surface irritation it was designed around, false for the two warnings that matter
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The brinzolamide label carries two Warnings and Precautions: sulfonamide hypersensitivity reactions, and corneal oedema in patients with low endothelial cell counts. The first states that brinzolamide is a sulfonamide, that it is absorbed systemically despite topical administration, that fatalities have occurred rarely from Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anaemia and other blood dyscrasias, and that sensitisation may recur on readministration by any route. The second mirrors the corneal endothelium warning dorzolamide acquired after a 1999 case series, because the corneal endothelial pump depends on the same carbonic anhydrase chemistry. Both warnings are properties of inhibiting this enzyme, and a formulation change cannot address either.
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What is not here
7 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
What was measured, goal by goal — found nothing in the sources checked.
How close this is to real life — found nothing in the sources checked.
Felt, measured, or meaningful — found nothing in the sources checked.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A thienothiazine sulfonamide that inhibits the same carbonic anhydrase II as dorzolamide and lowers pressure by an equivalent amount — 2.42 mmHg at three months across 114 pooled trials, twelfth of fourteen first-line drops — while causing burning on instillation in 1.8% of patients against dorzolamide’s 16.4%, at eleven times dorzolamide’s acquisition cost per millilitre and with blurred vision in 5% to 10% instead.
Recorded evidence blocks (9)
Q1
On the Brinzolamide label: indicated for what?
"Brinzolamide ophthalmic suspension is a carbonic anhydrase inhibitor indicated in the treatment of elevated intraocular pressure (IOP) in patients with ocular hypertension or open-angle glaucoma. Brinzolamide ophthalmic suspension is a carbonic anhydrase inhibitor indicated for in the treatment of elevated intraocular…": indications and usage on Brinzolamide's label. DailyMed label · fb7229d4-522e-4cb2-b513-9d34f3ded591 · 2026-04-20
Q2
39 registered trials of Brinzolamide — at which phases?
ophthalmic; Dose Level A / Brinzolamide 1% ophthalmic suspension
humanNCT02140060
ophthalmic; Dose Level B / Brinzolamide 1% ophthalmic suspension
recorded 2026-09-01 · last checked 2026-09-04
Q5
Brinzolamide's half-life is 111 days — which schedules were studied?
111 days, the half-life Brinzolamide's label states: "Due to its affinity for carbonic anhydrase II, brinzolamide distributes extensively into the RBCs and exhibits a long half-life in whole blood (approximately 111 days)." DailyMed label · fb7229d4-522e-4cb2-b513-9d34f3ded591 · 2026-04-20
Show the evidence
half lifepharmacokinetics
111 days; Due to its affinity for carbonic anhydrase II, brinzolamide distributes extensively into the RBCs and exhibits a long half-life in whole blood (approximately 111 days).
recorded 2026-04-20 · last checked 2026-09-04
Q6
Which 11 trials of Brinzolamide posted no result?
Posted no result
11 of 11 completed trials
Registrations
NCT00121147, NCT00061516, NCT00314158, NCT00440141, NCT00675207 and NCT00382226, and 5 more
Completion dates
oldest 2005-10; newest 2011-07
Show the evidence
Trial
NCT00121147
2005-10
NCT00061516
2006-02
NCT00314158
2007-01
NCT00440141
2007-03
NCT00675207
2007-07
NCT00382226
2007-08
5 further recorded trials
NCT00761995
2010-07
NCT00966576
2010-08
NCT00981786
2010-12
NCT01471158
2011-05
NCT01111890
2011-07
Q7
At the median, Brinzolamide's trials enrolled 120 people — anything larger?
Median enrolment
120
Largest enrolment
1184
Registered trials counted
39
Q8
What do 1565 spontaneous reports say about Brinzolamide — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Brinzolamide appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 1565 reaction mentions were counted: treatment failure 489; eye irritation 180; ocular hyperaemia 159; intraocular pressure increased 153. FAERS via Open Targets · CHEMBL220491 · 2026-06-24
Show the evidence
treatment failure
489
eye irritation
180
ocular hyperaemia
159
intraocular pressure increased
153
vision blurred
134
hypersensitivity
120
4 more recorded rows
eye pain
103
visual impairment
89
glaucoma
83
eye pruritus
55
recorded 2026-06-24 · last checked 2026-09-04
Q9
Which 10 reactions does Brinzolamide's label not list?
ChEMBL 37 — CC BY-SA 3.0 Unported · ChEMBL ATC CC BY-SA · ClinicalTrials.gov — US Government work · Open Targets 26.06 — CC0 · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work
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✓ public claims reviewed: 0 reviewed claim(s); drafts are never rendered
✓ source coverage passed: 6 source rows
✓ no critical contamination: no quarantine open
✓ canonical metadata passed: slug and display name present
✓ no raw internal fields: enforced by the copy-contract test over the rendered page
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