{"id":"brinzolamide","rwe":[{"pmid":"41816094","year":"2026","title":"Depression and Anxiety After Topical Carbonic Anhydrase Inhibitors.","finding":"","journal":"Ophthalmology science","studyType":"Clinical Study"},{"pmid":"41800193","year":"2026","title":"Stressing the limits of capillary blood in anti-doping analysis: perspectives on alkylamine-like stimulants and carbonic anhydrase II inhibitors in result management.","finding":"","journal":"Frontiers in sports and active living","studyType":"Clinical Study"},{"pmid":"41697795","year":"2026","title":"Comparative safety and efficacy of brinzolamide/timolol and dorzolamide/timolol in the treatment of glaucoma patients: A systematic review and meta-analysis.","finding":"","journal":"European journal of ophthalmology","studyType":"Clinical Study"},{"pmid":"41500398","year":"2026","title":"Mechanical and cellular response of lenses to acute ocular hypertension: Implications of AQP1 regulating water transport and lenses opacification.","finding":"","journal":"Experimental eye research","studyType":"Clinical Study"},{"pmid":"41408653","year":"2026","title":"Discovery of Novel NO-Donor Containing hCA II Inhibitors with Retinal Ganglion Cell-Protective Effects for the Efficient Treatment of Glaucoma.","finding":"","journal":"Journal of medicinal chemistry","studyType":"Clinical Study"}],"_fda":{"id":"0afb6589-51ba-432c-aed1-20a12d5d3455","set_id":"0afb6589-51ba-432c-aed1-20a12d5d3455","openfda":{"nui":["N0000175517","N0000000235"],"unii":["9451Z89515"],"route":["OPHTHALMIC"],"rxcui":["213272","308805"],"spl_id":["0afb6589-51ba-432c-aed1-20a12d5d3455"],"brand_name":["Azopt"],"spl_set_id":["0afb6589-51ba-432c-aed1-20a12d5d3455"],"package_ndc":["66758-085-70","66758-085-85"],"product_ndc":["66758-085"],"generic_name":["BRINZOLAMIDE"],"product_type":["HUMAN PRESCRIPTION DRUG"],"substance_name":["BRINZOLAMIDE"],"pharm_class_epc":["Carbonic Anhydrase Inhibitor [EPC]"],"pharm_class_moa":["Carbonic Anhydrase Inhibitors [MoA]"],"manufacturer_name":["Sandoz Inc"],"application_number":["NDA020816"],"is_original_packager":[true]},"version":"1","pregnancy":["8.1 Pregnancy Risk Summary There are no adequate and well-controlled studies in pregnant women to inform drug-associated risk. In reproductive toxicity studies, brinzolamide administered orally to rats induced fetal toxicity at 375 times the recommended human ophthalmic dose (RHOD) based on mg/kg. In rabbits, no fetal toxicity was observed following oral administration (see Data) . The background risk of major birth defects and miscarriage for the indicated population is unknown; however, in the U.S. general population, the estimated background risk of major birth defects is 2% to 4%, and of miscarriage is 15% to 20%, of clinically recognized pregnancies. Data Animal Data Embryo-fetal studies were conducted in pregnant rats administered 0, 2, 6, or 18 mg/kg/day brinzolamide by oral gavage on gestation days 6 to 17, to target the period of organogenesis. Decreased fetal body weight with reduced skeletal ossification were observed at 18 mg/kg/day (375 times the RHOD based on mg/kg). The no-observed-adverse-effect-level (NOAEL) for fetal toxicity was 6 mg/kg/day (125 times the RHOD). Decreased maternal weight gain was observed at 18 mg/kg/day. The NOAEL for maternal toxicity was 6 mg/kg/day (125 times the RHOD). Embryo-fetal studies were conducted in pregnant rabbits administered 0, 1, 3, or 6 mg/kg/day of brinzolamide by oral gavage on gestation days 6 to 18, to target the period of organogenesis. No treatment-related fetal effects were observed at any dose. The NOAEL for fetal toxicity was 6 mg/kg/day (125 times the RHOD based on mg/kg). Maternal weight loss during pregnancy was observed at 3 mg/kg/day (63 times the RHOD) and above. The NOAEL for maternal toxicity was 1 mg/kg/day (21 times the RHOD). A peri-/postnatal study was conducted in rats administered brinzolamide by oral gavage from gestation day 16 through lactation day 20. Decreased pup body weight was observed at 15 mg/kg/day (313 times the RHOD based on mg/kg). The NOAEL for developmental toxicity was 5 mg/kg/day (104 times the RHOD). Following oral administration of 14 C-brinzolamide to pregnant rats, radioactivity was found to cross the placenta and was present in the fetal tissues and blood."],"overdosage":["10 OVERDOSAGE Although no human data are available, electrolyte imbalance, development of an acidotic state, and possible nervous system effects may occur following oral administration of an overdose. Serum electrolyte levels (particularly potassium) and blood pH levels should be monitored."],"description":["11 DESCRIPTION AZOPT contains a carbonic anhydrase inhibitor formulated for multidose topical ophthalmic use. Brinzolamide is described chemically as: (R)-(+)-4-Ethylamino-2-(3-methoxypropyl)-3,4-dihydro-2H-thieno [3,2-e]-1,2-thiazine-6-sulfonamide-1,1- dioxide. Its empirical formula is C 12 H 21 N 3 O 5 S 3 , and its structural formula is: Brinzolamide has a molecular weight of 383.5 g/mol and a melting point of about 131°C. It is a white powder, which is insoluble in water, very soluble in methanol and soluble in ethanol. AZOPT is supplied as a sterile, aqueous suspension of brinzolamide which has been formulated to be readily suspended and slow settling, following shaking. It has a pH of approximately 7.5 and an osmolality of 300 mOsm/kg. Each mL of AZOPT contains: Active ingredient: brinzolamide 10 mg; Inactives: carbomer 974P, edetate disodium, hydrochloric acid and/or sodium hydroxide to adjust pH, mannitol, purified water, sodium chloride, and tyloxapol; Preservative: benzalkonium chloride 0.1 mg. Brinzolamide structural formula"],"how_supplied":["16 HOW SUPPLIED/STORAGE AND HANDLING AZOPT (brinzolamide ophthalmic suspension) 1% is supplied in plastic dispensers with a controlled dispensing-tip as follows: 10 mL NDC 66758-085-70 15 mL NDC 66758-085-85 Storage and Handling Store AZOPT at 4°C to 30°C (39°F to 86°F). Shake well before use. After opening, AZOPT can be used until the expiration date on the bottle."],"geriatric_use":["8.5 Geriatric Use No overall differences in safety or effectiveness have been observed between elderly and younger patients."],"pediatric_use":["8.4 Pediatric Use A 3-month controlled clinical study was conducted in which AZOPT was dosed only twice a day in pediatric patients 4 weeks to 5 years of age. Patients were not required to discontinue their IOP-lowering medication(s) until initiation of monotherapy with AZOPT. IOP-lowering efficacy was not demonstrated in this study in which the mean decrease in elevated IOP was between 0 mmHg and 2 mmHg. Five out of 32 patients demonstrated an increase in corneal diameter of one millimeter."],"effective_time":"20231124","clinical_studies":["14 CLINICAL STUDIES In two, 3-month clinical studies, AZOPT dosed 3 times per day in patients with elevated IOP, produced significant reductions in IOPs (4 mmHg to 5 mmHg). These IOP reductions are equivalent to the reductions observed with TRUSOPT* (dorzolamide hydrochloride ophthalmic solution) 2% dosed 3 times per day in the same studies. In 2 clinical studies in patients with elevated IOP, AZOPT was associated with less stinging and burning upon instillation than TRUSOPT* 2%."],"pharmacokinetics":["12.3 Pharmacokinetics Following topical ocular administration, brinzolamide is absorbed into the systemic circulation. 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). In humans, the metabolite N-desethyl brinzolamide is formed, which also binds to carbonic anhydrase and accumulates in RBCs. This metabolite binds mainly to carbonic anhydrase I in the presence of brinzolamide. In plasma, both parent brinzolamide and N-desethyl brinzolamide concentrations are low and generally below assay quantitation limits (less than 10 ng/mL). Binding to plasma proteins is approximately 60%. Brinzolamide is eliminated predominantly in the urine as unchanged drug. N-Desethyl brinzolamide is also found in the urine along with lower concentrations of the N-desmethoxypropyl and O-desmethyl metabolites. An oral pharmacokinetic study was conducted in which healthy volunteers received 1 mg capsules of brinzolamide twice per day for up to 32 weeks. This regimen approximates the amount of drug delivered by topical ocular administration of AZOPT dosed to both eyes 3 times per day and simulates systemic drug and metabolite concentrations similar to those achieved with long-term topical dosing. Red blood cell carbonic anhydrase activity was measured to assess the degree of systemic carbonic anhydrase inhibition. Brinzolamide saturation of RBC carbonic anhydrase II was achieved within 4 weeks (RBC concentrations of approximately 20 mcM). N-Desethyl brinzolamide accumulated in RBCs to steady-state within 20 to 28 weeks reaching concentrations ranging from 6 to 30 mcM. The inhibition of carbonic anhydrase II activity at steady-state was approximately 70% to 75%, which is below the degree of inhibition expected to have a pharmacological effect on renal function or respiration in healthy subjects."],"adverse_reactions":["6 ADVERSE REACTIONS Most common adverse reactions (incidence 5% to 10%) are blurred vision and bitter, sour, or unusual taste. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Sandoz Inc. at 1-800-525-8747 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to the rates in the clinical trials of another drug and may not reflect the rates observed in practice. In clinical studies of AZOPT, the most frequently reported adverse reactions reported in 5% to 10% of patients were blurred vision and bitter, sour, or unusual taste. Adverse reactions occurring in 1% to 5% of patients were blepharitis, dermatitis, dry eye, foreign body sensation, headache, hyperemia, ocular discharge, ocular discomfort, ocular keratitis, ocular pain, ocular pruritus, and rhinitis. The following adverse reactions were reported at an incidence below 1%: allergic reactions, alopecia, chest pain, conjunctivitis, diarrhea, diplopia, dizziness, dry mouth, dyspnea, dyspepsia, eye fatigue, hypertonia, keratoconjunctivitis, keratopathy, kidney pain, lid margin crusting or sticky sensation, nausea, pharyngitis, tearing, and urticaria. 6.2 Postmarketing Experience The following adverse reactions have been identified during postapproval use of brinzolamide containing products. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Serious skin and subcutaneous tissue reactions, such as Stevens-Johnson syndrome (SJS) and Toxic epidermal necrolysis (TEN) may occur with the use of brinzolamide due to its sulfonamide component [see Warnings and Precautions (5.1)] ."],"contraindications":["4 CONTRAINDICATIONS AZOPT is contraindicated in patients who are hypersensitive to any component of this product. Hypersensitivity to any component of this product. ( 4 )"],"drug_interactions":["7 DRUG INTERACTIONS • There is a potential additive effect of the known systemic effects of carbonic anhydrase inhibition in patients receiving both oral and topical carbonic anhydrase inhibitors. ( 7.1 ) • Rare instances of acid-base alterations have occurred with high-dose salicylate therapy. ( 7.2 ) 7.1 Oral Carbonic Anhydrase Inhibitors There is a potential for an additive effect on the known systemic effects of carbonic anhydrase inhibition in patients receiving an oral carbonic anhydrase inhibitor and AZOPT. The concomitant administration of AZOPT and oral carbonic anhydrase inhibitors is not recommended. 7.2 High-Dose Salicylate Therapy Carbonic anhydrase inhibitors may produce acid-base and electrolyte alterations. These alterations were not reported in the clinical trials with brinzolamide. However, in patients treated with oral carbonic anhydrase inhibitors, rare instances of acid-base alterations have occurred with high-dose salicylate therapy. Therefore, the potential for such drug interactions should be considered in patients receiving AZOPT."],"mechanism_of_action":["12.1 Mechanism of Action Carbonic anhydrase is an enzyme found in many tissues of the body, including the eye. It catalyzes the reversible reaction involving the hydration of carbon dioxide and the dehydration of carbonic acid. In humans, carbonic anhydrase exists as a number of isoenzymes, the most active being carbonic anhydrase II, found primarily in red blood cells (RBCs), but also in other tissues. Inhibition of carbonic anhydrase in the ciliary processes of the eye decreases aqueous humor secretion, presumably by slowing the formation of bicarbonate ions with subsequent reduction in sodium and fluid transport. The result is a reduction in IOP. AZOPT contains brinzolamide, an inhibitor of carbonic anhydrase II. Following topical ocular administration, brinzolamide inhibits aqueous humor formation and reduces elevated IOP. Elevated IOP is a major risk factor in the pathogenesis of optic nerve damage and glaucomatous visual field loss."],"recent_major_changes":["Warnings and Precautions, Sulfonamide Hypersensitivity Reactions ( 5.1 ) 6/2023"],"clinical_pharmacology":["12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action Carbonic anhydrase is an enzyme found in many tissues of the body, including the eye. It catalyzes the reversible reaction involving the hydration of carbon dioxide and the dehydration of carbonic acid. In humans, carbonic anhydrase exists as a number of isoenzymes, the most active being carbonic anhydrase II, found primarily in red blood cells (RBCs), but also in other tissues. Inhibition of carbonic anhydrase in the ciliary processes of the eye decreases aqueous humor secretion, presumably by slowing the formation of bicarbonate ions with subsequent reduction in sodium and fluid transport. The result is a reduction in IOP. AZOPT contains brinzolamide, an inhibitor of carbonic anhydrase II. Following topical ocular administration, brinzolamide inhibits aqueous humor formation and reduces elevated IOP. Elevated IOP is a major risk factor in the pathogenesis of optic nerve damage and glaucomatous visual field loss. 12.3 Pharmacokinetics Following topical ocular administration, brinzolamide is absorbed into the systemic circulation. 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). In humans, the metabolite N-desethyl brinzolamide is formed, which also binds to carbonic anhydrase and accumulates in RBCs. This metabolite binds mainly to carbonic anhydrase I in the presence of brinzolamide. In plasma, both parent brinzolamide and N-desethyl brinzolamide concentrations are low and generally below assay quantitation limits (less than 10 ng/mL). Binding to plasma proteins is approximately 60%. Brinzolamide is eliminated predominantly in the urine as unchanged drug. N-Desethyl brinzolamide is also found in the urine along with lower concentrations of the N-desmethoxypropyl and O-desmethyl metabolites. An oral pharmacokinetic study was conducted in which healthy volunteers received 1 mg capsules of brinzolamide twice per day for up to 32 weeks. This regimen approximates the amount of drug delivered by topical ocular administration of AZOPT dosed to both eyes 3 times per day and simulates systemic drug and metabolite concentrations similar to those achieved with long-term topical dosing. Red blood cell carbonic anhydrase activity was measured to assess the degree of systemic carbonic anhydrase inhibition. Brinzolamide saturation of RBC carbonic anhydrase II was achieved within 4 weeks (RBC concentrations of approximately 20 mcM). N-Desethyl brinzolamide accumulated in RBCs to steady-state within 20 to 28 weeks reaching concentrations ranging from 6 to 30 mcM. The inhibition of carbonic anhydrase II activity at steady-state was approximately 70% to 75%, which is below the degree of inhibition expected to have a pharmacological effect on renal function or respiration in healthy subjects."],"indications_and_usage":["1 INDICATIONS AND USAGE AZOPT is a carbonic anhydrase inhibitor indicated in the treatment of elevated intraocular pressure (IOP) in patients with ocular hypertension or open-angle glaucoma. AZOPT is a carbonic anhydrase inhibitor indicated for the treatment of elevated intraocular pressure (IOP) in patients with ocular hypertension or open-angle glaucoma. ( 1 )"],"warnings_and_cautions":["5 WARNINGS AND PRECAUTIONS • Sulfonamide hypersensitivity reactions. ( 5.1 ) • Corneal edema may occur in patients with low endothelial cell counts. ( 5.2 ) 5.1 Sulfonamide Hypersensitivity Reactions AZOPT is a sulfonamide and although administered topically, it is absorbed systemically. Therefore, the same types of adverse reactions that are attributable to sulfonamides may occur with topical administration of AZOPT. Fatalities have occurred, although rarely, due to severe reactions to sulfonamides, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias. Sensitization may recur when a sulfonamide is readministered irrespective of the route of administration. If signs of serious reactions or hypersensitivity occur, discontinue the use of this preparation immediately. 5.2 Corneal Endothelium Carbonic anhydrase activity has been observed in both the cytoplasm and around the plasma membranes of the corneal endothelium. There is an increased potential for developing corneal edema in patients with low endothelial cell counts. Caution should be used when prescribing AZOPT to this group of patients. 5.3 Severe Renal Impairment AZOPT has not been studied in patients with severe renal impairment [creatinine clearance (CrCl) less than 30 mL/min]. Because AZOPT and its metabolite are excreted predominantly by the kidney, AZOPT is not recommended in such patients. 5.4 Acute Angle-Closure Glaucoma The management of patients with acute angle-closure glaucoma requires therapeutic interventions in addition to ocular hypotensive agents. AZOPT has not been studied in patients with acute angle-closure glaucoma. 5.5 Risk of Contamination Avoid allowing the tip of the dispensing container to contact the eye or surrounding structures or other surfaces, since the product can become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions. 5.6 Contact Lens Wear The preservative in AZOPT, benzalkonium chloride, may be absorbed by soft contact lenses. Contact lenses should be removed during instillation of AZOPT, but may be reinserted 15 minutes after instillation."],"nonclinical_toxicology":["13 NONCLINICAL TOXICOLOGY 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility Carcinogenesis Brinzolamide caused urinary bladder tumors in female mice at oral doses of 10 mg/kg/day and in male rats at oral doses of 8 mg/kg/day in 2-year studies. Brinzolamide was not carcinogenic in male mice or female rats dosed orally for up to 2 years. The carcinogenicity appears secondary to kidney and urinary bladder toxicity. These levels of exposure cannot be achieved with topical ophthalmic dosing in humans. Mutagenesis The following tests for mutagenic potential were negative: (1) in vivo mouse micronucleus assay; (2) in vivo sister chromatid exchange assay; and (3) Ames E. coli test. The in vitro mouse lymphoma forward mutation assay was negative in the absence of activation, but positive in the presence of microsomal activation. Impairment of Fertility In reproduction studies of brinzolamide in rats, there were no adverse effects on the fertility or reproductive capacity of males or females at doses up to 18 mg/kg/day (375 times the RHOD based on mg/kg)."],"information_for_patients":["17 PATIENT COUNSELING INFORMATION Sulfonamide Hypersensitivity Reactions Advise patients that if serious or unusual ocular or systemic reactions or signs of hypersensitivity occur, they should discontinue the use of the product and consult their physician immediately [see Warnings and Precautions (5.1)] . Temporary Blurred Vision Vision may be temporarily blurred following dosing with AZOPT. Advise patients to exercise care in operating machinery or driving a motor vehicle. Avoiding Contamination of the Product Instruct patients to avoid allowing the tip of the dispensing container to contact the eye or surrounding structures or other surfaces, since the product can become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions. Intercurrent Ocular Conditions Advise patients that if they have ocular surgery or develop an intercurrent ocular condition (e.g., trauma or infection), they should immediately seek their physician's advice concerning the continued use of the present multi-dose container. Concomitant Topical Ocular Therapy If more than one topical ophthalmic drug is being used, the drugs should be administered at least ten minutes apart. Contact Lens Wear The preservative in AZOPT, benzalkonium chloride, may be absorbed by soft contact lenses. Contact lenses should be removed during instillation of AZOPT, but may be reinserted 15 minutes after instillation. *TRUSOPT is a registered trademark of Merck & Co., Inc. Manufactured by Alcon Laboratories, Inc. Fort Worth, Texas 76134 for Sandoz Inc., Princeton, NJ 08540 300064739-1123"],"dosage_and_administration":["2 DOSAGE AND ADMINISTRATION The recommended dose is one drop of AZOPT in the affected eye(s) 3 times daily. Shake well before use. AZOPT may be used concomitantly with other topical ophthalmic drug products to lower IOP. If more than one topical ophthalmic drug is being used, the drugs should be administered at least 10 minutes apart. • Instill one drop in the affected eye(s) 3 times daily. ( 2 ) • If more than one topical ophthalmic drug is being used, the drugs should be administered at least 10 minutes apart. ( 2 )"],"spl_product_data_elements":["Azopt brinzolamide BRINZOLAMIDE BRINZOLAMIDE MANNITOL TYLOXAPOL EDETATE DISODIUM SODIUM CHLORIDE HYDROCHLORIC ACID SODIUM HYDROXIDE WATER BENZALKONIUM CHLORIDE CARBOMER HOMOPOLYMER TYPE C (ALLYL PENTAERYTHRITOL CROSSLINKED)"],"dosage_forms_and_strengths":["3 DOSAGE FORMS AND STRENGTHS Ophthalmic suspension containing brinzolamide 1% (10 mg/mL). Ophthalmic suspension containing brinzolamide 1% (10 mg/mL). ( 3 )"],"use_in_specific_populations":["8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy Risk Summary There are no adequate and well-controlled studies in pregnant women to inform drug-associated risk. In reproductive toxicity studies, brinzolamide administered orally to rats induced fetal toxicity at 375 times the recommended human ophthalmic dose (RHOD) based on mg/kg. In rabbits, no fetal toxicity was observed following oral administration (see Data) . The background risk of major birth defects and miscarriage for the indicated population is unknown; however, in the U.S. general population, the estimated background risk of major birth defects is 2% to 4%, and of miscarriage is 15% to 20%, of clinically recognized pregnancies. Data Animal Data Embryo-fetal studies were conducted in pregnant rats administered 0, 2, 6, or 18 mg/kg/day brinzolamide by oral gavage on gestation days 6 to 17, to target the period of organogenesis. Decreased fetal body weight with reduced skeletal ossification were observed at 18 mg/kg/day (375 times the RHOD based on mg/kg). The no-observed-adverse-effect-level (NOAEL) for fetal toxicity was 6 mg/kg/day (125 times the RHOD). Decreased maternal weight gain was observed at 18 mg/kg/day. The NOAEL for maternal toxicity was 6 mg/kg/day (125 times the RHOD). Embryo-fetal studies were conducted in pregnant rabbits administered 0, 1, 3, or 6 mg/kg/day of brinzolamide by oral gavage on gestation days 6 to 18, to target the period of organogenesis. No treatment-related fetal effects were observed at any dose. The NOAEL for fetal toxicity was 6 mg/kg/day (125 times the RHOD based on mg/kg). Maternal weight loss during pregnancy was observed at 3 mg/kg/day (63 times the RHOD) and above. The NOAEL for maternal toxicity was 1 mg/kg/day (21 times the RHOD). A peri-/postnatal study was conducted in rats administered brinzolamide by oral gavage from gestation day 16 through lactation day 20. Decreased pup body weight was observed at 15 mg/kg/day (313 times the RHOD based on mg/kg). The NOAEL for developmental toxicity was 5 mg/kg/day (104 times the RHOD). Following oral administration of 14 C-brinzolamide to pregnant rats, radioactivity was found to cross the placenta and was present in the fetal tissues and blood. 8.2 Lactation 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. Brinzolamide has been detected in the milk of lactating rats. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for AZOPT and any potential adverse effects on the breastfed child from AZOPT. 8.4 Pediatric Use A 3-month controlled clinical study was conducted in which AZOPT was dosed only twice a day in pediatric patients 4 weeks to 5 years of age. Patients were not required to discontinue their IOP-lowering medication(s) until initiation of monotherapy with AZOPT. IOP-lowering efficacy was not demonstrated in this study in which the mean decrease in elevated IOP was between 0 mmHg and 2 mmHg. Five out of 32 patients demonstrated an increase in corneal diameter of one millimeter. 8.5 Geriatric Use No overall differences in safety or effectiveness have been observed between elderly and younger patients."],"package_label_principal_display_panel":["PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 66758-085-70 Azopt® (brinzolamide ophthalmic suspension) 1% 10 mL Sterile Sandoz france-carton","PRINCIPAL DISPLAY PANEL NDC 66758-085-70 Azopt ® (brinzolamide ophthalmic suspension) 1% 10 mL Sterile Sandoz switzerland-carton"],"carcinogenesis_and_mutagenesis_and_impairment_of_fertility":["13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility Carcinogenesis Brinzolamide caused urinary bladder tumors in female mice at oral doses of 10 mg/kg/day and in male rats at oral doses of 8 mg/kg/day in 2-year studies. Brinzolamide was not carcinogenic in male mice or female rats dosed orally for up to 2 years. The carcinogenicity appears secondary to kidney and urinary bladder toxicity. These levels of exposure cannot be achieved with topical ophthalmic dosing in humans. Mutagenesis The following tests for mutagenic potential were negative: (1) in vivo mouse micronucleus assay; (2) in vivo sister chromatid exchange assay; and (3) Ames E. coli test. The in vitro mouse lymphoma forward mutation assay was negative in the absence of activation, but positive in the presence of microsomal activation. Impairment of Fertility In reproduction studies of brinzolamide in rats, there were no adverse effects on the fertility or reproductive capacity of males or females at doses up to 18 mg/kg/day (375 times the RHOD based on mg/kg)."]},"tags":[{"label":"Carbonic Anhydrase Inhibitor","category":"class"},{"label":"Small Molecule","category":"modality"},{"label":"Carbonic anhydrase 2","category":"target"},{"label":"CA2","category":"gene"},{"label":"CA6","category":"gene"},{"label":"CA7","category":"gene"},{"label":"S01EC04","category":"atc"},{"label":"Ophthalmic","category":"route"},{"label":"Suspension/ Drops","category":"form"},{"label":"Off-Patent","category":"patent"},{"label":"Generic Available","category":"availability"},{"label":"Mature","category":"status"},{"label":"Ocular hypertension","category":"indication"},{"label":"Open-angle glaucoma","category":"indication"},{"label":"Sandoz","category":"company"},{"label":"Approved 1990s","category":"decade"},{"label":"Carbonic Anhydrase Inhibitors","category":"pharmacology"},{"label":"Enzyme Inhibitors","category":"pharmacology"}],"phase":"marketed","safety":{"boxedWarnings":[],"safetySignals":[{"llr":368.923,"date":"","count":296,"signal":"Treatment failure","source":"DrugCentral FAERS","actionTaken":"Reported 296 times (LLR=369)"},{"llr":343.425,"date":"","count":107,"signal":"Intraocular pressure increased","source":"DrugCentral FAERS","actionTaken":"Reported 107 times (LLR=343)"},{"llr":299.158,"date":"","count":121,"signal":"Eye irritation","source":"DrugCentral FAERS","actionTaken":"Reported 121 times (LLR=299)"},{"llr":297.189,"date":"","count":142,"signal":"Eye pain","source":"DrugCentral FAERS","actionTaken":"Reported 142 times (LLR=297)"},{"llr":235.564,"date":"","count":66,"signal":"Amaurosis fugax","source":"DrugCentral FAERS","actionTaken":"Reported 66 times (LLR=236)"},{"llr":235.264,"date":"","count":78,"signal":"Ocular discomfort","source":"DrugCentral FAERS","actionTaken":"Reported 78 times (LLR=235)"},{"llr":230.036,"date":"","count":112,"signal":"Blindness","source":"DrugCentral FAERS","actionTaken":"Reported 112 times (LLR=230)"},{"llr":198.937,"date":"","count":77,"signal":"Haemorrhagic stroke","source":"DrugCentral FAERS","actionTaken":"Reported 77 times (LLR=199)"},{"llr":185.146,"date":"","count":151,"signal":"Vision blurred","source":"DrugCentral FAERS","actionTaken":"Reported 151 times (LLR=185)"},{"llr":183.945,"date":"","count":63,"signal":"Urinary tract disorder","source":"DrugCentral FAERS","actionTaken":"Reported 63 times (LLR=184)"},{"llr":151.996,"date":"","count":75,"signal":"Photophobia","source":"DrugCentral FAERS","actionTaken":"Reported 75 times (LLR=152)"},{"llr":147.316,"date":"","count":76,"signal":"Generalised oedema","source":"DrugCentral FAERS","actionTaken":"Reported 76 times (LLR=147)"},{"llr":147.107,"date":"","count":67,"signal":"Head discomfort","source":"DrugCentral FAERS","actionTaken":"Reported 67 times (LLR=147)"},{"llr":143.733,"date":"","count":78,"signal":"Ocular hyperaemia","source":"DrugCentral FAERS","actionTaken":"Reported 78 times (LLR=144)"},{"llr":116.043,"date":"","count":61,"signal":"Glaucoma","source":"DrugCentral FAERS","actionTaken":"Reported 61 times (LLR=116)"}],"commonSideEffects":[{"effect":"blurred vision","drugRate":"5% to 10%","_validated":true,"placeboRate":""},{"effect":"bitter, sour, or unusual taste","drugRate":"5% to 10%","_validated":true,"placeboRate":""}],"contraindications":["Acute nephropathy"],"specialPopulations":{"Lactation":"There are no data on the presence of brinzolamide in human milk, the effects on the breastfed infant, or the effects on milk production. Brinzolamide has been detected in the milk of lactating rats.","Pregnancy":"There are no adequate and well-controlled studies in pregnant women to inform drug-associated risk. In reproductive toxicity studies, brinzolamide administered orally to rats induced fetal toxicity at 375-times the recommended human ophthalmic dose (RHOD) based on mg/kg. In rabbits, no fetal toxicity was observed following oral administration. The background risk of major birth defects and miscarriage for the indicated population is unknown; however, in the U.S. general population, the estimated background risk of major birth defects is 2% to 4%, and of miscarriage is 15% to 20%, of clinically recognized pregnancies.","Geriatric use":"No overall differences in safety or effectiveness have been observed between elderly and younger patients.","Paediatric use":"A 3-month controlled clinical study was conducted in which AZOPT was dosed only twice a day in pediatric patients 2 to 16 years of age. Patients were not required to discontinue their IOP-lowering medication(s) until initiation of monotherapy with AZOPT. IOP-lowering efficacy was not demonstrated in this study in which the mean decrease in elevated IOP was between 2 and 4 mmHg. Five out of 32 patients demonstrated an increase in corneal diameter of one millimeter."}},"trials":[],"aliases":[],"company":"Novartis","patents":[],"pricing":[{"market":"United States","source":"CMS National Average Drug Acquisition Cost (NADAC)","asOfDate":"2024-01-03","unitCost":"$11.9086/ML","priceType":"NADAC","sourceUrl":"https://data.medicaid.gov/dataset/4j6z-xnwq","annualCost":"$4,287","description":"BRINZOLAMIDE 1% EYE DROPS","retrievedDate":"2026-04-07"}],"_sources":{"trials":{"url":"https://clinicaltrials.gov/search?intr=BRINZOLAMIDE","method":"api_direct","source":"ClinicalTrials.gov","rawText":"","confidence":1,"sourceType":"ctgov","retrievedAt":"2026-04-20T02:13:51.527761+00:00"},"timeline":{"url":"https://en.wikipedia.org/wiki/Brinzolamide","method":"deterministic","source":"Wikipedia","rawText":"","confidence":0.8,"sourceType":"wikipedia","retrievedAt":"2026-04-20T02:13:58.756983+00:00"},"regulatory.ca":{"url":"","method":"api_direct","source":"Health Canada DPD","rawText":"","confidence":1,"sourceType":"health_canada_dpd","retrievedAt":"2026-04-20T02:13:56.836755+00:00"},"regulatory.eu":{"url":"","method":"api_direct","source":"European Medicines Agency","rawText":"","confidence":1,"sourceType":"ema_api","retrievedAt":"2026-04-20T02:13:51.600621+00:00"},"publicationCount":{"url":"https://pubmed.ncbi.nlm.nih.gov/?term=BRINZOLAMIDE","method":"api_direct","source":"PubMed/NCBI","rawText":"","confidence":1,"sourceType":"pubmed","retrievedAt":"2026-04-20T02:13:57.633939+00:00"},"mechanism.drugClass":{"url":"https://api.fda.gov/drug/label.json","method":"deterministic","source":"FDA Label (EPC)","rawText":"","confidence":1,"sourceType":"fda_label","retrievedAt":"2026-04-20T02:13:50.421718+00:00"},"administration.route":{"url":"","method":"deterministic","source":"FDA Label","rawText":"","confidence":1,"sourceType":"fda_label","retrievedAt":"2026-04-20T02:13:50.421759+00:00"},"safety.boxedWarnings":{"url":"","method":"deterministic","source":"FDA Label (no boxed warning)","rawText":"","confidence":1,"sourceType":"fda_label","retrievedAt":"2026-04-20T02:13:50.421765+00:00"},"mechanism.oneSentence":{"url":"","method":"ai_extraction","source":"FDA Label + AI","aiModel":"featherless","rawText":"12.1 Mechanism of Action Carbonic anhydrase is an enzyme found in many tissues of the body, including the eye. It catalyzes the reversible reaction involving the hydration of carbon dioxide and the dehydration of carbonic acid. In humans, carbonic anhydrase exists as a number of isoenzymes, the most active being carbonic anhydrase II, found primarily in red blood cells (RBCs), but also in other tissues. Inhibition of carbonic anhydrase in the ciliary processes of the eye decreases aqueous humor ","confidence":0.95,"sourceType":"fda_label","retrievedAt":"2026-04-20T02:14:18.076536+00:00"},"mechanism.target_chembl":{"url":"","method":"api_direct","source":"ChEMBL mechanism: Carbonic anhydrase II inhibitor","rawText":"","confidence":1,"sourceType":"chembl","retrievedAt":"2026-04-20T02:13:58.756923+00:00"},"crossReferences.chemblId":{"url":"https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL220491/","method":"api_direct","source":"ChEMBL (EMBL-EBI)","rawText":"","confidence":1,"sourceType":"chembl","retrievedAt":"2026-04-20T02:13:58.412993+00:00"},"safety.commonSideEffects":{"url":"","method":"ai_extraction","source":"FDA Label + AI","aiModel":"featherless","rawText":"6 ADVERSE REACTIONS Most common adverse reactions (incidence 5% to 10%) are blurred vision and bitter, sour, or unusual taste. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Sandoz Inc. at 1-800-525-8747 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to the rates in the clinical trials of ano","confidence":0.95,"sourceType":"fda_label","retrievedAt":"2026-04-20T02:14:23.818096+00:00"},"regulatory.fda_application":{"url":"","method":"deterministic","source":"FDA Label","rawText":"NDA020816","confidence":1,"sourceType":"fda_label","retrievedAt":"2026-04-20T02:13:50.421769+00:00"}},"allNames":"azopt","offLabel":[],"synonyms":["AL-4862","brinzolamide","azopt"],"timeline":[{"date":"1998-01-01","type":"neutral","source":"FDA Orange Book","milestone":"Rights transferred from ALCON PHARMS LTD to Sandoz"},{"date":"1998-04-01","type":"positive","source":"DrugCentral","milestone":"FDA approval (Alcon Pharms Ltd)"},{"date":"2000-03-09","type":"positive","source":"DrugCentral","milestone":"EMA approval (Novartis Europharm Limited)"},{"date":"2002-10-08","type":"positive","source":"DrugCentral","milestone":"PMDA approval (Alcon Japan)"},{"date":"2021-08-18","type":"neutral","source":"FDA Orange Book","milestone":"Generic entry — 2 manufacturers approved"}],"aiSummary":"Azopt (Brinzolamide) is a small molecule carbonic anhydrase inhibitor developed by Alcon Pharm Ltd and currently owned by Sandoz. It targets carbonic anhydrase 2 to treat ocular hypertension and open-angle glaucoma. Azopt is a generic medication, off-patent since there are no active Orange Book patents. It is used to reduce intraocular pressure in patients with glaucoma. As a carbonic anhydrase inhibitor, Azopt works by blocking the enzyme responsible for producing aqueous humor in the eye, thereby reducing pressure.","brandName":"Azopt","ecosystem":[{"indication":"Ocular hypertension","otherDrugs":[{"name":"betaxolol","slug":"betaxolol","company":"Alcon"},{"name":"bimatoprost","slug":"bimatoprost","company":""},{"name":"brimonidine","slug":"brimonidine","company":""},{"name":"carteolol","slug":"carteolol","company":""}],"globalPrevalence":1280000000},{"indication":"Open-angle glaucoma","otherDrugs":[{"name":"acetazolamide","slug":"acetazolamide","company":"Teva Branded Pharm"},{"name":"apraclonidine","slug":"apraclonidine","company":"Alcon"},{"name":"betaxolol","slug":"betaxolol","company":"Alcon"},{"name":"bimatoprost","slug":"bimatoprost","company":""}],"globalPrevalence":null}],"mechanism":{"target":"carbonic anhydrase II","novelty":"Follow-on","targets":[{"gene":"CA2","source":"DrugCentral","target":"Carbonic anhydrase 2","protein":"Carbonic anhydrase 2"},{"gene":"CA6","source":"DrugCentral","target":"Carbonic anhydrase 6","protein":"Carbonic anhydrase 6"},{"gene":"CA7","source":"DrugCentral","target":"Carbonic anhydrase 7","protein":"Carbonic anhydrase 7"},{"gene":"CA1","source":"DrugCentral","target":"Carbonic anhydrase 1","protein":"Carbonic anhydrase 1"},{"gene":"CA12","source":"DrugCentral","target":"Carbonic anhydrase 12","protein":"Carbonic anhydrase 12"},{"gene":"CA13","source":"DrugCentral","target":"Carbonic anhydrase 13","protein":"Carbonic anhydrase 13"},{"gene":"CA14","source":"DrugCentral","target":"Carbonic anhydrase 14","protein":"Carbonic anhydrase 14"},{"gene":"CA5B","source":"DrugCentral","target":"Carbonic anhydrase 5B, mitochondrial","protein":"Carbonic anhydrase 5B, mitochondrial"},{"gene":"CA9","source":"DrugCentral","target":"Carbonic anhydrase 9","protein":"Carbonic anhydrase 9"},{"gene":"CA5A","source":"DrugCentral","target":"Carbonic anhydrase 5A, mitochondrial","protein":"Carbonic anhydrase 5A, mitochondrial"}],"moaClass":"Carbonic Anhydrase Inhibitors","modality":"Small molecule","drugClass":"Carbonic Anhydrase Inhibitor [EPC]","explanation":"Brinzolamide works by inhibiting carbonic anhydrase II, an enzyme that helps form bicarbonate ions. By slowing this process, it reduces the production of aqueous humor in the eye, leading to lower intraocular pressure (IOP). This is important because elevated IOP is a key risk factor for optic nerve damage and glaucoma.","oneSentence":"Brinzolamide reduces intraocular pressure by inhibiting carbonic anhydrase II, decreasing aqueous humor secretion.","technicalDetail":"Carbonic anhydrase II is an isoenzyme found primarily in red blood cells and other tissues. It catalyzes the reversible reaction of carbon dioxide hydration and carbonic acid dehydration. Brinzolamide, a small molecule inhibitor, binds to carbonic anhydrase II, reducing its activity in the ciliary processes of the eye, which results in decreased aqueous humor secretion and reduced IOP."},"_wikipedia":{"url":"https://en.wikipedia.org/wiki/Brinzolamide","title":"Brinzolamide","extract":"Brinzolamide is a carbonic anhydrase inhibitor used to lower intraocular pressure in patients with open-angle glaucoma or ocular hypertension."},"commercial":{"launchDate":"1998","_launchSource":"DrugCentral (FDA 1998-04-01, ALCON PHARMS LTD)"},"references":[{"id":1,"url":"https://drugcentral.org/drugcard/396","fields":["approvals","synonyms","ATC","PK","indications","contraindications","DDIs","targets","patents","FAERS"],"source":"DrugCentral"},{"id":2,"url":"https://clinicaltrials.gov/search?intr=BRINZOLAMIDE","fields":["trials"],"source":"ClinicalTrials.gov"},{"id":3,"url":"https://pubmed.ncbi.nlm.nih.gov/?term=BRINZOLAMIDE","fields":["publications"],"source":"PubMed/NCBI"},{"id":4,"url":"https://en.wikipedia.org/wiki/Brinzolamide","fields":["history","overview"],"source":"Wikipedia"},{"id":5,"url":"https://www.fda.gov/drugs/drug-approvals-and-databases/orange-book-data-files","fields":["patents","exclusivity","genericManufacturers"],"source":"FDA Orange Book"}],"_emaChecked":true,"_enrichedAt":"2026-03-30T09:02:20.918961","_validation":{"fieldsValidated":2,"lastValidatedAt":"2026-04-20T02:14:28.408945+00:00","fieldsConflicting":0,"overallConfidence":0.95},"biosimilars":[],"competitors":[{"drugName":"acetazolamide","drugSlug":"acetazolamide","fdaApproval":"1953-07-27","genericCount":29,"patentStatus":"Off-patent — generic available","relationship":"same-class"},{"drugName":"dichlorphenamide","drugSlug":"dichlorphenamide","fdaApproval":"1958-07-22","genericCount":2,"patentStatus":"Off-patent — generic available","relationship":"same-class"},{"drugName":"dorzolamide","drugSlug":"dorzolamide","fdaApproval":"1994-12-09","genericCount":13,"patentStatus":"Off-patent — generic available","relationship":"same-class"},{"drugName":"methazolamide","drugSlug":"methazolamide","fdaApproval":"1959-01-26","genericCount":8,"patentStatus":"Off-patent — generic available","relationship":"same-class"}],"dataSources":[{"url":"https://data.medicaid.gov/dataset/4j6z-xnwq","name":"CMS National Average Drug Acquisition Cost (NADAC)","fields":["pricing"],"retrievedDate":"2026-04-07"}],"genericName":"brinzolamide","indications":{"approved":[{"name":"Ocular hypertension","source":"DrugCentral","snomedId":4210003,"regulator":"FDA","usPrevalence":119900000,"globalPrevalence":1280000000,"prevalenceMethod":"curated","prevalenceSource":"WHO, 2023"},{"name":"Open-angle glaucoma","source":"DrugCentral","snomedId":84494001,"regulator":"FDA"}],"offLabel":[],"pipeline":[]},"currentOwner":"Sandoz","drugCategory":"mature","labelChanges":[],"patentStatus":"Off-patent — no active Orange Book patents","relatedDrugs":[{"drugId":"acetazolamide","brandName":"acetazolamide","genericName":"acetazolamide","approvalYear":"1953","relationship":"same-class"},{"drugId":"dichlorphenamide","brandName":"dichlorphenamide","genericName":"dichlorphenamide","approvalYear":"1958","relationship":"same-class"},{"drugId":"dorzolamide","brandName":"dorzolamide","genericName":"dorzolamide","approvalYear":"1994","relationship":"same-class"},{"drugId":"methazolamide","brandName":"methazolamide","genericName":"methazolamide","approvalYear":"1959","relationship":"same-class"}],"trialDetails":[{"nctId":"NCT07074782","phase":"","title":"Retinal Ganglion Cell Neuroprotection Under Prostaglandin Analogues","status":"NOT_YET_RECRUITING","sponsor":"Association for Innovation and Biomedical Research on Light and Image","startDate":"2026-01","conditions":["Glaucoma"],"enrollment":1500,"completionDate":"2026-06"},{"nctId":"NCT02390284","phase":"PHASE3","title":"Stop Retinal Ganglion Cell Dysfunction 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