Purpose of review: In the current medical care environment, switching within class is often demanded by cost consideration, medical insurance coverage, or formulary restriction. With many choices of drugs available within a glaucoma medication class, questions exist whether switching within class is beneficial. The purpose of this article is to provide a clinical update on the feasibility of switching among the frequently used drugs within glaucoma medication class.
Recent findings: Although efficacies of medications within a therapeutic class are similar and significant differences are generally not observed in clinical trials, response to medication often varies among individual patients in a clinical practice. Such variation may be secondary to differences in drug-receptor interactions, patient's compliance and tolerability to medical treatment, or bioavailability of the medication in individual ocular condition. In addition, switching within class is often necessary to minimize the systemic or local adverse reactions from the active or inactive ingredients of the medication.
Summary: In addition to keeping up-to-date with the efficacy and safety profiles of drugs within each glaucoma medication class, clinicians should familiarize themselves with the different formulations available, preservative systems used, generics availability and compatibility, and the local insurance formulary restriction to deliver an effective glaucoma management.