Many patients ask me if their prescription medicine is causing their dry eyes. There are many drugs that contribute to dry eye symptoms. A few of them directly damage meibomian glands and likely other cells that are key in dry eye.
Here is a good list from the below reference:
Here is a good list from the below reference:
| Category | Subcategory | Systemic Drugs Identified or Implicated in Dry Eye a | Representative References b |
|---|---|---|---|
| Analgesic | Antirheumatic | Aspirin*, Ibuprofen* | |
| Cannabinoid | Dronabinol*, Tetrahydrocannabinol* | ||
| Opioid | Buprenorphine, Fentanyl, Methadone, Morphine*, Opium*, Oxymorphone, Tapentadol | ||
| Anesthesia | Ether*, Nitrous Oxide* | ||
| Anticholinergic (antimuscarinic) | Antiarrythmic/Bronchodilating | Atropine*, Diphenhydramine, Disopyramide, Homatropine, Ipratropium*, Methscopolamine, Scopolamine*, Tiotropium, Tolterodine | |
| Antihistamine | Azelastine, Brompheniramine*, Carbinoxamine*, Cetirizine*, Chlorpheniramine*, Clemastine*, Cyproheptadine*, Desloratidine*, Dexchlorphenamine*, Diphenhydramine*, Doxylamine*, Epinastine, Fexofenadine*, Hydroxyzine, Ketotifen, Loratidine*, Olopatadine, Promethazine, Pseudoephedrine, Tripelennamine*, Triprolidine* | ||
| Antidepressant | Agomelatine, Amitriptyline, Bupropion, Chlomipramine, Cialopram, Desipramine, Doxepin, Duloxetine, Fluoxetine, Fluvoxamine, Imipramine, Mianserine, Mirtazapine, Nortripty, Paroxetine, Reboxetine, Sertraline, Tianeptine, Trazodone, Venlafexine | ||
| Anti-Parkinson’s | Benapryzine, Benzhexol, Benztropine, Bornaprine, Levodopa, Methixine, Orphenadrine, Pamipexole, Procyclidine | ||
| Antipsychotic | Aiprasidone, Aripiprazole, Brompheniramine, Carbinoxamine, Chlorpheniramine, Chlorpromazine, Clemastine, Clozapine, Cyproheptadine, Dexchlorphiniramine, Fluphenazine, Haloperidol, Lithium carbonate, Olanzepine, Perphenazine, Promethazine, Quetiapine, Risperidone, Sulpiride, Thiethylperazine, Thioridazine Thiothixene, Trifluoperazine | ||
| Antispasmodic | Fesoterodine, Homatropine*, Oxybutynin, Propantheline, Propiverine, Solifenacin, Tolterodine*, Trospium | ||
| Decongestant | Oxymetazoline, Phenylephrine, Phenylpropanolamine, Pseudoephedrine, Xylometazoline | ||
| Antihypertensive | Adrenergic blocking | Acebutolol, Atenolol, Carvedilol, Labetalol, Metoprolol, Nadolol, Pindolol, Clonidine*, Prazosin, Oxprenolol*, Propranolol* | |
| Na + Cl – Co-transporter (diuretic) | Bendroflumethiazide, Chlorothiazide, Chlortalidone, Hydrochlorothiazide, Hydroflumethiazide, Indapamide, Methyclothiazide, Metolazone, Polythiazide, Trichlormethiazide | ||
| Antileprosy | Clofazimine* | ||
| Antimalarial | Chloroquine*, Hydrochloroquine* | ||
| Antineoplastic | Busulfan, Cetuximab*, Cyclophosphamide*, Docetaxel, Erlotinib*, Gefitinib*, Interferon, Methotrexate, Mitomicin C, Panitumumab*, Vinblastine*, Vertiporphin* | ||
| Anxiolytic/hypnotic | Alprazolam*, Diazepam*, Eszopiclone, Lorazepam*, Zolpidem, Zopiclone | ||
| Chelator/Calcium Regulator | Methoxsalen, Alendronate, Pamidronate, Risedronate | ||
| Depressant | Ethanol* | ||
| Herbal and Vitamins | Accutane =Isotretinoin (THIS ONE IS TOXIC TO THE EYE’s Meibomian glands)*, Niacin, Echinacea, Kava | For complete references on Isoretinoin refer to the TFOS DEWS II Sex, Gender, and Hormones report |
|
| Hormonal | Antiandrogen/Estrogen replacement | Alfuzosin, Doxazosin, Finasteride*, Leuprorelin*, Tamsulosin, Terazosin, Estrogen/progesterone, Medroxyprogesterone | For complete references refer to the TFOS DEWS II Sex, Gender, and Hormones report |
| Neurotoxin | Botulinum A* or B | , | |
| Sedative | Primidone, Phenylbarbitol |
Ocul Surf. 2017 Jul;15(3):511-538. doi: 10.1016/j.jtos.2017.05.004. Epub 2017 Jul 20.
TFOS DEWS II iatrogenic report.
Gomes JAP1, Azar DT2, Baudouin C3, Efron N4, Hirayama M5, Horwath-Winter J6, Kim T7, Mehta JS8, Messmer EM9, Pepose JS10, Sangwan VS11, Weiner AL12, Wilson SE13, Wolffsohn JS14.