Additive effect of 1% apraclonidine hydrochloride to nonselective beta-blockers

The short-term additive effect and side effects of adding 1% apraclonidine hydrochloride to nonselective beta-blockers were investigated in 21 patients with ocular hypertension or early primary open-angle glaucoma. After a unilateral single dose application of topical 1% apraclonidine hydrochloride, intraocular pressure (IOP), heart rate, and interpalpebral distance were measured. The mean IOP of treated eyes showed a decline from a baseline of 20.0 +/- 3.0 mmHg to 18.1 +/- 3.2 mmHg at 1 hour (P less than 0.005), 16.5 +/- 2.6 mmHg at 2 hours (P less than 0.001), 15.2 +/- 2.5 mmHg at 3 hours (P less than 0.001), 18.5 +/- 3.0 mmHg at 12 hours (P = 0.02), and 19.2 +/- 2.9 mmHg at 24 hours (P = 0.2). No statistically significant change in the heart rate was seen. The interpalpebral distance of the treated eyes showed a significant increase (P less than 0.05) at all time intervals except 24 hours (P = 0.17). The authors conclude that 1% apraclonidine hydrochloride provides an additive pressure-lowering effect to nonselective beta-blockers for at least 12 hours after a single application, and shows promise as a useful adjunctive agent for short-term use in glaucoma therapy.