Table 3 Medications contraindicated for patients with primary angle closure disease
Cases | Type of PACD | Patients’ regular medications | Alternative agents | Notes |
|---|---|---|---|---|
1 | APAC | Zolpidem | Ramelteon (melatonin receptor agonist) and/or suvorexant (orexin receptor antagonist) | None. |
Multi-ingredient cold medication (salicylamide, acetaminophen, caffeine and promethazine) | Acetaminophen | The necessity for antihistamines should be considered carefully. In view of lower kidney function (Ccr = 37.7 mL/min), careful consideration is also needed for prescribing NSAIDs. | ||
2 | APAC | Cloxazolam | NA | Because the patient took antidepressants, mirtazapine and sertraline, consultation with psychiatrist was considered for better control of the depressive disorder. |
Zolpidem and lormetazepam | Ramelteon (melatonin receptor agonist) and/or suvorexant (orexin receptor antagonist) | None | ||
Fesoterodine | Vibegron (adrenergic β3 agonist) | None | ||
3 | PACS | Eszopiclone | Ramelteon (melatonin receptor agonist) and/or suvorexant (orexin receptor antagonist) | None |
4 | PACS | Eszopiclone | Ramelteon (melatonin receptor agonist) | Because the patient took digoxin orally, replacement with suvorexant was not suitable (drug–drug interaction). |
5 | PACS | Eszopiclone | Ramelteon (melatonin receptor agonist) and/or suvorexant (orexin receptor antagonist) | None |
6 | PAC | Levodopa and carbidopa | NA | Changes to other drugs were difficult because of older age (77 years), and combination of the drug with dopamine agonist. |
Clonazepam | NA | Consultation with neurologist was recommended for better control of neurologic disease. | ||
Clotiazepam | NA | |||
7 | PACG | Imidafenacin | Vibegron (adrenergic β3 agonist) | Because the patient took naftopidil, consultation with urologists was considered for better control of prostatic hyperplasia. |
Zolpidem | Ramelteon (melatonin receptor agonist) and/or suvorexant (orexin receptor antagonist) | None | ||
8 | PACG | Brotizolam | Ramelteon (melatonin receptor agonist) and/or suvorexant (orexin receptor antagonist) | None |