Enhancement of the ocular hypotensive effect of acetazolamide by diflunisal

Michael E. Yablonski*, Thomas H. Maren, Mieko Hayashi, Nava Naveh, Seth D. Potash, Ness Pessah

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


We studied the effect of diflunisal on intraocular pressure in patients with glaucoma who were receiving maximally tolerated therapy. Diflunisal therapy, 500 mg twice daily, was started in 48 patients for one week. No changes were made in their regular antiglaucoma medications. Intraocular pressure was reduced an additional 3.8 ± 3.1 mm Hg (± S.D.) in the acetazolamide-treated patients (P < .0001) and 1.6 ± 1.5 mm Hg in methazolamide-treated patients (P < .02), while no significant reduction in intraocular pressure was found in patients receiving topical medications alone. In 15 acetazolamide-treated patients, total plasma concentrations of acetazolamide after diflunisal therapy were significantly higher than the prediflunisal levels, suggesting a modest decrease in renal excretion. In seven acetazolamide-treated patients, free plasma concentrations of acetazolamide were found to increase 5.6-fold. after diflunisal therapy. We concluded that diflunisal potentiated the ocular hypotensive effect of acetazolamide by increasing its free plasma level.

Original languageEnglish
Pages (from-to)332-336
Number of pages5
JournalAmerican Journal of Ophthalmology
Issue number15
StatePublished - 15 Sep 1988


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