Medical treatment: First line agents and monotherapy

Abstract

Timolol maleate was the most potent topical IOP-lowering drug introduced after pilocarpine and epinephrine years ago, and a number of different beta-blocker preparations were approved after its introduction into the marketplace. Following its approval by the U.S. Food and Drug Administration (FDA) in 1978, it was considered the gold standard initial treatment for nearly two decades until 1996 when the first prostaglandin analog was granted approval by the FDA. Prostaglandin analogs are more potent IOP-lowering drugs than timolol and other beta blockers. However, this fact does not mean that beta blockers cannot be used as a first-line agent. This class of medication remains efficacious, tolerated, and cost effective. The following history is an illustration of this reality. © 2010 Springer-Verlag Berlin Heidelberg.