Cosopt (dorzolamide-timolol)
Cosopt is a long-established carbonic anhydrase inhibitor + beta‑blocker combination that is frequently chosen for canine glaucoma because it delivers consistent aqueous suppression without relying on prostaglandin pathways. Its mature market presence and availability of lower‑cost generics often make it the most economical first‑line combination compared with newer proprietary formulations like DuoTrav or Azarga, while offering a complementary mechanism to alpha‑agonist combinations such as Combigan.
Dual-action tag-team
Rapid pressure drop
Dual-action tag-team
Rapid pressure drop
Review Summary
"Users (mostly veterinarians and long‑term pet owners) report Cosopt reliably lowers intraocular pressure with good overall tolerability, though some dogs show transient stinging or mild irritation on application. Many note clear clinical benefit but mention prescription cost and dosing frequency as downsides."
Vet-friendly ease
Contains dorzolamide (topical carbonic anhydrase inhibitor) plus timolol (beta‑blocker) for dual aqueous suppression
Vet-friendly ease
Contains dorzolamide (topical carbonic anhydrase inhibitor) plus timolol (beta‑blocker) for dual aqueous suppression
Increased Safety & Security
Time-Saving Convenience
Cosopt is a long-established carbonic anhydrase inhibitor + beta‑blocker combination that is frequently chosen for canine glaucoma because it delivers consistent aqueous suppression without relying on prostaglandin pathways. Its mature market presence and availability of lower‑cost generics often make it the most economical first‑line combination compared with newer proprietary formulations like DuoTrav or Azarga, while offering a complementary mechanism to alpha‑agonist combinations such as Combigan.
Dual-action tag-team
Rapid pressure drop
Vet-friendly ease
Contains dorzolamide (topical carbonic anhydrase inhibitor) plus timolol (beta‑blocker) for dual aqueous suppression
Typically dosed twice daily with onset in hours and additive IOP lowering versus single agents
Dual-action tag-team
Rapid pressure drop
Vet-friendly ease
Contains dorzolamide (topical carbonic anhydrase inhibitor) plus timolol (beta‑blocker) for dual aqueous suppression
Typically dosed twice daily with onset in hours and additive IOP lowering versus single agents
$30-70 CAD
Combigan (brimonidine-timolol)
Combigan pairs an alpha‑2 agonist with a beta‑blocker to provide both decreased aqueous production and enhanced outflow signaling, giving veterinarians an alternative mechanism when carbonic anhydrase inhibitors or prostaglandin combinations are less suitable for a dog. Although typically priced above simple generics, its distinct pharmacology makes it a valuable adjunct or substitute in cases where the CAI+beta regimen (Cosopt/Azarga) or prostaglandin combos (DuoTrav/Xalacom) are not optimal.
Alpha-beta harmony
Soothing ocular calm
Alpha-beta harmony
Soothing ocular calm
Review Summary
"Combigan is appreciated for effective pressure control in many patients and convenient combination dosing, but reviewers frequently cite transient lethargy or systemic effects in sensitive dogs and occasional ocular discomfort. Overall satisfaction is moderate to good when monitored closely by a veterinarian."
Simple twice-daily
Combines brimonidine (alpha‑2 agonist) with timolol to reduce aqueous production and increase outflow pathways
Simple twice-daily
Combines brimonidine (alpha‑2 agonist) with timolol to reduce aqueous production and increase outflow pathways
Increased Safety & Security
Time-Saving Convenience
Combigan pairs an alpha‑2 agonist with a beta‑blocker to provide both decreased aqueous production and enhanced outflow signaling, giving veterinarians an alternative mechanism when carbonic anhydrase inhibitors or prostaglandin combinations are less suitable for a dog. Although typically priced above simple generics, its distinct pharmacology makes it a valuable adjunct or substitute in cases where the CAI+beta regimen (Cosopt/Azarga) or prostaglandin combos (DuoTrav/Xalacom) are not optimal.
Alpha-beta harmony
Soothing ocular calm
Simple twice-daily
Combines brimonidine (alpha‑2 agonist) with timolol to reduce aqueous production and increase outflow pathways
Usually dosed twice daily and can provide complementary IOP lowering from two mechanisms
Alpha-beta harmony
Soothing ocular calm
Simple twice-daily
Combines brimonidine (alpha‑2 agonist) with timolol to reduce aqueous production and increase outflow pathways
Usually dosed twice daily and can provide complementary IOP lowering from two mechanisms
$70-130 CAD
Azarga (brinzolamide-timolol)
Azarga combines brinzolamide with timolol in a proprietary suspension that many clinicians find comfortable for canine application and that competes directly with Cosopt on mechanism while offering a differentiated formulation. As an Alcon product, it occupies a premium position relative to generics but can offer formulation‑related tolerability advantages that justify the cost in animals sensitive to solution‑based carbonic anhydrase inhibitors.
Creamy cloud drop
Gentle steady control
Creamy cloud drop
Gentle steady control
Review Summary
"Azarga is commonly praised for strong intraocular pressure reduction and generally good tolerability; some users report brief blurred vision or mild irritation after instillation. Reviewers like the combination format and report steady results with continued use."
Suspension shimmer
Contains brinzolamide (carbonic anhydrase inhibitor in a suspension) plus timolol for combined aqueous suppression
Suspension shimmer
Contains brinzolamide (carbonic anhydrase inhibitor in a suspension) plus timolol for combined aqueous suppression
Increased Safety & Security
Time-Saving Convenience
Azarga combines brinzolamide with timolol in a proprietary suspension that many clinicians find comfortable for canine application and that competes directly with Cosopt on mechanism while offering a differentiated formulation. As an Alcon product, it occupies a premium position relative to generics but can offer formulation‑related tolerability advantages that justify the cost in animals sensitive to solution‑based carbonic anhydrase inhibitors.
Creamy cloud drop
Gentle steady control
Suspension shimmer
Contains brinzolamide (carbonic anhydrase inhibitor in a suspension) plus timolol for combined aqueous suppression
Suspension formulation can cause transient blurring but is often better tolerated ocularly than some alternatives
Creamy cloud drop
Gentle steady control
Suspension shimmer
Contains brinzolamide (carbonic anhydrase inhibitor in a suspension) plus timolol for combined aqueous suppression
Suspension formulation can cause transient blurring but is often better tolerated ocularly than some alternatives
$40-90 CAD
DuoTrav (travoprost-timolol)
DuoTrav brings together a prostaglandin analogue and a beta‑blocker, delivering some of the strongest IOP‑lowering seen in combination therapies and therefore often preferred in more advanced canine glaucoma cases. Its travoprost formulation and preservative system are positioned as a technical advantage for ocular tolerability compared with older prostaglandin combinations, but that premium positioning typically comes with higher acquisition cost versus generic prostaglandin/beta combos like Xalacom.
Prostaglandin powerhouse
Nighttime pressure cut
Prostaglandin powerhouse
Nighttime pressure cut
Review Summary
"DuoTrav receives high marks for potent pressure lowering with once‑daily dosing and good owner adherence, and most long‑term users report noticeable improvement with manageable side effects. A minority note local irritation or cost concerns but overall satisfaction is strong."
Once-daily snooze
Combines travoprost (prostaglandin analogue that increases uveoscleral outflow) with timolol for dual action
Once-daily snooze
Combines travoprost (prostaglandin analogue that increases uveoscleral outflow) with timolol for dual action
Increased Safety & Security
Time-Saving Convenience
DuoTrav brings together a prostaglandin analogue and a beta‑blocker, delivering some of the strongest IOP‑lowering seen in combination therapies and therefore often preferred in more advanced canine glaucoma cases. Its travoprost formulation and preservative system are positioned as a technical advantage for ocular tolerability compared with older prostaglandin combinations, but that premium positioning typically comes with higher acquisition cost versus generic prostaglandin/beta combos like Xalacom.
Prostaglandin powerhouse
Nighttime pressure cut
Once-daily snooze
Combines travoprost (prostaglandin analogue that increases uveoscleral outflow) with timolol for dual action
Typically dosed once daily (prostaglandin) with strong nocturnal IOP reduction—convenient for many regimens
Prostaglandin powerhouse
Nighttime pressure cut
Once-daily snooze
Combines travoprost (prostaglandin analogue that increases uveoscleral outflow) with timolol for dual action
Typically dosed once daily (prostaglandin) with strong nocturnal IOP reduction—convenient for many regimens
$120-220 CAD
Xalacom (latanoprost-timolol)
Xalacom couples latanoprost with timolol to offer a potent prostaglandin‑based combination that is widely available and often available in lower‑cost generic forms, giving it a strong cost‑competitiveness for long‑term management in dogs. Technically similar in on‑target efficacy to other prostaglandin combinations such as DuoTrav, Xalacom's main market advantage is broader availability and affordable pricing, making it a practical choice when budget and access are decisive factors.
Fast-acting prostaglandin
Sharp IOP reduction
Fast-acting prostaglandin
Sharp IOP reduction
Review Summary
"Xalacom is widely regarded as effective and fast‑acting for glaucoma control, with many users reporting consistent IOP reduction; some note periocular pigmentation or eyelash changes and occasional ocular discomfort. Overall reviews are positive when used under veterinary guidance."
Bedtime-friendly dose
Contains latanoprost (potent prostaglandin analogue) combined with timolol for complementary IOP lowering
Bedtime-friendly dose
Contains latanoprost (potent prostaglandin analogue) combined with timolol for complementary IOP lowering
Increased Safety & Security
Time-Saving Convenience
Xalacom couples latanoprost with timolol to offer a potent prostaglandin‑based combination that is widely available and often available in lower‑cost generic forms, giving it a strong cost‑competitiveness for long‑term management in dogs. Technically similar in on‑target efficacy to other prostaglandin combinations such as DuoTrav, Xalacom's main market advantage is broader availability and affordable pricing, making it a practical choice when budget and access are decisive factors.
Fast-acting prostaglandin
Sharp IOP reduction
Bedtime-friendly dose
Contains latanoprost (potent prostaglandin analogue) combined with timolol for complementary IOP lowering
Latanoprost’s once‑daily prostaglandin effect plus timolol’s aqueous suppression offers strong pressure control
Fast-acting prostaglandin
Sharp IOP reduction
Bedtime-friendly dose
Contains latanoprost (potent prostaglandin analogue) combined with timolol for complementary IOP lowering
Latanoprost’s once‑daily prostaglandin effect plus timolol’s aqueous suppression offers strong pressure control
$90-180 CAD