What Macular Degeneration Drugs Should You Avoid?

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Some evidence suggests that certain drugs may contribute to age-related macular degeneration (AMD), an eye disease that causes central vision loss.

AMD, also known as macular degeneration, is an eye disease that occurs when aging causes damage to the macula — the central part of the retina that controls sharp, straight-ahead vision.

AMD is a leading cause of vision loss in older adults and is linked to decreased quality of life and greater reliance on caregivers. In particular, losing your central vision makes it more difficult to drive, see faces, read, or do anything that requires seeing straight ahead or looking at fine details.

While AMD is primarily linked to aging, genetics, and smoking, some research suggests that certain medications can contribute to its development.

Which drugs cause macular degeneration?

No medications directly cause macular degeneration, but some medications and substances can increase your risk of AMD or make the condition worse if you already have it.

It’s important not to stop taking any prescribed medications without first talking with your doctor. Very often, the health benefits of these medications outweigh any potential risks.

Tobacco

Smoking is the most consistent risk factor for AMD. Within the last few decades, numerous studies across different populations have noted a link between smoking and AMD.

Depending on the type of AMD, people who smoke are 2 to 4 times more likelyTrusted Source to develop the condition than those who don’t smoke.

Smoking is associated with reduced oxygen flow, blood vessel damage, reduced nutrient absorption, and an increase in harmful chemicals circulating in the body. All these factors can damage the retina and, specifically, the macula.

Blood pressure medications

There is some evidence that long-term use of certain types of blood pressure medications may increase the risk of AMD.

In The Beaver Dam Eye StudyTrusted Source, researchers found a link between early stage macular degeneration and vasodilators, a type of blood pressure medication that opens (dilates) the blood vessels.

The team also found an association between oral beta-blockers, such as Tenormin (atenolol) and Lopressor (metoprolol), and the development of wet AMD, a less common and more serious form of the condition.

For the study, the researchers observed participants every 5 years for 20 years. The study began with 4,926 participants and involved 9,676 total visits throughout its duration.

The findings show that taking any vasodilator, such as Loniten (minoxidil) or Apresoline (hydralazine), increases the risk of developing early AMD by 72%. Among participants who were taking vasodilators, 19.1% developed early AMD, compared with only 8.2% of those who were not taking them.

In the population taking beta-blockers, about 1.2% developed wet AMD. In those not taking beta-blockers, only about 0.5% developed the condition. Overall, taking beta-blockers was associated with a 71% increase in the odds of developing wet AMD.

NSAIDS

Some evidenceTrusted Source suggests that long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), particularly at high doses, may increase the risk of AMD.

NSAIDs are a class of medications used to reduce inflammation and relieve pain. This category includes both over-the-counter medications, such as aspirin, and prescription medications, such as celecoxib and diclofenac.

According to findingsTrusted Source from The Beaver Dam Eye Study, using aspirin regularly has been linked to the worsening of wet AMD, a less common type of AMD that may respond to injections or laser procedures.

However, the risk is considered relatively small: a 1.76% risk of developing wet AMD after 10 years for aspirin users versus 1.03% for nonusers.

Still, other evidence suggests no real risk at all. A 2019 analysis of participants in the landmark Age-Related Eye Disease Study (AREDS) and AREDS2 found no significant association between aspirin use and progression to late AMD or its subtypes.

Can ibuprofen cause macular degeneration?

Although ibuprofen is an NSAID, there’s no real evidence that ibuprofen use is a risk factor for AMD development.

In particular, researchTrusted Source on the California Teachers Study cohort, which included more than 88,000 people, did not find any link between AMD and frequency or duration of ibuprofen use

What increases your risk for macular degeneration?

You may have a higher risk of developing AMD if you:

  • are older than 60
  • smoke
  • are white
  • have a family history of AMD
  • drink alcohol excessively
  • eat lots of foods that have a high glycemic index
  • do not eat enough fruits or vegetables
  • are not physically active
  • have a body mass index of 30 or higher
  • have diabetes

How to avoid macular degeneration

You may be able to lower your risk of AMD or slow its progression by doing the following:

  • quitting smoking
  • eating a generally healthy diet, including lots of leafy greens
  • getting regular physical activity
  • maintaining healthy blood pressure and cholesterol levels

Bottom line

While no medications or substances directly cause AMD, a few may contribute to its development or progression.

Smoking is the best-known risk factor. If you smoke, consider seeking support to quit. Stopping smoking as soon as possible can immediately decrease your risk.

Certain blood pressure medications, such as vasodilators and beta-blockers, may also increase the risk of AMD in some people. NSAIDs may slightly increase the risk in some people, but the evidence is conflicting.

Overall, it’s important to keep taking any medications your doctor has prescribed for you. If you’re worried about the risk of AMD, discuss the pros and cons with your doctor before making any decisions.

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