Meds and you

27 September 2013

The combination of brimonidine and timolol

The combination of brimonidine and timolol is an anti-glaucoma preparation. Anti-glaucoma preparations are drugs that reduce pressure inside the eye.

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The combination of brimonidine and timolol is the active ingredient of Combigan eye drops (Nappi code: 709863-001).

General information
The combination of brimonidine and timolol is an anti-glaucoma preparation. Anti-glaucoma preparations are drugs that reduce pressure inside the eye.

In South Africa the combination of brimonidine and timolol is registered for the reduction of raised intra-ocular pressure and for the treatment of chronic open-angle glaucoma.

For this medication to be effective, it has to be taken regularly, even if you do not notice an immediate effect.

It should be noted that because this drug may cause visual disturbances and/or dizziness, driving and any hazardous tasks should be avoided until you know how this medication affects you.

This product should not be used if you have soft contact lenses in your eyes.

How does the combination of brimonidine and timolol work?
Both Brimonidine and timolol cause blood vessels in the eye to narrow, although one is an alpha-adrenoceptor agonist, and the other beta-receptor blocker. By narrowing these blood vessels, less fluid passes through the blood vessel into the eyeball, thereby reducing pressure within the eye.

Fast facts
Drug schedule: schedule 3
Available as: the combination of brimonidine and timolol is available as eye drops.
What does it do? This combination reduces pressure within the eye.
Overdose risk: medium
Dependence risk: low
Is the combination of brimonidine and timolol available as a generic? no
Is this combination available on prescription only? yes

User information
Onset of effect: within 1 hour
Stopping this medicine: do not stop taking this drug without consulting your doctor.
Prolonged use: Regular eye examinations are advised.

Special precautions

Consult your doctor before using this drug if:

  • you have or had heart disease
  • you have a history of stroke or angina
  • you have asthma
  • you have depression
  • you have chronic bronchitis
  • you have diabetes
  • you have liver or kidney disease
  •  
  • you have reynaud’s syndrome
  •  
  • you have a slow heart rate (<50 beats per minute)
  •  
  • you are taking any other medication
  •  

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: this medication is not intended for use in children under the age of 18.
The elderly: caution is advised in the elderly as side effects are more likely to occur.
Alcohol:
no special precautions need to be taken.

Possible side effects

 

Side Effect
Frequency
Consult your doctor
 
Common
Rare
Only if severe
In all cases
redness
X
 
X
 
burning
X
 
X
 
stinging
X
 
X
 
blurred vision
X
 
X
 
itching
X
 
X
 
sensitivity to light
X
 
X
 
inflammation of conjunctiva
 
X
X
 
inflammation of eyelid
 
X
X
 
headache
 
X
X
 
dry mouth
 
X
X
 
taste alterations
 
X
X
 
fatigue
 
X
X
 
dizziness
 
X
X
 
drowsiness
 
X
X
 
palpitations
 
X
 
X
corneal disorders
 
X
 
X

Interactions Drug interactions

 

thiomersal use at least 5 minutes apart to prevent precipitation
dipivefrine additive reduction of intra-ocular pressure
acetazolamide additive reduction of intra-ocular pressure
pilocarpine additive reduction of intra-ocular pressure
reserpine lowering of blood pressure, slow heart rate and dizziness may occur
digoxin increased side effects of digoxin
verapamil increased side effects of verapamil
oral beta-receptor blockers increased risk of side effects with both drugs
adrenaline, noradrenaline risk of high blood pressure
tricyclic antidepressants increased risk of side effects; blunting of pressure-reducing effect
mianserin increased risk of side effects; blunting of pressure-reducing effect
mono-amine oxidase inhibitor antidepressants increased risk of side effects

Disease interactions
Consult your doctor before using this combination if you have or had heart disease, you have a history of stroke or angina, you have asthma, depression, chronic bronchitis, diabetes, liver or kidney disease, Reynaud’s syndrome or if you have a slow heart rate (<50 beats per minute).

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage
Adults: 1 drop in affected eye(s) twice daily, preferably in the evening. ______________________________________________________________________________

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
 

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