Combigan

Reduction of IOP in patients w/ chronic open-angle glaucoma or ocular HTN who are insufficiently responsive to topical β-blockers.

1 drop in the affected eye(s) bid approx 12 hr apart.

Hypersensitivity. Reactive airway disease including bronchial asthma, history of bronchial asthma or severe COPD. Sinus bradycardia, sick sinus syndrome, SA nodal block, 2nd & 3rd degree AV block not controlled w/ pacemaker, overt cardiac failure, cardiogenic shock. Patients on MAOI therapy. Neonates & infants; childn <2 yr.

Delayed ocular hypersensitivity reactions. Gradually w/draw treatment in patients w/ CHD. Systemic β-blocker adverse reactions (eg, same types of CV & pulmonary) may occur. Cardiac & resp reactions due to bronchospasm in patients w/ asthma. Choroidal detachment. Patients w/ severe or unstable & uncontrolled CV disease (eg, CHD, Prinzmetal's angina & cardiac failure) & hypotension; 1st degree heart block; depression, cerebral or coronary insufficiency, w/ severe peripheral circulatory disturbance/disorders (ie, Raynaud's phenomenon), orthostatic hypotension; mild or moderate COPD; corneal diseases; history of atopy or severe anaphylactic reaction. Patients subject to spontaneous hypoglycemia or diabetic patients (especially w/ labile diabetes). Monitor patients w/ history of severe cardiac disease for sign of cardiac failure & check the pulse rates. May mask signs of hyperthyroidism & cause worsening of Prinzmetal's angina, severe peripheral & central circulatory disorders & hypotension; signs & symptoms of acute hypoglycaemia. Adequately control cardiac failure before beginning therapy. Remove contact lens prior to application & re-insert at least 15 min after instillation. Concomitant use w/ systemic β-adrenergic blockers. Not recommended to use 2 topical β-adrenergic blockers. May impair compensatory tachycardia & increase risk of hypotension w/ anesth. May affect ability to drive & use machines. Hepatic or renal impairment. Not to be used during pregnancy & lactation. Not to be used in neonates. Childn <18 yr. High incidence & severity of somnolence in childn ≥2 yr especially those weighing ≤20 kg. Not recommended in childn or adolescents.

Conjunctival hyperaemia, burning sensation in the eye. Stinging sensation in the eye, eye pruritus, dryness, discharge, pain & irritation, allergic conjunctivitis, conjunctival folliculosis, visual disturbance, blepharitis, epiphora, corneal erosion, superficial punctate keratitis, foreign body sensation; depression; somnolence, headache; HTN; oral dryness; eyelid oedema, pruritus & erythema; asthenic conditions; abnormal LFTs. Blurred vision, reduced visual acuity; dizziness; bradycardia; hypotension; nausea; facial erythema.

Additive or potentiating effect w/ CNS depressants (alcohol, barbiturates, opiates, sedatives or anaesth). Potential additive effects w/ oral Ca channel blockers, guanethidine, β-blockers, antiarrhythmics (including amiodarone), digitalis glycosides or parasympathomimetics; of β-blockade (both systemic & on IOP) w/ systemic (eg, oral or IV) β-adrenergic blocking agent. Occasional mydriasis w/ mydriatic agents eg, adrenaline. May increase hypoglycemic effect of antidiabetic agents. Potentiated hypertensive reaction to sudden w/drawal of clonidine; systemic β-blockade w/ quinidine. Concomitant use w/ systemic antihypertensives; TCAs; adrenergic receptor agonists or antagonists (eg, isoprenaline, prazosin). Additive IOP lowering effect w/ prostamides, prostaglandins, carbonic anhydrase inhibitors & pilocarpine.

Antiglaucoma Preparations

S01ED51 - timolol, combinations ; Belongs to the class of beta blocking agents. Used in the treatment of glaucoma.

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