Combigan Overdosage

There is limited data available of overdosage in humans with the use of COMBIGAN. Bradycardia has been reported in association with use of a higher than recommended dose. If overdosage occurs, treatment should be symptomatic and supportive; a patent airway should be maintained.
Brimonidine: Symptoms of brimonidine overdose such as hypotension, bradycardia, hypothermia, apnoea, coma, hypotonia, lethargy, pallor, respiratory depression, and somnolence have been reported in a few neonates, infants, and children receiving brimonidine tartrate ophthalmic solution as part of medical treatment of congenital glaucoma or by accidental oral ingestion (see Use in Children under Precautions).
Oral overdoses of other alpha-2-agonists have been reported to cause symptoms such as hypotension, asthenia, vomiting, lethargy, sedation, bradycardia, arrhythmias, miosis, apnoea, hypotonia, hypothermia, respiratory depression and seizure.
Timolol: There have been reports of inadvertent overdosage with timolol ophthalmic solution resulting in systemic effects similar to those seen with systemic beta-adrenergic blocking agents such as bradycardia, hypotension, bronchospasm, headache, dizziness, shortness of breath and cardiac arrest. An in vitro haemodialysis study, using 14C timolol added to human plasma or whole blood showed that timolol was readily dialysed from these fluids; however, a study of patients with renal failure showed that timolol did not dialyse readily.
If overdose occurs, treatment should be symptomatic and supportive.