uses
What is brimonidine/timolol used for?Brimonidine/timolol is commonly used to lower pressure inside the eye in people with open-angle glaucoma or ocular hypertension. People with these conditions have increased pressure inside the eye.Brimonidine/timolol may also be used for other conditions as determined by your healthcare provider.How does brimonidine/timolol work (mechanism of action)?High pressure inside the eye can lead to nerve damage and vision loss. Brimonidine/timolol works by reducing the amount of fluid in your eye. This helps to lower pressure inside the eye.How is brimonidine/timolol supplied (dosage forms)?Brands and other namesCombiganDosage forms and strengths0.2%/0.5% ophthalmic solution (eye drops)How should I store brimonidine/timolol?Brimonidine/timolol should be stored at temperatures between 59 F to 77 F (15 C to 25 C). Protect from light.
how to use
eye drop
drug interactions
Does brimonidine/timolol interact with foods or drinks?There are no known interactions between brimonidine/timolol and foods or drinks.It is unknown if drinking alcohol will affect brimonidine/timolol. The risk of drowsiness may be increased if you drink alcohol while using brimonidine/timolol.Does brimonidine/timolol interact with other medicines (drug interactions)?Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.In particular, make sure that you discuss if you are using any of the following medicines before using brimonidine/timolol.A medicine for high blood pressureA beta-blocker that you take by mouth, such as atenolol (Tenormin) or metoprolol (Lopressor, Toprol XL, and others), which is a medicine commonly used for high blood pressure or certain heart conditionsOther beta-blocker eye drops, such as levobunolol (AKBeta, Betagan) or betaxolol (Betoptic)A calcium channel blocker, such as nifedipine (Procardia), which is a medicine commonly used for high blood pressure or certain heart conditionsDigoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failureQuinidine, which is a medicine used to control your heart rate or rhythm (antiarrhythmic)A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine (Prozac), which is a medicine commonly used for anxiety and depressionEpinephrine injection (Epipen, Auvi-Q, and others)A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depressionA monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s diseaseAny other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, or medicines for anxietySome other medicines may alter the blood levels of brimonidine/timolol. Tell your healthcare provider about all medicines that you take or have recently taken.This may not be a complete list of medicines that can interact with brimonidine/timolol. Always check with your healthcare provider.
side effects
What are the most common side effects of brimonidine/timolol?The most common side effects of brimonidine/timolol are listed below. Tell your healthcare provider if you have any of these side effects that bother you.Eye redness, itching, or irritation Small bumps on the inside of the eyelids or sometimes on the surface of the eye (conjunctival follicles) Burning and stinging after you put the drop in your eyeTiredness or drowsinessThere may be other side effects of brimonidine/timolol that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.What are the serious side effects of brimonidine/timolol?While less common, the most serious side effects of brimonidine/timolol are described below, along with what to do if they happen.Severe Allergic Reactions. Brimonidine/timolol may cause allergic reactions, which can be serious. Stop using brimonidine/timolol and get help right away if you have any of the following symptoms of a serious allergic reaction.Breathing problems or wheezingRacing heartFever or general ill feelingSwollen lymph nodesSwelling of the face, lips, mouth, tongue, or throatTrouble swallowing or throat tightnessItching, skin rash, or pale red bumps on the skin called hivesNausea or vomitingDizziness, feeling lightheaded, or faintingStomach crampsJoint painNew or Worsening Heart Failure. Brimonidine/timolol mainly works in the eye but may be absorbed into the blood and affect other parts of the body, such as the heart. While rare, brimonidine/timolol may cause or worsen heart failure, which is a condition where the heart is not pumping as well as it should. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.Shortness of breath or trouble breathing, especially while lying downSwelling in your feet, ankles, or legsUnusually fast weight gainUnusual tirednessBreathing Problems. While rare, brimonidine/timolol may cause the muscles around the airways to tighten (bronchospasm). Stop using brimonidine/timolol and get help right away if you have sudden breathing problems.Low Blood Pressure. Brimonidine/timolol may rarely cause low blood pressure (hypotension). Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.Dizziness, feeling lightheaded, or faintingConfusionFeeling weak or tiredHeart Rate Changes. Brimonidine/timolol may rarely make your heart beat slower than normal (bradycardia). Call your healthcare provider right away if you have any of the following symptoms. Feeling lightheaded, dizziness, or faintingConfusionFeeling weak or easily tired Chest painShortness of breath
overdose and misseddose
What should I do if I accidentally use too much brimonidine/timolol?If you or someone else has used too much brimonidine/timolol, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.What should I do if I miss a dose of brimonidine/timolol?If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.
warnings and Precautions
Who should not use brimonidine/timolol?Allergies to Ingredients. People who are allergic to any of the following should not use brimonidine/timolol.BrimonidineTimololCombiganAny of the ingredients in the specific product dispensedYour pharmacist can tell you all of the ingredients in the specific brimonidine/timolol products they stock.Breathing Problems. Brimonidine/timolol should not be used by people with severe chronic obstructive pulmonary disease (COPD), asthma, or a history of asthma.Certain Heart Problems. Brimonidine/timolol should not be used by people with the following heart conditions.Heart failure, which is when your heart is not pumping as well as it shouldBradycardia, which is when your heart is beating too slowHeart block, which is when the electrical signals in your heart are slowedCardiogenic shock, which is when your heart cannot pump enough blood to the rest of your bodyChildren Less Than Two Years Old. Brimonidine/timolol should not be used in children under two years old. Check with a healthcare provider before using eye drops in young children. What should I know about brimonidine/timolol before using it?Do not use brimonidine/timolol unless it has been prescribed to you by a healthcare provider. Use it as prescribed.Do not share brimonidine/timolol with other people, even if they have the same condition as you. It may harm them.Keep brimonidine/timolol out of the reach of children.Brimonidine/timolol is an eye drop medicine. Make sure that you or a caregiver understands how to properly administer eye drops. If you have any questions, talk to your healthcare provider.If you use more than one eye medicine, administer them at least 5 minutes apart. Ask your healthcare provider if you are unsure about when to use your eye medicines.Eye infections may occur if your eye drop container gets contaminated with bacteria or other germs. In some cases, eye infections may become severe and lead to vision loss. To prevent eye injury and infection, be careful not to let the tip of the container touch your eye, fingers, or any other surfaces. Wash your hands before each use. Make sure to put the cap back on after each use. If the liquid changes in color or looks cloudy, do not use it.Tell your healthcare provider right away if you have an eye infection, eye injury, vision changes, or need to have eye surgery while using brimonidine/timolol. Symptoms of an eye infection may include pink or itchy eyes, blurry vision or irritation, eye discharge, swollen eyelids, and fever.Brimonidine/timolol may cause drowsiness or blurry vision. Do not drive or do other activities that require alertness and clear vision until you know how brimonidine/timolol affects you.Remove contact lenses before using brimonidine/timolol eye drops. Then wait at least 15 minutes before you put your contacts back in.What should I tell my healthcare provider before using brimonidine/timolol?Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if brimonidine/timolol is right for you.In particular, make sure that you discuss any of the following.Blood Flow Problems. Brimonidine/timolol may worsen the symptoms of certain blood flow problems (vascular insufficiency). Tell your healthcare provider if you have any of the following conditions. They can help decide if brimonidine/timolol is safe for you.Circulation problems, or poor blood flow to the brain or heartSlowed brain or nerves (central nervous system depression), which may cause confusion, sleepiness, and slow reaction times, among other problems Low blood pressure when standing up (orthostatic hypotension)Raynaud’s syndrome, which is a condition where small blood vessels in the fingers and toes temporarily narrow, causing them to sometimes feel cold and change colorInflamed or blocked blood vessels in your arms and legsOther Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.Heart problemsBreathing problemsDiabetesThyroid disordersMyasthenia gravisAngle-closure glaucomaSevere cardiovascular diseaseEye problems affecting the clear layer that covers the front of your eye (cornea) or eye surfacePast or Planned Surgery. Using brimonidine/timolol may raise the risk of problems following a certain type of eye surgery for glaucoma. Also, using brimonidine/timolol may increase the risks with medicines commonly used during major surgery (anesthesia). Tell your healthcare provider if you had eye surgery in the past or if you have major surgery planned.Other Medicines and Supplements. Brimonidine/timolol may interact with other medicines and supplements. Before using brimonidine/timolol, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.Pregnancy. It is not known if or how brimonidine/timolol could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use brimonidine/timolol while you are pregnant or trying to get pregnant.Breastfeeding. Brimonidine/timolol passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop brimonidine/timolol.
about
Brimonidine/timolol is an eye drop that helps lower pressure inside the eye. The most common side effects are eye itching, bumps, redness, or irritation. Keep all appointments to have your eyes checked. Contact your healthcare provider right away if you have serious side effects, such as dizziness, chest pain, confusion, or shortness of breath.