Timolol-Dorzolamide

Timolol-Dorzolamide is a combination of prescription medication used to treat the symptoms of certain types of glaucoma and other causes of high pressure inside the eye. 

• Timolol-Dorzolamide is available under the following different brand names: Cosopt, Cosopt PF

Common side effects of Timolol-Dorzolamide include:

• temporary blurred vision,
• cloudy vision,
• double vision,
• temporary burning/stinging/itching/redness of the eye,
• watery eyes,
• dry eyes,
• feeling as if something is in the eye,
• drooping eyelid,
• sensitivity of eyes to light,
• bitter or strange taste in the mouth,
• cough,
• flu symptoms,
• nausea,
• upset stomach,
• stomach pain,
• back pain,
• sore throat,
• stuffy nose,
• headache, or
• drowsiness.

Serious side effects of Timolol-Dorzolamide include:

• dizziness,
• slow or irregular heartbeat,
• muscle weakness,
• mental/mood changes, or
• coldness/numbness/pain in the hands or feet.

Rare side effects of Timolol-Dorzolamide include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and Pediatric dosage

Ophthalmic Solution

• 0.5 % / 2 %

Open-Angle Glaucoma or Ocular Hypertension

Adult dosage

• In still 1 drop in the affected eye(s) every 12 hours

Pediatric dosage

• Children below 2 years
  • Contraindicated
• Children above 2 years
  • Instill1 drop in the affected eye(s) every 12 hours

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Timolol-Dorzolamide has no noted severe interactions with any other drugs.
• Timolol-Dorzolamide has serious interactions with at least 35 other drugs.
• Timolol-Dorzolamide has moderate interactions with at least 131 other drugs.
• Timolol-Dorzolamide has minor interactions with at least 28 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Children aged below 2 years
• Hypersensitivity, asthma, severe COPD, sinus bradycardia, 2nd/ 3rd degree AV block (except in patients with an artificial pacemaker), overt cardiac failure, cardiogenic shock

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Timolol-Dorzolamide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Timolol-Dorzolamide?”

Cautions

• Dorzolamide (a sulfonamide), although administered topically, is absorbed systemically; the same types of adverse reactions attributable to sulfonamides may occur with topical administration, including severe skin reactions; severe respiratory reactions, including death due to bronchospasm in patients with asthma, and rarely death in association with cardiac failure, reported following systemic or ophthalmic administration of timolol maleate
• Hypersensitivity may occur; fatalities have occurred, although rarely, due to severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias; sensitization may recur when a sulfonamide is readministered irrespective of the route of administration; if signs of serious reactions or hypersensitivity occur, discontinue use of this preparation
• Bacterial keratitis is associated with the use of multiple-dose containers of topical ophthalmic products, inadvertently contaminated by patients who, in most cases, had concurrent corneal disease or disruption of the ocular epithelial surface
• Conjunctivitis reported with chronic administration (may resolve upon discontinuation of therapy)
• Sympathetic stimulation may be essential for the support of the circulation in diminished myocardial contractility; its inhibition by beta-adrenergic receptor blockade may precipitate more severe failure; in patients without a history of cardiac failure continued depression of the myocardium with beta-blocking agents over some time can, in some cases, lead to cardiac failure; discontinue therapy at the first sign or symptom of cardiac failure
• Not for use as monotherapy in angle-closure glaucoma
• Use caution in diabetes, heart failure, psychiatric disease (may cause or exacerbate CNS depression), peripheral vascular disease
• Not for administration to patients with chronic obstructive pulmonary disease (.g., chronic bronchitis, emphysema) of mild or moderate severity, bronchospastic disease, or a history of the bronchospastic disease (other than bronchial asthma or a history of bronchial asthma, in which timolol is contraindicated)
• Patients may be unresponsive to usual doses of epinephrine used to treat anaphylactic reactions; patients with a history of atopy or a history of severe anaphylactic reactions to a variety of allergens may be more reactive to repeated accidental, diagnostic, or therapeutic challenges with such allergens
• Beta-adrenergic blockade has been reported to potentiate muscle weakness consistent with certain myasthenic symptoms (.g, diplopia, ptosis, and generalized weakness); timolol has been reported rarely to increase muscle weakness in some patients with myasthenia gravis or myasthenic symptoms
• Beta-adrenergic receptor blocking agents may mask signs and symptoms of acute hypoglycemia; administer with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents
• Beta-adrenergic blocking agents may mask certain clinical signs (.g., tachycardia) of hyperthyroidism; manage carefully patients suspected of developing thyrotoxicosis to avoid abrupt withdrawal of beta-adrenergic blocking agents that might precipitate a thyroid storm
• Not studied in patients with severe renal impairment (CrCl below 30 mL/min); not recommended; dorzolamide and its metabolite are excreted predominantly by the kidney
• Use with caution in hepatic impairment; not studied
• There is increased potential for developing corneal edema in patients with low endothelial cell counts; use caution
• Avoid concomitant administration with systemic beta-blockers or carbonic anhydrase inhibitors
• Use caution in patients taking calcium channel blockers, cardiac glycosides, or inhaled anesthetic agents
• Mediated reflexes during surgery
  • Necessity or desirability of withdrawal of beta-adrenergic blocking agents before major surgery is controversial; beta-adrenergic receptor blockade impairs the ability of the heart to respond to beta-adrenergically mediated reflex stimuli; this may augment the risk of general anesthesia in surgical procedures
  • Some patients receiving beta-adrenergic receptor blocking agents have experienced protracted severe hypotension during anesthesia; difficulty in restarting and maintaining the heartbeat has also been reported; for these reasons, in patients undergoing elective surgery, some authorities recommend gradual withdrawal of beta-adrenergic receptor blocking agents
  • If necessary, during surgery, the effects of beta-adrenergic blocking agents may be reversed by sufficient doses of adrenergic agonists

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Excreted in breast milk; not recommended