Generic Name: brimonidine/timolol (bri-MON-i-DEEN/TIM-oh-lol)
Brand Name: Combigan
Brimonidine/timolol drops is used for:
Treating increased pressure in the eye (ocular hypertension) and open-angle glaucoma. It may also be used for other conditions as determined by your doctor.
Brimonidine/timolol drops is an alpha-agonist and beta-blocker combination. It works by decreasing fluid production and pressure inside the eye.
Do NOT use brimonidine/timolol drops if:
- you are allergic to any ingredient in brimonidine/timolol drops
- you have severe chronic obstructive pulmonary disease (COPD) or a history of asthma
- you have moderate to severe heart block, heart failure, or an unusually slow heartbeat
- you are in shock caused by severe heart problems
- you are using another beta-blocker eye drop (eg, betaxolol)
- the patient is younger than 2 years old
Contact your doctor or health care provider right away if any of these apply to you.
Before using brimonidine/timolol drops:
Some medical conditions may interact with brimonidine/timolol drops. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of lung or breathing problems (eg, bronchitis, COPD, emphysema), diabetes, low blood sugar, depression, high or low blood pressure (including dizziness on standing), heart problems (eg, heart block, heart failure), certain muscle problems (eg, myasthenia gravis, muscle weakness), blood vessel problems (eg, in the brain or heart, Raynaud phenomenon), or an overactive thyroid
- if you have had eye surgery, or you have an eye infection or injury, a drooping eyelid, or other eye problems (eg, narrow-angle glaucoma, double vision)
- if you will be having surgery
- if you wear contact lenses
Some MEDICINES MAY INTERACT with brimonidine/timolol drops. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Certain antiarrhythmics (eg, disopyramide, flecainide, quinidine), calcium channel blockers (eg, diltiazem, verapamil), cimetidine, digoxin, furazolidone, linezolid, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), reserpine, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because serious heart problems or low blood pressure may occur
- Clonidine because high blood pressure may occur in some cases, especially if you suddenly stop taking clonidine while taking brimonidine/timolol drops
- Tricyclic antidepressants (eg, amitriptyline) because they may decrease brimonidine/timolol drops's effectiveness
- Insulin or oral antidiabetics (eg, glyburide, repaglinide) because the risk of low blood sugar (eg, dizziness, headache, hunger, shakiness or weakness, sweating) or slow heart rate may be increased. Brimonidine/timolol drops may also hide certain signs of low blood sugar
- Alpha-blockers (eg, alfuzosin, prazosin), barbiturates (eg, phenobarbital), medicine for high blood pressure, opioid medicines (eg, hydrocodone), oral beta-blockers (eg, propranolol), other beta-blocker eye drops (eg, betaxolol), or sleep medicines (eg, zolpidem) because the risk of their side effects may be increased by brimonidine/timolol drops
- Epinephrine, certain sympathomimetics (eg, albuterol, salmeterol), or theophylline because their effectiveness may be decreased by brimonidine/timolol drops
This may not be a complete list of all interactions that may occur. Ask your health care provider if brimonidine/timolol drops may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use brimonidine/timolol drops:
Use brimonidine/timolol drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Brimonidine/timolol drops is only for the eye. Do not get it in your nose or mouth.
- Soft contact lenses may absorb a chemical in brimonidine/timolol drops. Remove contact lenses before you use brimonidine/timolol drops; lenses may be placed back in the eyes 15 minutes after use of brimonidine/timolol drops.
- To use brimonidine/timolol drops in the eye, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean, dry tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
- To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed.
- Do NOT overtighten the cap on the bottle. This may damage the bottle or cap.
- Do NOT try to make the hole of the medicine dropper larger.
- If you use any other medicines in the eye, they should be used at least 5 minutes before or after brimonidine/timolol drops.
- Use brimonidine/timolol drops on a regular schedule to get the most benefit from it. Using it at the same time each day will help you remember.
- Continue to use brimonidine/timolol drops even if your condition improves. Do not miss any doses.
- If you miss a dose of brimonidine/timolol drops, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use brimonidine/timolol drops.
Important safety information:
- Brimonidine/timolol drops may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use brimonidine/timolol drops with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using brimonidine/timolol drops; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
- Brimonidine/timolol drops may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Tell your doctor or dentist that you use brimonidine/timolol drops before you receive any medical or dental care, emergency care, or surgery.
- Contact your doctor if you have an eye injury or infection, or if you will be having eye surgery.
- Diabetes patients - Brimonidine/timolol drops may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk for an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are using brimonidine/timolol drops.
- Brimonidine/timolol drops may cause harm if it is swallowed. If you may have taken it by mouth, contact your poison control center or emergency room right away.
- Lab tests, including eye exams and eye pressure, may be performed while you use brimonidine/timolol drops. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Caution is advised when using brimonidine/timolol drops in CHILDREN; they may be more sensitive to its effects, especially drowsiness.
- Brimonidine/timolol drops should not be used in CHILDREN younger than 2 years old; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using brimonidine/timolol drops while you are pregnant. Brimonidine/timolol drops is found in breast milk. Do not breast-feed while taking brimonidine/timolol drops.
Possible side effects of brimonidine/timolol drops:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Abnormal taste; bloodshot eyes; blurred vision; dizziness; drowsiness; dry eyes; feeling that something is in your eye; headache; increased tear production; minor burning, itching, or stinging of the eye; nausea.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or discomfort; confusion; eye irritation, swelling, pain, or discharge; eyelid pain, redness, scaling, drooping, or swelling; fainting; mental or mood changes; one-sided weakness; pain, numbness, weakness, or tingling of an arm or leg; severe or persistent headache or dizziness; shortness of breath; slow or irregular heartbeat; slurred speech; sudden unusual weight gain; swelling of the hands, ankles, or feet; very cold or blue fingers or toes; vision changes; wheezing.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include chest pain; difficulty breathing or shortness of breath; dizziness; severe or persistent headache; slow or irregular heartbeat.Proper storage of brimonidine/timolol drops:
Store brimonidine/timolol drops at room temperature, between 59 and 77 degrees F (15 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep brimonidine/timolol drops out of the reach of children and away from pets.
- If you have any questions about brimonidine/timolol drops, please talk with your doctor, pharmacist, or other health care provider.
- Brimonidine/timolol drops is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take brimonidine/timolol drops or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about brimonidine/timolol drops. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to brimonidine/timolol drops. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using brimonidine/timolol drops.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.