Combigan

Generic Name: brimonidine and timolol ophthalmic (bri MOE ni deen and TIM oh lol)
Brand Names: Combigan

What is Combigan?

Combigan contains brimonidine and timolol.

Brimonidine is an alpha-agonist that reduces the amount of fluid in the eye, which decreases pressure inside the eye.

Timolol is a beta-blocker that also reduces pressure inside the eye.

Combigan is used to treat glaucoma or ocular hypertension (high pressure inside the eye).

Combigan may also be used for other purposes not listed in this guide.

Important information about Combigan

Do not use Combigan if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You should not use Combigan if you are allergic to brimonidine (Alphagan) or timolol (Timoptic, Cosopt), or if you have certain conditions. Be sure your doctor knows if you have asthma, or severe chronic obstructive pulmonary disease (COPD), heart disease or heart failure, slow heartbeats, or a heart condition called "AV block."

Before using Combigan, tell your doctor if you have diabetes, overactive thyroid, circulation problems, allergies, low blood pressure, myasthenia gravis, or a history of depression

Do not use Combigan while you are wearing contact lenses. This medication may contain a preservative that can be absorbed by soft contact lenses. Wait at least 15 minutes after using Combigan before putting your contact lenses in.

Do not allow the dropper tip to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

Before using Combigan

Do not use Combigan if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You should not use Combigan if you are allergic to brimonidine (Alphagan) or timolol (Timoptic, Cosopt), or if you have certain conditions. Be sure your doctor knows if you have:

• asthma, or severe chronic obstructive pulmonary disease (COPD);

• heart disease or heart failure;

• slow heartbeats; or

• a heart condition called "AV block."

Before using Combigan, tell your doctor if you have:

• depression;

• diabetes;

• overactive thyroid;

• circulation problems, such as Raynaud's syndrome or Buerger's disease;

• a history of fainting or low blood pressure;

• allergies; or

• a muscle disorder such as myasthenia gravis.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use Combigan.

FDA pregnancy category C. Combigan may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Brimonidine and timolol can pass into breast milk and may harm a nursing baby. Do not use Combigan without telling your doctor if you are breast-feeding a baby.

How should I use Combigan?

Use Combigan exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Wash your hands before using the eye drops. Do not use Combigan while you are wearing contact lenses. Combigan may contain a preservative that can be absorbed by soft contact lenses. Wait at least 15 minutes after using the eye drops before putting your contact lenses in.

To apply the eye drops:

• Tilt your head back slightly and pull down your lower eyelid. Hold the Combigan dropper above the eye with the dropper tip down. Look up and away from the dropper as you squeeze out a drop, then close your eye.

• Gently press your finger to the inside corner of the eye (near your nose) for about 1 minute to keep the liquid from draining into your tear duct.

• If you use any other eye medications, wait about 5 minutes after using Combigan eye drops before using the other medication.

• Do not allow the dropper tip to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

Do not use Combigan if the liquid has changed colors or has particles in it. Call your doctor for a new prescription.

Tell your doctor right away if you have any eye injury or infection. If you have any type of surgery, including eye surgery, tell the surgeon ahead of time that you are using Combigan. You may need to stop using the medicine for a short time.

Store Combigan at room temperature away from heat and moisture. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine, or if anyone has accidentally swallowed it.

Overdose symptoms may include dizziness, headache, slow heart rate, and feeling short of breath or like you might pass out.

What should I avoid while using Combigan?

Combigan can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid using any eye medications your doctor has not prescribed. Cold or allergy medicine, narcotic pain medicine, sleeping pills, sedatives, and medicine for seizures can add to sleepiness caused by Combigan. Tell your doctor if you regularly use any of these medicines.

Combigan side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Combigan: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• severe swelling, itching, burning, redness, pain, or discomfort in or around your eye;

• bronchospasm (wheezing, chest tightness, trouble breathing);

• pounding heartbeats or fluttering in your chest;

• slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);

• feeling like you might pass out;

• numbness, tingling, or cold feeling in your hands or feet;

• muscle weakness; or

• confusion, hallucinations, unusual thoughts or behavior.

Less serious Combigan side effects may include:

• mild burning, stinging, or itching of your eyes;

• dry eyes, blurred vision;

• mildly swollen or puffy eyes;

• feeling like something is in your eye;

• weakness, tired feeling;

• cough, sore throat;

• nausea, upset stomach;

• headache;

• drowsiness;

• unusual or unpleasant taste in your mouth;

• sensitivity to light;

• dry nose;

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Combigan?

Before using Combigan, tell your doctor if you are using any of the following medications:

• an antidepressant;

• blood pressure medications;

• cimetidine (Tagamet);

• digoxin (digitalis, Lanoxin);

• HIV /AIDS medicine such as ritonavir (Norvir);

• an antihistamine such as diphenhydramine (Benadryl);

• an antifungal antibiotic such as terbinafine (Lamisil);

• anti-malaria medication such as hydroxychloroquine (Plaquenil);

• medicine to treat psychiatric disorders, such as thioridazine (Mellaril);

• a heart rhythm medication such as propafenone (Rythmol) or quinidine (Quinidex, Quin-Release Quin-G);

• a calcium channel blocker such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), nifedipine (Procardia, Adalat), verapamil (Calan, Covera, Isoptin, Verelan), and others; or

• another beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta, Ziac), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), timolol (Betimol, Blocadren, Cosopt, Timoptic, Istalol), and others.

This list is not complete and there may be other drugs that can interact with Combigan. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Combigan.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Combigan only for the indication prescribed.
• Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Copyright 1996-2009 Cerner Multum, Inc. Version: 1.02. Revision Date: 03/31/2009 4:09:14 PM.

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