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Combigan Side Effects

Generic Name: brimonidine / timolol ophthalmic

Note: This page contains information about the side effects of brimonidine / timolol ophthalmic. Some of the dosage forms included on this document may not apply to the brand name Combigan.

Not all side effects for Combigan may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to brimonidine / timolol ophthalmic: ophthalmic solution

In addition to its needed effects, some unwanted effects may be caused by brimonidine / timolol ophthalmic. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking brimonidine / timolol ophthalmic:

More common
  • Burning, dry, or itching eyes
  • discharge or excessive tearing
  • redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
  • stinging in the eyes
  • tiny bumps on lining of the eyelid
Less common
  • Blurred or loss of vision
  • disturbed color perception
  • dizziness
  • double vision
  • feeling of having something in the eye
  • halos around lights
  • headache
  • nervousness
  • night blindness
  • pounding in the ears
  • sensitivity of the eyes to light
  • slow, fast, or irregular heartbeat
  • tunnel vision
  • watery eyes

If any of the following symptoms of overdose occur while taking brimonidine / timolol ophthalmic, get emergency help immediately:

Symptoms of overdose
  • Chest pain or discomfort
  • cough
  • difficulty breathing
  • lightheadedness, dizziness or fainting
  • no blood pressure or pulse
  • noisy breathing
  • stopping of heart
  • tightness in the chest
  • unconsciousness

Some of the side effects that can occur with brimonidine / timolol ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common
  • Dry mouth
  • feeling sad or empty
  • irritability
  • lack of appetite
  • lack or loss of strength
  • loss of interest or pleasure
  • sleepiness or unusual drowsiness
  • trouble concentrating
  • trouble sleeping

For Healthcare Professionals

Applies to brimonidine / timolol ophthalmic: ophthalmic solution


Ocular side effects have included allergic conjunctivitis, follicular conjunctivitis, conjunctival hyperemia, eye pruritis, ocular burning, and stinging. Also reported were diplopia, choroidal detachment following filtration surgery, cystoid macular edema, decreased corneal sensitivity, pseudophemphigoid ptosis, refractive changes, blepharitis, blepharoconjunctivitis, conjunctival edema, conjunctival hemorrhage, conjunctivitis, blurred vision, corneal erosion, epiphora, eye discharge, eye dryness, eye irritation, eye pain, eyelid edema, eyelid pruritis, lid disorder, tearing, visual field defect, vitreous detachment, vitreous disorder, vitreous floaters, worsened visual acuity, iritis, keratoconjunctivitis sicca, miosis, foreign body sensation, superficial punctate keratitis, and visual disturbance.[Ref]


Cardiovascular side effects have included arrythmia, bradycardia, tachycardia, cardiac arrest, cardiac failure, cerebral ischemia, cerebral vascular accident, claudication, cold hands and feet, edema, heart block, palpitation, pulmonary edema, Raynaud's phenomena, syncope, and worsening of angina pectoris.[Ref]


Gastrointestinal side effects have included anorexia, diarrhea, gastrointestinal pain, gastrointestinal disorder, dyspepsia, hepatomegaly, ischemic colitis, mesenteric arterial thrombosis, diarrhea, vomiting, and nausea.[Ref]


Immunologic side effects have included systemic lupus erythematosus.[Ref]

Nervous system

Nervous system side effects have included increased signs and symptoms of myasthenia gravis, insomnia, nightmares, paresthesias, headache, asthenia, somnolence, dizziness, fatigue, photophobia, taste perversion, confusion, slightly clouded sensorium, and vertigo[Ref]


Psychiatric side effects have included hallucinations, anxiety, disorientation, nervousness, memory loss, behavorial changes and psychic disturbances, slightly clouded sensorium, decreased performance on neuropsychometrics, diminished concentration, emotional liability, an acute reversible syndrome characterized by disorientation for time and place, and reversible mental depression progressing to catatonia.[Ref]


Respiratory side effects have included cough, oral dryness, dyspnea, bronchitis, bronchial obstruction, rales, bronchospasm, nasal dryness, dyspnea, nasal congestion, rhinitis, sinus infection, sinusitis, pharyngitis, colds, and respiratory infections.[Ref]


Hematologic side effects have included agranulocytosis, nonthrombocytopenic purpura, and thrombocytopenic purpura,[Ref]


Genitourinary side effects have included urination difficulties, decreased libido, impotence, Peyronie's disease, and retroperitoneal fibrosis.[Ref]


Hypersensitivity side effects have included anaphylaxis, angioedema, urticaria, fever combined with aching and sore throat, laryngospasm with respiratory distress, erythematous rash and both generalized and localized rash. Ocular hypersensitivity reactions have been reported, sometimes associated with an increase in intraocular pressure.[Ref]


Endocrine side effects have included masking of symptoms of hypoglycemia in diabetic patients, hypercholesterolemia, hyperglycemia, and hypoglycemia.[Ref]


General side effects have included decreased exercise tolerance, extremity pain, local weakness, weight loss, tinnitus, flu syndrome, and abnormal taste.[Ref]


Musculoskeletal side effects have included arthralgia.[Ref]


Postmarketing adverse reactions in infants have included apnea, bradycardia, coma, hypotension, hypothermia, hypotonia, lethargy, pallor, respiratory depression, and somnolence.


1. "Product Information. Combigan (brimonidine-timolol ophthalmic)." Allergan Inc, Irvine, CA.

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