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XALACOM EYE DROPS

Active substance: TIMOLOL MALEATE

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Xalacom
RECTO

50 micrograms/ml and 5 mg/ml
Eye Drops, Solution
Latanoprost + Timolol

8R3267
146

Package Leaflet: Information for the user
Read all of this leaflet carefully before you start using this medicine
because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may
harm them, even if their signs of illness are the same as yours.
• If you get any side effects talk to your doctor or pharmacist. This includes any possible
side effects not listed in this leaflet. Please tell your doctor or pharmacist.
What is in this leaflet:
1. What Xalacom is and what it is used for
2. What you need to know before you use Xalacom
3. How to use Xalacom
4. Possible side effects
5. How to store Xalacom
6. Contents of the pack and other information

1. What Xalacom is and what it is used for

Xalacom contains two medicines: latanoprost and timolol. Latanoprost belongs to a
group of medicines known as prostaglandin analogues. Timolol belongs to a group of
medicines known as beta-blockers. Latanoprost works by increasing the natural outflow
of fluid from the eye into the bloodstream. Timolol works by slowing the formation of fluid
in the eye.
Xalacom is used to reduce the pressure in your eye if you have conditions known as
open angle glaucoma or ocular hypertension. Both these conditions are linked to an
increase in the pressure within your eye, eventually affecting your eyesight. Your doctor
will usually prescribe you Xalacom when other medicines have not worked adequately.

2. What you need to know before you use Xalacom

Xalacom can be used in adult men and women (including the elderly), but is not
recommended for use if you are less than 18 years of age.
Do not use Xalacom eye drops solution:
• if you are allergic (hypersensitive) to either of the medicines in Xalacom (latanoprost or
timolol), beta-blockers, or any of the other ingredients of Xalacom (listed in section 6)
• if you have now or have had in past respiratory problems such as asthma, severe
chronic obstructive bronchitis (severe lung disease which may cause wheeziness,
difficulty in breathing and/or long-standing cough)
• if you have serious heart problems or heart rhythm disorders
• if you are pregnant (or trying to become pregnant)
• if you are breast feeding
Warnings and precautions
Before you use this medicine, tell your doctor if you have now or have had in the past:
• coronary heart disease (symptoms can include chest pain or tightness, breathlessness
or choking), heart failure, low blood pressure
• disturbances of heart rate such as slow heart beat
• breathing problems, asthma or chronic obstructive pulmonary disease
• poor blood circulation disease (such as Raynaud’s disease or Raynaud’s syndrome)
• diabetes as timolol may mask signs and symptoms of low blood sugar
• overactivity of the thyroid gland as timolol may mask signs and symptoms
• you are about to have any kind of eye surgery (including cataract surgery) or have had
any kind of eye surgery in the past
• you suffer from eye problems (such as eye pain, eye irritation, eye inflammation or
blurred vision)
• you know that you suffer from dry eyes
• you wear contact lenses. You can still use Xalacom but follow the instructions for
contact lens wearers in Section 3
• you know that you suffer from angina (particularly a type known as Prinzmetal angina)
• you know that you suffer from severe allergic reactions that would usually require
hospital treatment
• you have suffered or are currently suffering from a viral infection of the eye caused by
the herpes simplex virus (HSV)
Tell your doctor before you have an operation that you are using Xalacom as timolol may
change effects of some medicines used during anaesthesia.
Other medicines and Xalacom
Xalacom can affect or be affected by other medicines you are using, including other eye
drops for the treatment of glaucoma. Tell your doctor if you are using or intend to use
medicines to lower blood pressure, heart medicine or medicines to treat diabetes. Tell
your doctor or pharmacist if you are taking, have recently taken or might take any other
medicines (including using eye drops).
In particular, speak to your doctor or pharmacist if you know that you are taking any of
the following types of medicine:
• Prostaglandins, prostaglandin analogues or prostaglandin derivates
• Beta-blockers
• Epinephrine
• Drugs used to treat high blood pressure such as oral calcium channel blockers,
guanethidine, antiarrythmics, digitalis glycosides or parasympathomimetics
• Quinidine (used to treat heart conditions and some types of malaria)
• Antidepressants known as fluoxetine and paroxetine
Xalacom with food and drink
Normal meals, food or drink have no effect on when or how you should use Xalacom.
Pregnancy and breast-feeding
Do not use Xalacom if you are pregnant unless your doctor considers it necessary. Tell
your doctor immediately if you are pregnant, think you are pregnant or are planning to
become pregnant.
Do not use Xalacom if you are breast-feeding. Xalacom may get into your milk. Ask your
doctor for advice before taking any medicine during breast-feeding.
Driving and using machines
When you use Xalacom your vision may become blurred for a short time. If this happens
to you, do not drive or use any tools or machines until your vision becomes clear again.
Xalacom contains
Xalacom contains a preservative called benzalkonium chloride. This preservative may
cause eye irritation or disruption to the surface of the eye. It can be absorbed by contact
lenses and is known to discolour soft contact lenses. Therefore, avoid contact with soft
contact lenses. See the instructions for contact lens wearers in Section 3.

3. How to use Xalacom

Always use this medicine exactly as your doctor has told you. Check with your doctor or
pharmacist if you are not sure.
The usual dosage for adults (including the elderly) is one drop once a day in the affected
eye(s).
Do not use Xalacom more than once a day, because the effectiveness of the treatment
can be reduced if you administer it more often.
Use Xalacom as instructed by your doctor until your doctor tells you to stop.
Your doctor may want you to have extra checks on your heart and circulation if you use
Xalacom.
Contact lens wearers
If you wear contact lenses, you should remove them before using Xalacom. After using
Xalacom you should wait 15 minutes before putting your contact lenses back in.

Instructions for use

1. Wash your hands and sit or stand comfortably.
2. Twist off the outer cap (which can be thrown away).

Figure 1
3. Unscrew the protective inner cap. The protective cap should
be retained.

Figure 2
4. Use your finger to gently pull down the lower eyelid of your
affected eye.
5. Place the tip of the bottle close to, but not touching your eye.
6. Squeeze the bottle gently so that only one drop goes into your
eye, then release the lower eyelid.
7. After using Xalacom, press a finger into the corner of your eye,
by the nose (figure 4) for 2 minutes. This helps to stop
latanoprost + timolol getting into the rest of the body.
Figure 3

Figure 4

8. Repeat in your other eye if your doctor has told you to do this.
9. Put the protective inner cap back on the bottle.

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If you use Xalacom with other eye drops
Wait at least 5 minutes between using Xalacom and using the other eye drops.
If you use more Xalacom than you should
If you put too many drops in your eye you may experience some minor irritation in your
eye and your eyes may water and turn red. This should pass but if you are worried
contact your doctor for advice.

code

8R3267

guidelines

TSE-I028F

dimensions

105x520/43

date

2-JUL-13 EA

country

ENGLAND + MALTA

VERSO

If you swallow Xalacom
If you swallow Xalacom accidentally you should contact your doctor for advice. If you
swallow a lot of Xalacom you may feel sick, have stomach pains, feel tired, flushed and
dizzy and start to sweat.
If you forget to use Xalacom
Carry on with the usual dosage at the usual time. Do not take a double dose to make up
to the dose you have forgotten. If you are unsure about anything talk to your doctor or
pharmacist.

4. Possible side effects

Like all medicines this medicine can cause side effects, although not everybody gets
them.
You can usually carry on taking the drops, unless the effects are serious. If you're
worried, talk to a doctor or pharmacist. Do not stop using Xalacom without speaking to
your doctor.
Listed below are the known side effects of using Xalacom. The most important side-effect
is the possibility of a gradual, permanent change in your eye colour. It is also possible that
Xalacom might cause serious changes in the way your heart works. If you notice changes
in your heart rate or heart function you should speak to a doctor and tell them you have
been using Xalacom.
The following are known side effects of using Xalacom:
Very common effects (may affect more than 1 in 10 people):
• A gradual change in your eye colour by increasing the amount of brown pigment in the
coloured part of the eye known as the iris. If you have mixed-colour eyes (blue-brown,
grey-brown, yellow-brown or green-brown) you are more likely to see this change than
if you have eyes of one colour (blue, grey, green or brown eyes). Any changes in your
eye colour may take years to develop. The colour change may be permanent and may
be more noticeable if you use Xalacom in only one eye. There appears to be no
problems associated with the change in eye colour. The eye colour change does not
continue after Xalacom treatment is stopped.
Common effects (may affect up to 1 in 10 people):
• Eye irritation (a feeling of burning, grittiness, itching, stinging or the sensation of a
foreign body in the eye) and eye pain.
Uncommon effects (may affect up to 1 in 100 people):
• Headache
• Redness of the eye, eye infection (conjunctivitis), blurred vision, watery eyes,
inflammation of the eyelids, irritation or disruption of the surface of the eye
• Skin rashes or itching (pruritus)
Other side effects
Although not seen with Xalacom, the following additional side effects have been seen
with the medicines in Xalacom (latanoprost and timolol) and therefore might occur when
you use Xalacom:
The following side effects have been seen with latanoprost:
Infections and Infestations:
• Developing a viral infection of the eye caused by the herpes simplex virus (HSV).
Immune System Disorders:
• Symptoms of allergic reaction (swelling and redness of the skin and rash).
Psychiatric Disorders:
• Depression, memory loss, decreased sex drive, inability to sleep, nightmares.
Nervous System Disorders:
• Dizziness, tingling or numbness in the skin, changes in blood flow to the brain,
worsening of symptoms of myasthenia gravis (if you already suffer from this condition),
sudden fainting or feeling you may faint (syncope).
Eye Disorders:
• Changes to the eyelashes and fine hairs around the eye (increased number, length,
thickness and darkening), changes to the direction of eyelash growth, swelling around
the eye, swelling of the coloured part of the eye (iritis/uveitus), swelling at the back of
the eye (macular oedema), inflammation/irritation of the surface of the eye (keratitis),
dry eyes, fluid filled cyst within the coloured part of the eye (iris cyst), light sensitivity
(photophobia), sunken eye appearance (deepening of the eye sulcus).
Ear Disorders:
• Whistling/ringing in the ears (tinnitus).
Heart (Cardiac) Disorders:
• Worsening of angina, awareness of heart rhythm (palpitations).
Breathing (Respiratory) Disorders:
• Asthma, worsening of asthma, shortness of breath.
Skin Disorders:
• Darkening of the skin around the eyes.
Muscle and Skeletal Disorders:
• Joint pain, muscle pain
General Disorders:
• Chest pain
Like other medicines applied into eyes, Xalacom is absorbed into the blood. The timolol
portion of this combination may cause similar side effects as seen with intravenous
and/or oral beta-blocking agents. Incidence of side effects after topical ophthalmic
application is lower than when medicines are, for example, taken by mouth or injected.
Listed side effects include reactions seen within the class of beta-blockers when used for
treating eye conditions:
• Generalized allergic reactions including swelling beneath the skin that can occur in
areas such as the face and limbs and can obstruct the airway which may cause
difficulty swallowing or breathing, hives or itchy rash, localized and generalized rash,
itchiness, severe sudden life-threatening allergic reaction.
• Low blood glucose levels.
• Difficulty sleeping (insomnia), depression, nightmares, memory loss.
• Fainting, stroke, reduced blood supply to the brain, increases in signs and symptoms
of myasthenia gravis (muscle disorder), dizziness, unusual sensations like pins and
needles, and headache.
• Signs and symptoms of eye irritation (e.g. burning, stinging, itching, tearing, redness),
inflammation of the eyelid, inflammation in the cornea, blurred vision and detachment
of the layer below the retina that contains blood vessels following filtration surgery
which may cause visual disturbances, decreased corneal sensitivity, dry eyes, corneal
erosion (damage to the front layer of the eyeball), drooping of the upper eyelid (making
the eye stay half closed), double vision.
• Slow heart rate, chest pain, palpitations, oedema (fluid build up), changes in the
rhythm or speed of the heartbeat, congestive heart failure (heart disease with
shortness of breath and swelling of the feet and legs due to fluid build up), a type of
heart rhythm disorder, heart attack, heart failure.
• Low blood pressure, Raynaud's phenomenon, cold hands and feet.
• Constriction of the airways in the lungs (predominantly in patients with pre-existing
disease), difficulty breathing, cough.
• Taste disturbances, nausea, indigestion, diarrhoea, dry mouth, abdominal pain,
vomiting.
• Hair loss, skin rash with white silvery coloured appearance (psoriasiform rash) or
worsening of psoriasis, skin rash.
• Muscle pain not caused by exercise.
• Sexual dysfunction, decreased libido.
• Muscle weakness/tiredness.
In very rare cases, some patients with severe damage to the clear layer at the front of the
eye (the cornea) have developed cloudy patches on the cornea due to calcium build-up
during treatment.
If you get any side effects talk to your doctor. This includes any possible side effects not
mentioned in this leaflet.

5. How to store Xalacom

Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated after EXP on the carton and
bottle label. The expiry date refers to the last day of that month.
Store the unopened bottle of Xalacom in a refrigerator (between 2°C to 8°C). After
opening the bottle it is not necessary to store it in a refrigerator but do not store it above
25°C. After opening do not use this bottle for more than 4 weeks. When you are not
using Xalacom, keep the bottle in the outer carton, in order to protect from light.
Do not throw away any medicines via wastewater or household waste. Ask your
pharmacist how to throw away medicines you no longer use. The measures will help
protect the environment.

6. Contents of pack and other information
What Xalacom contains
The active substances are latanoprost 50 micrograms/ml and timolol (as timolol maleate)
5 mg/ml.
The other ingredients are:
Sodium chloride
Benzalkonium chloride
Sodium dihydrogen phosphate monohydrate (E399i)
Disodium phosphate anhydrous (E399ii)
Hydrochloric acid solution (for adjustment to pH 6.0)
Sodium hydroxide solution (for adjustment to pH 6.0)
Water for injections
What Xalacom looks like and contents of the pack
This pack contains one bottle containing 2.5 ml of Xalacom Eye Drops, Solution.
Xalacom is a clear, colourless liquid.
Xalacom is available in pack sizes of 1, 3 and 6 bottles. Not all pack sizes may be
marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder: Pfizer Limited, Ramsgate Road, Sandwich, Kent, CT13
9NJ, United Kingdom
Manufacturer: Pfizer Manufacturing Belgium NV, Rijksweg 12, 2870 Puurs, Belgium.
This medicinal product is authorised in the Member States of the EEA under
the following names
Xalacom in Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Estonia, France,
Germany, Greece, Hungary, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg,
Malta, The Netherlands, Portugal, Slovakia, Slovenia, Spain and United Kingdom.
Xalcom in Denmark, Finland, Iceland, Norway, Romania and Sweden.
This leaflet was last revised in: 06/2013

Process Black

Ref: XM 13_0 UK

8R3267

code

8R3267

guidelines

TSE-I028F

dimensions

105x520/43

date

2-JUL-13 EA

country

ENGLAND + MALTA

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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