Brimonidine and timolol (Ophthalmic)
bri-MOE-ni-deen TAR-trate, TIM-oh-lol MAL-ee-ate
Medically reviewed on June 7, 2018
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antiglaucoma Combination
Pharmacologic Class: Brimonidine
Uses For This Medicine
Brimonidine and timolol ophthalmic (eye) drops are used to treat increased pressure in the eye caused by glaucoma or a condition called hypertension of the eye. Both conditions are caused by high pressure in your eye and can lead to pain from pressure in your eye and then can eventually harm your vision. Brimonidine and timolol can help you keep your sight by reducing the pressure in your eye and stopping eye pain.
Brimonidine and timolol is available only with your doctor's prescription.
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For brimonidine and timolol, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to brimonidine and timolol or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of brimonidine and timolol eye drops in children 2 years of age and older. However, use in children younger than 2 years of age is not recommended.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of brimonidine and timolol eye drops in the elderly.
|All Trimesters||C||Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.|
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking brimonidine and timolol, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using brimonidine and timolol with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using brimonidine and timolol with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amtolmetin Guacil
- Choline Salicylate
- Flufenamic Acid
- Insulin Aspart, Recombinant
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Human Inhaled
- Insulin Human Isophane (NPH)
- Insulin Human Regular
- Insulin Lispro, Recombinant
- Mefenamic Acid
- Niflumic Acid
- Nimesulide Beta Cyclodextrin
- Salicylic Acid
- Sodium Salicylate
- St John's Wort
- Tiaprofenic Acid
- Tolfenamic Acid
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of brimonidine and timolol. Make sure you tell your doctor if you have any other medical problems, especially:
- Asthma, or history of or
- Bradycardia (slow heartbeat) or
- Cardiogenic shock (shock caused by heart attack) or
- Chronic obstructive pulmonary disease (COPD), severe or
- Heart block or
- Heart failure—Should not be used in patients with these conditions.
- Bacterial eye infection (e.g., keratitis) or
- Blood vessel disorders (e.g., cerebral or coronary insufficiency, Raynaud's phenomenon, thromboangiitis obliterans) or
- Cornea (part of the eye) problems, history of or
- Depression or
- Eye surgery, recent or
- Heart disease or
- Lung disease or
- Orthostatic hypotension (dizziness, faintness, or lightheadedness when getting up from lying or sitting position) or
- Stroke, history of—Use with caution. May make these conditions worse.
- Diabetes or
- Hyperthyroidism (overactive thyroid) or
- Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat.
- Myasthenia gravis—May worsen symptoms of this condition, such as muscle weakness.
Proper Use of This Medicine
Your eye doctor will tell you how much of brimonidine and timolol to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
To use the eye drops:
- Shake the medicine well just before each use.
- First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
- Immediately after using the eye drops, wash your hands to remove any medicine that may be on them.
- To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed. Serious damage to the eye and possible loss of vision may result from using contaminated eye medicines.
Remove your contact lenses before using brimonidine and timolol. Wait at least for 15 minutes before putting the contact lenses back in.
If your doctor ordered two different eye medicines to be used together, wait at least 5 minutes before using the second medicine. This will help prevent the second medicine from “washing out” the first one.
The dose of brimonidine and timolol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of brimonidine and timolol. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For ophthalmic dosage form (eye drops):
- For glaucoma or hypertension of the eye:
- Adults and children 2 years of age and older—Use one drop in the affected eye(s) two times a day, at least 12 hours apart.
- Children younger than 2 years of age—Use is not recommended.
- For glaucoma or hypertension of the eye:
If you miss a dose of brimonidine and timolol, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using This Medicine
It is very important that your doctor check your the progress at regular visits to make sure brimonidine and timolol is working properly and to check for unwanted effects.
If itching, redness, swelling, or other signs of eye or eyelid irritation occur, stop using brimonidine and timolol and check with your doctor. These signs may mean that you are allergic to brimonidine and timolol.
Brimonidine and timolol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, shortness of breath, swelling of the face, fingers, feet, or lower legs, weight gain, or wheezing.
Brimonidine and timolol may cause changes in your blood sugar levels. Also, brimonidine and timolol may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.
Make sure any doctor or dentist who treats you knows that you are using brimonidine and timolol. You may need to stop using brimonidine and timolol several days before having surgery.
Brimonidine and timolol may cause blurred vision or other vision problems that may last for several minutes after you put them in your eye. If any of these occur, do not drive, use machines, or do anything else that could be dangerous if you are not able to see well. If these eye changes are bothersome, check with your doctor.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
This Medicine Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
- 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
- Blurred or loss of vision
- disturbed color perception
- double vision
- feeling of having something in the eye
- halos around lights
- night blindness
- pounding in the ears
- sensitivity of the eyes to light
- slow, fast, or irregular heartbeat
- tunnel vision
- watery eyes
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
- Chest pain or discomfort
- difficulty breathing
- lightheadedness, dizziness or fainting
- no blood pressure or pulse
- noisy breathing
- stopping of heart
- tightness in the chest
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Dry mouth
- feeling sad or empty
- lack of appetite
- lack or loss of strength
- loss of interest or pleasure
- sleepiness or unusual drowsiness
- trouble concentrating
- trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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More about brimonidine/timolol ophthalmic
- Brimonidine/timolol ophthalmic Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- Support Group
- En Español
- 12 Reviews
- Drug class: ophthalmic glaucoma agents
Other brands: Combigan