Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- carvedilol
- Combigan (brimonidine / timolol ophthalmic)
Interactions between your drugs
carvedilol timolol ophthalmic
Applies to: carvedilol, Combigan (brimonidine / timolol ophthalmic)
MONITOR: Ophthalmic beta blocker solutions are systemically absorbed and can produce clinically significant systemic effects even at low or undetectable plasma levels. Additive effects of beta blockade may occur in patients receiving both oral and ophthalmic beta blocking agents.
MANAGEMENT: Blood pressure and intraocular pressure monitoring is recommended during concurrent use. Patients should be advised to notify their physician if they experience a slow pulse, irregular heartbeat, dizziness, shortness of breath, or syncope.
References (2)
- "Product Information. Acupress (carteolol ophthalmic)." Otsuka American Pharmaceuticals Inc, Rockville, MD.
- (2001) "Product Information. Timoptic (timolol ophthalmic)." Merck & Co., Inc
carvedilol brimonidine ophthalmic
Applies to: carvedilol, Combigan (brimonidine / timolol ophthalmic)
MONITOR: Topically administered alpha-2 adrenergic receptor agonists such as apraclonidine and brimonidine are systemically absorbed, with the potential for producing rare but clinically significant systemic effects such as hypotension and bradycardia. The possibility for an additive or potentiating effect on blood pressure and heart rate should be considered when used with other medications that affect these parameters, such as ophthalmic and systemic beta blockers, vasodilators, cardiac glycosides, and antihypertensive agents.
MANAGEMENT: Blood pressure and pulse rate should be monitored regularly when topical alpha-2 adrenergic receptor agonists are prescribed in combination with cardiovascular drugs. Patients should be advised to notify their physician if they experience slow pulse, irregular heartbeat, dizziness, lightheadedness, or syncope.
References (7)
- King MH, Richards DW (1990) "Near syncope and chest tightness after administration of apraclonidine before argon laser iridotomy." Am J Ophthalmol, 110, p. 308-9
- "Product Information. Iopidine (apraclonidine ophthalmic)." Alcon Laboratories Inc
- Nordlund JR, Pasquale LR, Robin AL, Rudikoff MT, Ordman J, Chen KS, Walt J (1995) "The cardiovascular, pulmonary, and ocular hypotensive effects of 0.2% brimonidine." Arch Ophthalmol, 113, p. 77-83
- (2001) "Product Information. Alphagan (brimonidine ophthalmic)." Allergan Inc
- Walters TR (1996) "Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies." Surv Ophthalmol, 41 ( Suppl, s19-26
- Pekdemir M, Yanturali S, Karakus G (2005) "More than just an ocular solution." Emerg Med J, 22, p. 753-4
- (2013) "Product Information. Mirvaso (brimonidine topical)." Galderma Laboratories Inc
timolol ophthalmic brimonidine ophthalmic
Applies to: Combigan (brimonidine / timolol ophthalmic), Combigan (brimonidine / timolol ophthalmic)
MONITOR: Topically administered alpha-2 adrenergic receptor agonists such as apraclonidine and brimonidine are systemically absorbed, with the potential for producing rare but clinically significant systemic effects such as hypotension and bradycardia. The possibility for an additive or potentiating effect on blood pressure and heart rate should be considered when used with other medications that affect these parameters, such as ophthalmic and systemic beta blockers, vasodilators, cardiac glycosides, and antihypertensive agents.
MANAGEMENT: Blood pressure and pulse rate should be monitored regularly when topical alpha-2 adrenergic receptor agonists are prescribed in combination with cardiovascular drugs. Patients should be advised to notify their physician if they experience slow pulse, irregular heartbeat, dizziness, lightheadedness, or syncope.
References (7)
- King MH, Richards DW (1990) "Near syncope and chest tightness after administration of apraclonidine before argon laser iridotomy." Am J Ophthalmol, 110, p. 308-9
- "Product Information. Iopidine (apraclonidine ophthalmic)." Alcon Laboratories Inc
- Nordlund JR, Pasquale LR, Robin AL, Rudikoff MT, Ordman J, Chen KS, Walt J (1995) "The cardiovascular, pulmonary, and ocular hypotensive effects of 0.2% brimonidine." Arch Ophthalmol, 113, p. 77-83
- (2001) "Product Information. Alphagan (brimonidine ophthalmic)." Allergan Inc
- Walters TR (1996) "Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies." Surv Ophthalmol, 41 ( Suppl, s19-26
- Pekdemir M, Yanturali S, Karakus G (2005) "More than just an ocular solution." Emerg Med J, 22, p. 753-4
- (2013) "Product Information. Mirvaso (brimonidine topical)." Galderma Laboratories Inc
Drug and food/lifestyle interactions
No alcohol/food interactions were found with the drugs in your list. However, this does not necessarily mean no food interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No duplication warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
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