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Brimonidine / timolol ophthalmic Side Effects

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.

Major Side Effects

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

Minor Side Effects

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


Very common (10% or more): Conjunctival hyperemia, burning sensation
Common (1% to 10%): Stinging sensation in the eye, allergic conjunctivitis, corneal erosion, superficial punctuate keratitis, eye pruritus, conjunctival folliculosis, visual disturbance, blepharitis, epiphora, eye dryness, eye discharge, eye pain, eye irritation, foreign body sensation, eyelid edema, eyelid pruritus, eyelid erythema
Uncommon (0.1% to 1%): Worsened visual acuity, conjunctival edema, conjunctivitis, vitreous floater, asthenopia, photophobia, papillary hypertrophy, eyelid pain, conjunctival blanching, corneal edema, corneal infiltrates, vitreous detachment, allergic contact dermatitis
Postmarketing reports: Blurred vision, keratoconjunctivitis sicca

-Frequency not reported: Iritis, iridocyclitis (anterior uveitis), miosis, cataract, conjunctival blanching, hordeolum, lid crusting, lid disorder

-Rare (less than 0.1%): Corneal calcification (with the use of phosphate containing eye drops in some patients with significantly damaged corneas)
-Frequency not reported: Keratitis, choroidal detachment following filtration surgery, decreased corneal sensitivity, corneal erosion, ptosis, diplopia, cystoid macular edema, pseudopemphigoid, refractive changes, blepharoptosis[Ref]


Common (1% to 10%): Hypertension
Uncommon (0.1% to 1%): Congestive heart failure, palpitations
Postmarketing reports: Arrhythmia, bradycardia, tachycardia, hypotension, pallor

-Frequency not reported: Vasodilation

-Frequency not reported: Chest pain, atrioventricular block, cardiac arrest, cardiac failure, Raynaud's phenomenon, cold hands and feet, claudication, worsening of angina pectoris[Ref]


Common (1% to 10%): Oral dryness
Uncommon (0.1% to 1%): Nausea, diarrhea

-Frequency not reported: Gastrointestinal symptoms

-Frequency not reported: Dyspepsia, abdominal pain, vomiting[Ref]


-Frequency not reported: Systemic allergic reactions, systemic lupus erythematosus, flu syndrome

-Frequency not reported: Systemic allergic reactions including angioedema, urticaria, localized and generalized rash, pruritus, anaphylactic reaction[Ref]

Nervous system

Common (1% to 10%): Somnolence, headache
Uncommon (0.1% to 1%): Dizziness, syncope, taste perversion
Postmarketing reports: Coma, lethargy

-Frequency not reported: Cerebrovascular accident, cerebral ischemia, increases in signs and symptoms of myasthenia gravis, paresthesia, disorientation, memory loss, tinnitus[Ref]


Common (1% to 10%): Depression

-Frequency not reported: Insomnia

-Frequency not reported: Insomnia, nightmare, behavioral changes and psychic disturbances including confusion, hallucination[Ref]


Uncommon (0.1% to 1%): Rhinitis, nasal dryness
Postmarketing reports: Respiratory depression

-Frequency not reported: Upper respiratory symptoms, dyspnea, apnea

-Frequency not reported: Bronchospasm (predominantly in patients with pre-existing bronchospastic disease), dyspnea, cough, upper respiratory infection, nasal congestion[Ref]


-Frequency not reported: Sexual dysfunction, decreased libido, Peyronie's disease, retroperitoneal fibrosis[Ref]


The commonly reported side effects were allergic conjunctivitis, conjunctival folliculosis, conjunctival hyperemia, eye pruritus, ocular burning, and stinging.[Ref]


Postmarketing reports: Hypotonia

-Frequency not reported: Myalgia[Ref]


Common (1% to 10%): Asthenic conditions
Postmarketing reports: Facial erythema

-Frequency not reported: Edema, fatigue[Ref]


-Frequency not reported: Skin reaction including erythema, pruritus, rash

-Frequency not reported: Alopecia, psoriasiform rash or exacerbation of psoriasis, rash[Ref]


Common (1% to 10%): Abnormal Liver Function Tests[Ref]


-Frequency not reported: Masked symptoms of hypoglycemia in diabetes patients, hypercholesterolemia

-Frequency not reported: Hypoglycemia[Ref]


1. Cerner Multum, Inc. "Australian Product Information." O 0

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

3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

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

Disclaimer: 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. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.