Dosing and uses of Combigan (timolol-brimonidine)
Adult dosage forms and strengths
timolol/brimonidine
ophthalmic solution
- (5mg/2mg)/mL (0.5%/0.2%)
Elevated IOP in Patients with Glaucoma or Ocular Hypertension
1 gtt in affected eye(s) BID approximately 12 hours apart
Pediatric dosage forms and strengths
timolol/brimonidine
ophthalmic solution
- (5mg/2mg)/mL (0.5%/0.2%)
Elevated IOP in Patients with Glaucoma or Ocular Hypertension
<2 years: Contraindicated
≥2 years old: 1 gtt in affected eye(s) BID approximately 12 hours apart
Combigan (timolol-brimonidine) adverse (side) effects
5-15%
Allergic conjunctivitis
Conjunctival folliculosis
Conjunctival hyperemia
Eye pruritus
Ocular burning
Stinging
1-5%
Asthenia
Blepharitis
Corneal erosion
Depression
Epiphora
Eye discharge
Eye dryness
Eye irritation
Eye pain
Eyelid edema
Eyelid erythema
Eyelid pruritus
Foreign body sensation
Headache
Hypertension
Oral dryness
Somnolence
Superficial punctate keratitis
Visual disturbance
Warnings
Contraindications
Hypersensitivity to either product or other components
Reactive airway disease, including severe COPD or active or history of bronchial asthma
Sinus bradycardia, 2°/3° AV block, overt cardiac failure, cardiogenic shock
Concurrency with MAO inhibitors
Cautions
Not to be used alone for acute angle-closure glaucoma
Depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, thromboangiitis obliterans, diabetes mellitus, severe cardiovascular dz, renal/hepatic impairment, myasthenia gravis
Ocular hypersensitivity reported with brimonidine ophthalmic solutions; including some reports with Increased IOp
If other eye drops used, instill at least 5 min apart
May mask hyperthyroidism/thyrotoxicosis symptoms
Remove soft contact lenses; may reinsert 15 min post-instillation
Pregnancy and lactation
Pregnancy category: C
Lactation: use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
