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Combigan
Combigan is a combination of brimonidine tartrate and timolol maleate, both used to reduce intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. Brimonidine is an alpha-2 adrenergic agonist that decreases aqueous humor production and increases outflow, while timolol is a beta-blocker that reduces the production of aqueous humor. Together, these medications effectively lower IOP and reduce the risk of optic nerve damage and vision loss.
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Frequently Asked Questions
How soon does Combigan start working?
Combigan typically starts to lower intraocular pressure (IOP) within a few hours of administration.
Can I use Combigan with contact lenses?
Remove contact lenses before applying Combigan and wait at least 15 minutes before reinserting them.
How often should I use Combigan?
Combigan is typically used twice daily, about 12 hoursdaily. Follow your doctor's instructions closely.
Can I stop using Combigan if my eye pressure improves?
No, you should not stop using Combigan without consulting your doctor. Eye pressure can increase again if treatment is discontinued.
What should I do if I miss a dose?
If you miss a dose, use it as soon as you remember. If it’s close to the next scheduled dose, skip the missed one and resume your normal schedule. Do not double up doses.
Comprehensive Drug Guide
How Does Combigan Work?
- Brimonidine reduces the production of aqueous humor and increases its drainage from the eye.
- Timolol also decreases the production of aqueous humor. Together, these effects reduce intraocular pressure.
Common Dosages
- Ophthalmic solution: Each drop contains 0.2% brimonidine tartrate and 0.5% timolol maleate.
Typical Dosing
- The typical dosing is one drop in the affected eye(s) twice daily, approximately 12 hours apart.
Typical Dosing
FDA Approved Indications
- Reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.
Who Shouldn't Take Combigan?
- Asthma or severe chronic obstructive pulmonary disease (COPD), as timolol can cause bronchoconstriction.
- Bradycardia or heart block, as timolol may worsen these conditions.
- Hypersensitivity to brimonidine, timolol, or any components of the formulation.
Advice From The Pharmacist
- Wait at least 5 minutes between using Combigan and other eye drops.
- Do not touch the dropper tip to any surface to avoid contamination.
- Apply pressure to the inner corner of the eye for 1 minute after instillation to reduce systemic absorption.
Side Effects of Combigan
Common Side Effects
- Dry mouth
- Fatigue
- Blurred vision
- Eye irritation or redness
Uncommon/Severe Side Effects
- Bradycardia
- Worsening asthma or COPD
- Low blood pressure
Risks and Warnings of Combigan
- Respiratory issues: Timolol can cause bronchospasm, particularly in patients with a history of asthma or COPD.
- Heart issues: Timolol can slow the heart rate (bradycardia) or worsen certain heart conditions, so monitoring is required.
Interactions with Combigan
Common Drug Interactions
- Oral beta-blockers: Taking oral beta-blockers (e.g., propranolol) alongside Combigan can increase the risk of bradycardia or hypotension.
- Antihypertensives: Other blood pressure-lowering medications may have an additive effect when used with Combigan, leading to excessively low blood pressure.
Alternatives to Combigan
- Alphagan P (brimonidine): A single-agent brimonidine eye drop.
- Timoptic (timolol): A single-agent timolol eye drop.
- Cosopt (dorzolamide/timolol): Another combination product used to lower IOP in glaucoma.
