Brimonidine and Timolol

By helping cut down on fluid in the eye, ophthalmic brimonidine and timolol help to prevent pressure in the eye, eye pain and eventual sight loss.

Overview:

Ophthalmic brimonidine and timolol are used to treat conditions such as hypertension of the eye or glaucoma. These conditions are associated with high pressure in the eye, which in turn can lead to eye pain and the risk of sight damage or loss. By reducing the pressure in your eye, these medications can cut down on any eye pain you experience and reduce the risk that you will lose your sight.

Timolol, a beta blocker, helps you by cutting down the amount of fluid which your eye produces. Brimonidine, an alpha agonist, also does this, and it has the added effect of improving eye fluid drainage for those fluids which do get produced.

This combination medication can only be obtained with a prescription from a physician and is only available as a solution. In the USA, this medication has the brand name Combigan. That means you may see it referred to in this way on packaging, and in pharmacies and stores.

Condition(s) treated:

  • Glaucoma
  • Hypertension of the eye

Type of medicine:

  • Alpha agonist (brimonidine)
  • Beta blocker (timolol)

Side effects:

As with all medications, taking ophthalmic brimonidine and timolol can lead to unpleasant side effects as well as relief from symptoms. The potential side effects of ophthalmic brimonidine and timolol can broadly be split into three different categories, based on their severity.

The most serious category of potential side effects from taking ophthalmic brimonidine and timolol are those which indicate that an overdose may have occurred. In the event that you experience any of these side effects, you should go to the emergency room right away. You or someone who is with you should inform the staff on duty there that you are taking ophthalmic brimonidine and timolol.

Symptoms in this category include obvious emergency medical problems, such as unconsciousness, absence of a pulse or blood pressure, difficulty breathing, or the stopping of the heart. In addition, serious side effects can include problems in your chest area, such as chest discomfort or pain, noisy breathing, a feeling of tightness around your heart or a cough. Experiencing fainting or lightheadedness, or a sensation of feeling dizzy, also counts as a serious side effect.

The next category of possible side effects from taking ophthalmic brimonidine and timolol include those which still require medical attention but do not constitute an emergency. In the event that you experience symptoms from this category, you should consult your physician at the next available opportunity.

More common side effects in this category are focused around the eye region. They include sensations of stinging, burning or itchiness in the eye, small lumps on the lining of your eyelid, redness or pain around a swollen eye, or the presence of discharge.

Less common side effects in this category include other eye problems, such as problems perceiving color, experiencing double or blurred vision, night blindness, appearing to perceive halos around lights, watery eyes, and more. Headaches are also a symptom placed in this category.

Finally, the third category of side effects from taking ophthalmic brimonidine and timolol are those which do not necessarily require medical attention. Often, side effects such as these can arise naturally as a result of taking the medication and will then go away within a few days. If they persist, or they are causing you trouble, you should speak to your physician or healthcare professional.

Symptoms in this category include some mental health conditions or emotional problems, including a feeling of sadness and irritability. Other symptoms in this category include a dry mouth, a high degree of sleepiness or fatigue, difficulty falling to sleep or concentrating, a loss of appetite and more.

Remember, these are not necessarily exhaustive lists. You should always read the information booklet which should come with your medication in order to fully understand the possible side effects.

If you have any concerns about the side effects of taking ophthalmic brimonidine and timolol, you should consult your physician or healthcare professional. They will be able to put your mind at rest, and they may also be able to help advise you on ways to manage the side effects you're experiencing.

Dosage:

When it comes to taking ophthalmic brimonidine and timolol, the exact dosage will often be determined by your doctor. You should always follow these instructions.

However, some standard dosages are available as a guide. For those suffering from glaucoma or hypertension of the eye, it is generally recommended that adults and children aged two years or older should take one drop in the affected eye or eyes twice per day, ensuring that an interval of at least 12 hours is left in between the two doses.

It is recommended that children under two years of age do not take ophthalmic brimonidine and timolol.

In the event that you miss a dose of your ophthalmic brimonidine and timolol, you should decide what to do based on the time. If you remember not long after your planned dose time and it is still a long time until the next dose is due according to your planned schedule, you should go ahead and take the missed dose.

However, if your next dose is impending or about to be due, you should avoid taking the missed dose and take the next one when it falls due, then endeavor to return to your normal dose schedule.

When it comes to taking this drug, there are specific instructions to be followed for the proper use and application of the medication.

Firstly, if you wear contact lenses you should ensure that you remove them before applying these eye drops. For all users, you should ensure that the cap is firmly screwed on then shake the eye drop bottle vigorously prior to applying it. Following this, you should ensure that you have washed your hands for hygiene purposes. Then, tilt back your head and pull the lower section of your eyelid away from your eye in order to create a space to apply the drops.

Once you have successfully applied the medication, you should release your grip on your eyelid and close your eyes. You should avoid blinking, as this could prevent the medicine from working as successfully as it otherwise could. With your eyes still closed, you should press down on your eye's inner corner for a minute or two in order to help the eye absorb the drops.

When this process is complete, you should ensure that you clean your hands in order to prevent the spread of the medication to surfaces in your home or workplace. In addition, remember to prevent the tip of the eye drop bottle from touching the surface of your eye - or, indeed, any other surface. This will discourage the spread of germs and help you cut down on the risk of eye infection.

If you wear contact lenses and you removed them prior to taking your ophthalmic brimonidine and timolol, you should wait for at least 15 minutes after taking the medication before re-inserting them.

In some circumstances, your doctor may have instructed you to use two different eye medicines in the same treatment round. If this applies to you, it's vital to allow an interval of at least five minutes to elapse in between applying the two drops. The reason for this is that the first eye drops can be washed out by the second set, so it's important to allow enough time for the drops to be absorbed before going ahead.

Interactions:

As with any medication, it's possible that ophthalmic brimonidine and timolol will interact with other medications once inside the human body.

It's not always possible to tell in advance whether or not you will be affected by drug interactions, as this can vary from patient to patient. There are also many drugs which can interact with ophthalmic brimonidine and timolol. For these reasons, you should always keep an up to date list of any medications, supplements and other substances which you are currently taking and ensure that your physician is fully aware of this list.

Based on this information, your physician may alter the configuration of drugs which you are currently taking in order to prevent problems for you.

The first category of interactions contains those which are the most serious. There are over 50 medications in this category, including a wide range of medications from the anti-allergy epinephrine family such as EpiPen, EpiPen 2-Pak, EpiPen Auto-Injector, EpiPen Jr, EpiPen JR 2-Pak and EpiPen JR Auto-Injector. Other drugs in this category include aminophylline, glycopyrrolate/indacaterol, diltiazem, isoetharine, and metaproterenol.

The second category involves those which can interact in a moderate way with ophthalmic brimonidine and timolol. There are hundreds of medications in this category, including a number of famous brands which you may have in your medicine cupboard.

These include allergy medications such as 12 Hour Allergy Relief (with clemastine), 12 Hour Allergy-D (cetirizine/pseudoephedrine), 12 Hour Cold (dexbrompheniramine/pseudoephedrine) and 12 Hour Cough Relief (dextromethorphan).

Other medications in this category include bisoprolol, mirabegron, codeine, duloxetine, and nicardipine.

The final category, drugs with a risk of minor interactions, is the smallest. Ticagrelor, sometimes known as Brilinta, carries a minor risk, as does glucagon (also known as GlucaGen).

In addition, this medication can also interact with some food and drink items as well as other illnesses. Alcohol carries a risk of moderate interactions, and as a result it is recommended that patients cut down on (or cut out altogether) the use of alcohol while on this medication. Furthermore, some conditions - such as asthma, diabetes and cardiogenic shock - can interact with this drug, so ensure your physician is up to date on your medical history.

These are not exhaustive lists, which is why it is vital for your physician to be fully aware of your current health situation in order to make a safe and accurate judgment about your medication.

Warnings:

Taking ophthalmic brimonidine and timolol can sometimes result in vision issues. In the event that this happens, you should not drive vehicles or use heavy machinery.

Your blood sugar can alter as a result of taking ophthalmic brimonidine and timolol. If you take a blood sugar or urine sugar test while on this medication you should inform your physician if there are any unusual results.

This list is not exhaustive. A full list of warnings should be available from the information booklet which comes along with your ophthalmic brimonidine and timolol, so you should consult this list and retain the booklet in case you need it in the future.

Storage:

When it comes to keeping your ophthalmic brimonidine and timolol stored away safely, there are a number of precautions you should take in order to prevent problems or accidents involving your medication.

Firstly, you should ensure that your ophthalmic brimonidine and timolol remains stored in a closed container to prevent damage from the surroundings. The environmental conditions in which this container should be stored should be free from excessive heat or direct light, and there should be no moisture. Your medication should also not be frozen, as this can severely damage it.

Secondly, your ophthalmic brimonidine and timolol should be stored out of the reach of children. This can help cut down on the risk of accidental consumption. Even if you don't have children living with you in your house, it is important to store it out of their reach in case you have children to visit in the future and you don't remember to move it.

While you should not stop taking this medication unless directed to do so by a medical professional, in the event that you do happen to have leftover medication you should dispose of it in the appropriate way. If you are unsure how to go about doing this, you should speak to your healthcare professional. You should also not keep out of date ophthalmic brimonidine and timolol.

Summary:

Ophthalmic brimonidine and timolol is a combination medication designed to reduce pressure on the eye associated with diseases like glaucoma and hypertension of the eye. In doing so, it helps to reduce eye pain and cuts the risk that the conditions will lead to sight damage or loss in the future.

The drug, which works by cutting down on the amount of fluid the eye produces and improving drainage for the remaining fluid, is known as Combigan in the USA. It is only available with a prescription from a physician.

Some side effects are possible when taking this drug. These include serious problems, such as the absence of a pulse, fainting or unconsciousness. In the event that you experience these side effects, you should go to your nearest emergency room. Less serious side effects such as stinging eyes and headaches require a visit to your physician, while some side effects - like irritability or a dry mouth - can usually be left to go away on their own.

While some standard dosages do exist, the exact dosage you will need to take will be determined by your physician, and you should always follow their instructions. You should ensure you remove any contact lenses before using the medication and wash your hands before and after using it.

This drug can interact with a number of other drugs, including some over the counter medications. For that reason, you should ensure that your physician has an up to date list of all the drugs you are currently taking in order to make an accurate judgment about what your configuration of medication should look like.

You should not drive while taking this medication if it has affected your vision, and you should also avoid using heavy machinery if this occurs. Ensure you store your medication out of the reach of children and away from sources of heat, direct light and other adverse environmental conditions. Always dispose of your medication appropriately, and ask your healthcare professional for advice if you are unsure how to do this.

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Last Reviewed:
December 22, 2017
Last Updated:
December 22, 2017