Combigan Eye Drops: Uses, Dosage, Side Effects (Brimonidine Tartrate / Timolol Maleate)

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Key takeaways

• Read the Patient Information Leaflet provided by your pharmacist, or which is contained within the product packaging, before starting use of Combigan Eye Drops, or any other medication

• Avoid touching the dropper tip, or letting it touch your eye or any other surface

• Remove contact lenses before dispensing the eye drops

• Inform your doctor if any side effects develop, persist or worsen

What side effects are possible with this medication?

Possible side effects of this medication include:

• Blurred vision

• Burning/stinging/itching/redness of the eye

• Watery eyes

• Dry eyes

• Dry mouth

• Feeling of something in the eye

• Headache

• Dizziness or drowsiness

Combigan Eye Drops contain the active ingredients timolol and brimonidine which can cause serious side effects if not used correctly. In addition to these side effects, Combigan may also interact with certain medications like beta blockers and quinidine.

It is important for patients to discuss any allergies or medical conditions with their doctor before using Combigan or any other medication, lest the patient risks a severe allergic reaction. Furthermore, it is essential to seek immediate medical assistance should severe side effects develop, such as continuous dizziness or confusion.

Drug ingredients and other details

The active ingredients in this medication may interact with other medications. Combigan Drops contain the active ingredients brimonidine tartrate and timolol maleate, both of which can lower blood pressure, affect heart rate, and cause eye lid swelling and eye inflammation.

Additionally, Combigan Drops may interact with certain medications, including beta blockers, antidepressants, digoxin, epinephrine, and high blood pressure medications.

To minimize potential interactions, it is important to inform your doctor about all the medications you are taking.

IMPORTANT SAFETY INFORMATION

Although Combigan drops are generally regarded as benign and safe, it is important to be aware of some of the potential risks. These include triggering or exacerbating existing allergies, and possible interactions with other medications. Patients should ensure their doctor is familiar with their allergies, and with any other drugs or substances, including alcohol or cannabis, that the patient may be consuming. It is also important for the attending physician to be familiar with a patient's medical history before prescribing any medication. Conditions to look out for include lung, heart, kidney, blood or liver disease, irregular heartbeat, blood circulation disorders, or if the patient experiences dizziness after standing.

Serious side effects of Combigan Drops may include vision changes, eye pain, swelling or discharge, irregular heartbeat, muscle weakness, and unusual fatigue. If you experience any of these symptoms, seek immediate medical attention.

It is also important to note that swallowing Combigan in large quantities can result in an overdose. It is therefore important to keep the medicine away from children and pets. If an overdose occurs, seek immediate medical assistance.

Combigan Eye Drops should only be used topically, and should not be ingested.

What other drugs could interact with this medication?

Certain medications, including beta-blockers, some antidepressants, digoxin, epinephrine, high blood pressure medications, and quinidine may interact with Combigan Drops. These interactions can have serious effects on how the medication works and could put the patient's health at risk.

It is important to be aware of these potential interactions:

• Be sure to tell your doctor about all medications you are taking, including prescription and over-the-counter drugs.

• Do not start or stop any medications without first consulting your doctor.

• Some substances that cause drowsiness (such as opioids) can also interact with Combigan Drops; talk to your pharmacist for information about potential drug interactions.

Eye side effects

Using this medication may result in temporary blurred vision, a sensation of burning, stinging or itching, excess redness, watery or dry eyes, dry mouth, eye irritation, headache, and dizziness or drowsiness. If these side effects persist or worsen, patients should refrain from continued use of the eye drops and should inform their doctor about the unwanted reactions.

Serious side effects can include vision changes, eye pain, and swelling and discharge, which all may require immediate medical attention.

Heart side effects

Using Combigan Eye Drops may induce heart and circulatory-related problems in some patients, and can include Arrhythmia (irregular heartbeat), muscle weakness, unusual tiredness, mental/mood changes, hand or foot numbness, foot and ankle swelling, sudden and unexplained weight gain, and shortness of breath.

How does this medication work? What will it do for me?

Combigan works by reducing the pressure in the eye, helping to prevent further damage to vision. It does this by increasing the outflow of fluid from the eye, while decreasing its production. This helps reduce intraocular pressure and prevents optic nerve damage that can lead to blindness.

Combigan is a combination of two drugs: brimonidine tartrate and timolol maleate, which act as vasoconstrictors and beta blockers respectively. Together, these ingredients help reduce intraocular pressure and improve overall vision health.

Combigan should be used exactly as directed by a doctor or pharmacist for best results.

What happens if I miss a dose?

If a dose of Combigan Drops is missed, it should be taken as soon as possible. However, if it is nearly time for the next dose, then the missed dose should be skipped to avoid an overdose. It is important to follow our doctor's instructions, and not exceed administering more than the prescribed amount.

Discuss any changes in your medications with your doctor before taking Combigan Drops.

Avoid using this medication while pregnant or breastfeeding unless directed by a medical professional.

Inform your doctor if you have any allergies or health conditions that would affect administering Combigan Drops.

Using these precautions can help reduce potential side effects when taking Combigan Drops.

Use of Combigan in Children and possible side effects

Combigan Eye Drops should not be administered to children aged two-years and younger as post-marketing observations note a number of serious side-effects associated with infants receiving brimonidine. Observed deleterious effects include apnea, bradycardia, coma, hypotension, hypothermia, hypotonia, lethargy, pallor, respiratory depression, and somnolence have been reported in infants receiving brimonidine. Furthermore, the safety and effectiveness of brimonidine tartrate and timolol maleate have not been studied in children below the age of two years. However, according to the drug's information monograph, safety and effectiveness of Combigan have been established in the 2 - 16 years-of-age cohort through various controlled studies, although drowsiness and a lack of alertness were common side-effects. Irrespective, checking with your pediatrician prior to administering the drops to your child is highly recommended.

Other possible side effects children may experience when using Combigan Drops may include:

•  Blurred vision

• Burning/stinging/itching/redness of the eye

• Watery eyes

• Dry eyes

• Dry mouth

• Feeling of something in the eye

• Headache

• Dizziness or drowsiness

More serious side effects could also include:

• Vision changes

• Eye pain/swelling/discharge

• Irregular heartbeat

• Muscle weakness

• Mental/mood changes

Parents should inform their doctor about any allergies to the medication or other substances prior to giving Combigan Drops to their children. To reduce the risk of these side effects, it's important for parents to adhere to dosage instructions carefully and get regular checkups with their child's healthcare provider.

How to properly administer the drops

When administering Combigan Eye Drops, it is important to ensure instructions, as provided by our doctor or by the product information sheet, are followed carefully.

Administering the drops is a relatively simple procedure:

• Washing our hands before applying the drops is advised, and we want to avoid touching the dropper tip or letting it touch our eye or any other surface. It's important to keep the applicator tip clean and unobstructed.

• To ensure accurate application, it helps to tilt our head back, and while looking up, we pull down our lower eyelid to make a pouch. By gently squeezing the applicator bottle, we can then deposit the drops directly on our eye ball, in an amount as prescribed by our doctor.

• Consult your doctor if you develop an infection or eye injury, or if you have had recent eye surgery.

In addition, upon administering the drops, mild and temporary side effects such as blurred vision, burning/stinging/itching/redness of the eye may occur. However, these should be reported to a doctor if they persist or worsen.

Mild side effects

Mild ocular discomfort including blurred vision, burning, stinging, itching or redness of the eye may occur following administration of the medication. These side effects are typically transient and should improve within a few days.

Mild and temporary symptoms including dry or watery eyes, feeling of something in the eye, headache and dizziness have been reported by patients, and should not cause alarm. However, if these side effects persist, or worsen, it is important to speak with a doctor for further advice.

If any serious side effects occur such as vision changes, eye pain/swelling/discharge, irregular heartbeat or muscle weakness, seek immediate medical help. Allergic reactions to the medication are rare but require immediate attention if they occur.

Will I need to use this drug long-term?

The decision of whether to use Combigan long-term is contingent on a number of factors, and may only be determined through consultation with the patient and their doctor, and whether the patient's condition requires on-going treatment. Unfortunately, blindness resulting from glaucoma is irreversible, but this happens only the most extreme cases. Medications, treatments and on-going checkups can slow and even prevent vision loss if the condition is diagnosed early. Treatments are designed to reduce intraocular pressure by draining aqueous humor or by reducing its production through medications. In addition to topical eye drops such as Combigan, other treatments include oral medicines, laser or traditional surgery, or a combination of treatments. Depending on the treatment option that is best for the patient, long-term use of Combigan may not be required.

Should long-term use of Combigan Eye Drops be adopted, the duration and frequency of use may vary depending on the individual's medical condition, age, and treatment response. In addition to medicinal treatment, the following measures should be included in the patient's wellness plan:

• Continuous eye pressure monitoring to assess treatment efficacy

• Regularly scheduled ophthalmologic examinations

• Adjustment of dosage and/or treatment as needed for effectiveness

It is important to note that the dosage may need to be adjusted for increased eye pressure from open-angle glaucoma or ocular hypertension.

Dosage for increased eye pressure from open-angle glaucoma or ocular hypertension

For individuals with increased eye pressure from open-angle glaucoma or ocular hypertension, the dosage may require adjustment to achieve optimal effectiveness.

Combigan Drops are available in a single 0.2%/0.5% strength concentration.

The recommended initial dose is one (1) drop of either strength in the affected eye two times daily; however, your doctor may adjust this dose based on your individual needs and treatment response.

It is important to use the medication exactly as prescribed by your doctor or pharmacist. Any changes to the dosage should be discussed first with the healthcare professional. Failure to follow the prescribed dosage schedule could lead to serious side effects or decreased effectiveness of the drug.

Drug forms and strengths

The following should be considered when selecting the appropriate drug form and strength:

• Patient age

• Severity of glaucoma or ocular hypertension

• Other medications being used to treat the condition

It is important to discuss with your healthcare provider which form and strength of Combigan Drops will be most effective, based on your individual condition.

Additionally, it is crucial to understand potential side effects and risks associated with using this medication.

Increased eye pressure explained

Combigan Drops contain an active ingredient that is used to lower intraocular pressure in individuals with glaucoma or ocular hypertension. This medication works by decreasing the amount of fluid in the eye, thus reducing the pressure. However, if it is overused, this can lead to increased eye pressure and may cause permanent vision loss.

The following should be taken into account when using Combigan:

• Monitor your eye pressure regularly via tonometry tests as advised by your doctor

• Use only as directed by your doctor and do not exceed recommended dose

• Consult your doctor immediately if you experience any unusual changes such as blurred vision or eye pain or discomfort

Combigan and drugs that slow the central nervous system

When using medications that slow the central nervous system, it is important to be aware of potential interactions with Combigan Drops. These could include beta blockers, certain antidepressants, digoxin, epinephrine, high blood pressure medications, and quinidine. It is therefore essential to inform your doctor about any drugs you are taking or plan to take before starting the medication.

Allergic reactions are rare but require immediate medical attention if they occur. Consulting your doctor is also advisable if you develop an eye infection or injury or have had eye surgery. To ensure safe usage and minimize risks of adverse effects from drug interactions, always follow your doctor's instructions carefully.

Can I wear contacts during my Combigan treatment?

Preservatives and other additives in Combigan can discolor certain soft (hydrophilic) contact lenses, so these should be removed when administering Combigan Eye Drops. The manufacturer advises waiting at least 15 minutes after using the eye drops before reinstalling contact lenses.

Additional Precautions

Always store Combigan Eye Drops at temperature away from moisture and heat. Do not freeze. When not in use, keep the bottle tightly closed to prevent evaporation and condensing the compound.

Do not use the drops if the liquid has changed color or has particles in it. Also check if there is an expire date on the bottle and that the date has not passed. In all these prior circumstances, contact your pharmacy to have the bottle replaced.

It is advised by the manufacturer to wait at least 10 minutes after using Combigan before using any other eye drops your doctor has prescribed.

Overdose symptoms

Overdose of the medication may cause serious symptoms and require immediate medical attention. Symptoms of overdose can include:

• Vision changes

• Eye pain/swelling/discharge

• Irregular heartbeat

• Muscle weakness

• Unusual tiredness

• Mental/mood changes

• Numbness/pain in hands or feet

• Swelling ankles/feet

• Sudden unexplained weight gain

• Shortness of breath

If any of these symptoms occur after taking Combigan Drops in large quantities or if someone has overdosed on this medication accidentally or deliberately, seek emergency medical help immediately. US residents can call their local poison control center at 1-800-222-1222 for help.

Combigan with digoxin and calcium channel blockers

When combining Combigan with digoxin or calcium channel blockers, it is important to be aware of potential drug interactions. These include:

• An increased risk of side effects due to additive effects on the heart rate and blood pressure

• A decrease in effectiveness of either medication if taken together

• Changes in the elimination of either medication from the body

Therefore, close monitoring may be necessary for patients taking both drugs together.

Conditions that lower blood pressure

Certain conditions, such as high blood pressure and diabetes, may lower the effectiveness of Combigan. When these conditions are present, it is important to consult a physician before using Combigan Drops.

Other medical conditions that may cause a decrease in blood pressure include dehydration, kidney disease, heart failure or arrhythmias. Additionally, certain medications can also reduce blood pressure levels. Examples of these medications are beta blockers and calcium channel blockers. Therefore, it is essential to inform your doctor about all current medications before using Combigan Drops to ensure optimal results without any adverse reactions or drug interactions.

Conditions that cause weak muscles

Weak muscles can be caused by various factors; aging, poor nutrition or lack of exercise are among them. Other causes include medical conditions that affect the nerves and muscles, including certain types of arthritis, chronic diseases like diabetes or kidney failure, and neurodegenerative disorders like multiple sclerosis or amyotrophic lateral sclerosis. These conditions can lead to decreased muscle strength and mobility, which impacts a person's ability to perform everyday activities.

Diabetes or risk of low blood sugar

People with diabetes are at risk for developing low blood sugar levels due to taking medications that lower glucose levels in the body. When using Combigan Drops, it is important to monitor your blood sugar levels closely. Your doctor may need to adjust your dosage of insulin or other diabetes medications if changes occur.

Additionally, those who have a history of depression should use caution when taking Combigan Drops as they may increase the risk of suicidal thoughts or behavior.

People with kidney or liver disease should also consult their doctor before using this medication as it may cause an elevation in certain liver enzymes.

Lastly, those with a history of muscle weakness disorders should talk to their doctor before starting Combigan Drops as it can worsen these conditions.