Brimolol

Per mL Brimonidine tartrate 2 mg, timolol maleate 5 mg

Reduction of IOP in patients w/ chronic open-angle glaucoma or ocular HTN who are insufficiently responsive to topical β-blockers.

Adult & elderly Instill 1 drop in affected eye(s) bd, approx 12 hr apart.

Hypersensitivity. Reactive airway disease including bronchial asthma or history of bronchial asthma, severe COPD; sinus bradycardia, sick sinus syndrome, 2nd- or 3rd-degree AV block uncontrolled w/ pacemaker, overt cardiac failure, cardiogenic shock. Concomitant use w/ MAOIs or antidepressants affecting noradrenergic transmission eg, TCAs & mianserin. Neonates & infants <2 yr.

Discontinue use if allergic reactions occur. History of atopy or severe anaphylactic reaction to variety of allergens. CV disease eg, CHD, Prinzmetal's angina, cardiac failure, hypotension therapy w/ β-blockers, 1st-degree heart block; asthma, mild/moderate COPD; metabolic acidosis, untreated phaeochromocytoma; corneal diseases; spontaneous hypoglycaemia or uncontrolled diabetes; severe peripheral circulatory disturbances/disorders ie, Raynaud's phenomenon; closed-angle glaucoma. Avoid abrupt w/drawal. May mask signs & symptoms of acute hypoglycemia, hyperthyroidism. May cause eye irritation due to benzalkonium Cl. Remove contact lens prior to administration & reinsert after 15 min. Allow 5-min interval if >1 ophth drug is used. Concomitant use w/ surgical anaesth. Not recommended w/ another topical β-blocker. May affect ability to drive & use machines. Hepatic or renal impairment. Not to be used during pregnancy & lactation. Not recommended in childn & adolescents 2-17 yr; <20 kg.

Conjunctival hyperaemia, burning sensation. Stinging & foreign body sensation, eye pruritus, dryness, discharge, pain & irritation, allergic conjunctivitis, conjunctival folliculosis, visual disturbance, blepharitis, epiphora, corneal erosion, superficial punctate keratitis, eyelid oedema, pruritus & erythema; depression; somnolence, headache; HTN; oral dryness; asthenic conditions; abnormal LFTs.

Additive or potentiated effects w/ CNS depressants (alcohol, barbiturates, opiates, sedatives or anaesth), oral Ca-channel blockers, guanethidine, β-blockers, antiarrhythmics, digitalis glycosides or parasympathomimetics, systemic antihypertensives. Mydriasis w/ adrenaline. Increased hypoglycaemic effect of antidiabetics. Potentiated hypertensive reaction to sudden clonidine w/drawal. Potentiated systemic β-blockade w/ CYP2D6 inhibitors eg, quinidine, SSRIs. Attenuated compensatory tachycardia & increased risk of hypotension w/ anaesth. Increased plasma conc w/ cimetidine, hydralazine, alcohol. Affected amine metabolism & uptake w/ TCAs eg, chlorpromazine, methylphenidate, reserpine. Possible additive IOP lowering effect w/ prostamides, prostaglandins, carbonic anhydrase inhibitors, pilocarpine. Concomitant use w/ iodine contrast drugs or lidocaine IV; isoprenaline, prazosin.

Antiglaucoma Preparations

S01ED51 - timolol, combinations ; Belongs to the class of beta blocking agents. Used in the treatment of glaucoma.

B