Combigan (Brimonidine Tartrate/Timolol)
What is Combigan?
Combigan is a medication prescribed to treat glaucoma or ocular hypertension (high pressure inside the eye) in adult patients and children 2 years and older.
Combigan belongs to the drug classes, Antiglaucoma, Combos. This medication works by reducing the production of liquid and increasing the amount of liquid that is drained in the eye. This reduces the pressure inside the eye while still continuing to feed the eye.
Combigan is not recommended:
- If you are allergic or have had an allergic reaction to Combigan or ingredients in Combigan.
- If you are under 2 years of age.
- If you have, or ever had a reactive airway disease, such as bronchial asthma, chronic bronchitis, emphysema, slow heartbeat, impaired conduction of the heart, heart failure, or impaired pumping of the heart.
What are the Indications for Combigan?
Combigan is approved to treat glaucoma and ocular hypertension.
How is Combigan used?
Storage
Combigan should be stored in its original bottle at room temperature, and away from light. Do not refrigerate and use within 28 days of opening.
Keep out of reach of children.
Instruction
Tilt your head back and look at the ceiling. Use one of your fingers to pull down your lower eyelid to form a pocket. Gently squeeze 1 drop into the pocket. Don’t let the bottle tip touch your eye, fingers, or anything else. Gently close your eyes and lightly press on the inside corners of your eyes.
If you wear contact lenses, remove them first and wait 15 minutes after using your eye drops to put them back into your eyes.
If you miss a dose, take it as soon as you remember. If it is a few hours until your next dose, only take one dose. Do not catch up by taking two doses at once.
Do not change your dosage, take more than what is prescribed, or stop using Combigan without consulting with your doctor. If you took more than prescribed, contact your doctor immediately or seek emergency medical care.
Dosage
Combigan is available in eye drop form in one strength: 0.2% brimonidine tartrate/0.5% timolol maleate. The recommended dose is 1 drop in the affected eye(s) twice a day, about 12 hours apart. If you use any other medication, wait at least 5 minutes after using Combigan before using the other eye drops.
Side Effects
It’s important to understand that although Combigan is FDA-approved, it comes with side effects that may or may not affect you.
Before starting Combigan, you should discuss possible side effects with your doctor or pharmacist.
Common Side Effects
Not all side effects require medical attention. As your body adjusts to Combigan, side effects may go away. Tell your doctor if you experience the following symptoms, and they become severe or do not go away on their own.
Common side effects include:
- Stinging or pain in the eye
- Allergic reaction in the eye or the skin around the eye
- Small breaks in the surface of the eye
- Swelling, redness or inflammation of the eyelid
- Irritation or a feeling of something in the eye
- Itching of the eye and eyelid
- Follicles or white spots on the see through layer which covers the surface of the eye
- Temporary blurred vision
- Watery eyes
- Dry eyes or mouth
- Sticky eyes
- Fatigue
- Unusual taste in your mouth
- Headache
Serious Side Effects
Severe adverse reactions while taking Combigan may occur. Seek emergency medical care or call 911 if you experience any of the following symptoms:
- Muscle weakness: eyelid dropping, blurry vision, unusual tiredness.
- Depression: mental/mood changes, feeling sad or lonely, not enjoying or wanting to do activities.
- Stomach or intestines: fever or abdominal pain that does not go away, change in bowel habits.
- Serious allergic reactions: trouble breathing.
- Cardiovascular: low blood pressure, heart failure, slow/irregular heartbeat.
- Vision: sensitivity to light, eye pain/swelling/discharge/burning, redness, itching.
- Severe allergic reaction: difficulty breathing, hives, swelling of the face or throat.
The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.
Warnings & Precautions
Before using Combigan, tell your doctor or pharmacist:
- If you are allergic to Combigan or any ingredients in Combigan
- If you have, or have in the past suffered from respiratory problems such as asthma or lung disease.
- If you are taking monoamine oxidase inhibitors (MAOI) or certain other antidepressant drugs.
- If you have heart, kidney or liver problems.
- If you are pregnant or plan to become pregnant.
- If you are breastfeeding or plan to breastfeed.
Contamination
Eye drops can become contaminated with bacteria if the tip of the dropper touches any surface, including your eye. This can cause eye infections, which may lead to serious eye damage and loss of vision.
Heart disease
If you have heart conditions, such as heart block, heart failure or angina, you may experience increased symptoms of their condition when using this medication.
Pregnant or Planning to Become Pregnant
If you are pregnant or plan to become pregnant, speak to your healthcare provider before taking this medication.
Breastfeeding or Planning to Breastfeed
If you are breastfeeding or plan to breastfeed, speak to your healthcare provider before taking this medicine as it may get into your milk.
Interactions & Contraindications
Before using Combigan, tell your doctor or pharmacist if you take any medications, herbal supplements, or vitamins.
Combigan should not be used:
- If you have or ever had a reactive airway disease including bronchial asthma, chronic bronchitis, emphysema, slow heartbeat, impaired conduction of the heart, heart failure, or impaired pumping of the heart.
- In children aged 2 years and younger.
MAO inhibitors
Patients who have been receiving MAOI therapy should wait 14 days after discontinuation before using Combigan.
Blood pressure medication
Using Combigan with blood pressure medication may lower blood pressure.
Antidepressants
Using Combigan with antidepressant medication may increase the effects of the antidepressant medication and lower your blood pressure.