Combipres Eye Drops

Uses:

• Ocular hypertension
• Open-angle glaucoma, Ocular hypertension
• Glaucoma

How does Combipres Eye Drops work?

Combipres is a combination of two medicines: Timolol and Brimonidine. Timolol is a beta blocker while Brimonidine is a sympathomimetic. They work by decreasing the production of aqueous humor (fluid in the eye), thereby lowering the increased eye pressure.

Side Effects of Combipres Eye Drops

• 5-15% Allergic conjunctivitis,
• Conjunctival folliculitis,
• Conjunctival hyperemia,
• Eye pruritus,
• Ocular burning,
• Stinging 1-5% Asthenia,
• Blepharitis,
• Corneal erosion,
• Depression,
• Epiphora,
• Eye discharge,
• Eye dryness,
• Eye irritation,
• Eye pain,
• Eyelid edema,
• Eyelid erythema,
• Eyelid pruritus,
• Foreign body sensation,
• Headache,
• Hypertension, Oral dryness,
• Somnolence,
• Superficial punctate keratitis,
• Visual disturbance

Quick Suggestions:

• Combipres is a combination of two medicines that lowers high pressure in the eye and reduces the risk of vision loss.
• Apply pressure on the corner of the eye (close to the nose) for about 1 minute, immediately after instilling the drop.
• If you wear soft contact lenses, remove them before putting in these eye drops, and wait at least 15 minutes before putting your lenses back in.
• Do not touch the tip of the dropper to any surface, or to your eye, to avoid contaminating the eye drops.
• Wait for at least 5-10 minutes before delivering the next medication in the same eye to avoid dilution.
• It may cause short-term blurring of vision when first used. Use caution before driving or using machines.
• It may cause a temporary burning or itching sensation in the eye. Inform your doctor if this does not go away.
• Make sure to use within 4 weeks of opening the bottle.

Indication of Combipres Eye Drops

This eye drop is indicated for lowering intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

Pharmacology

Brimonidine is an alpha 2-adrenoceptor agonist that works to reduce aqueous humor production and increase uveoscleral flow. Timolol is a non-selective beta-adrenergic receptor blocker. It does not have significant intrinsic sympathomimetic activity, direct myocardial depressant activity, or local Anaesth activity. The exact mechanism of the ocular hypotensive effect is unclear, but it is thought to be related to the reduction of aqueous humor formation. beta-blockade also causes a lowering of BP.

Dosage & Administration of Combipres Eye Drops

The recommended dosage for this eye drop medication is as follows:

• Administer one drop into the affected eye(s) two times a day, with approximately 12 hours between each dose.

This medicine is for external use only. Take it in the dose and duration as advised by your doctor. Check the label for directions before use. Hold the dropper close to the eye without touching it. Gently squeeze the dropper and place the medicine inside the lower eyelid. Wipe off extra liquid.

If you are using more than one topical ophthalmic (eye) product, it's important to space the installation of each eye drop at least 5 minutes apart to ensure their effectiveness. Safety and effectiveness in children below the age of 12 years have not been established.

Interaction

Brimonidine Tartrate: Possibility of an additive or potentiating effect with CNS depressants e.g. alcohol, barbiturates, opiates, sedatives, or anesthetics. Caution when used with ?-blockers (ophthalmic and systemic), antihypertensive, or cardiac glycosides. TCAs can affect the metabolism and uptake of circulating amines. 

Timolol: Concomitant admin w/ reserpine may increase hypotension and bradycardia. Additive effects w/ other antihypertensives (e.g. hydralazine, methyldopa). Increased ?-adrenergic blockade (e.g. decreased heart rate) w/ quinidine. Rebound HTN due to abrupt withdrawal of clonidine. The hypotensive effect may be antagonized by NSAIDs (e.g. indomethacin, ibuprofen).
Storage Conditions

Contraindications

Contraindicated in patients with hypersensitivity to any component of this product. Also contraindicated in bronchial asthma, severe chronic obstructive pulmonary disease, sinus bradycardia, second or third-degree atrioventricular block, overt cardiac failure, and cardiogenic shock.

Pregnancy & Lactation

• Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.
• Timolol has been detected in human milk following oral and ophthalmic drug administration. It is not known whether brimonidine passes into human breast milk. However, it has been shown to pass into the milk of nursing animals. Because of the potential for serious adverse reactions from this combination in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Precautions & Warnings

Patients wearing soft contact lenses should wait for at least 15 min after instilling brimonidine tartrate before inserting soft contact lenses. Renal or hepatic impairment. CV disease. Use with caution in patients with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, or thromboangitis obliterans. Pregnancy, lactation. Lactation: use caution

• Combipres is a combination of two medicines that lower high pressure in the eye and reduce the risk of vision loss.
• Apply pressure on the corner of the eye (close to the nose) for about 1 minute, immediately after instilling the drop.
• If you wear soft contact lenses, remove them before putting in these eye drops, and wait at least 15 minutes before putting your lenses back in.
• Do not touch the tip of the dropper to any surface, or to your eye, to avoid contaminating the eye drops.
• Wait for at least 5-10 minutes before delivering the next medication in the same eye to avoid dilution.
• It may cause short-term blurring of vision when first used. Use caution before driving or using machines.
• It may cause a temporary burning or itching sensation in the eye. Inform your doctor if this does not go away.
• Make sure to use it within 4 weeks of opening the bottle.

Storage Conditions

Store in a cool & dry place, protected from light. Keep out of reach of children. Do not use more than 4 weeks after opening. It is desirable that the contents should not be used more than four weeks after the first opening of the bottle.