Combigan (Brimonidine/Timolol)

What is Combigan?

Combigan is a combination of two medications – an alpha-agonist called brimonidine and a beta-blocker called timolol.

What is Combigan used for?

Combigan is used to treat ocular hypertension (high pressure inside the eye) and glaucoma (open-angle type). This further prevents blindness.

How does Combigan work?

Combigan contains brimonidine and timolol. Brimonidine lowers the amount of fluid formed in the eye and allows better fluid drainage from within the eye. Timolol is a beta blocker that also reduces pressure in the eye by reducing the amount of fluid formed in the eye.

How to use Combigan

Combigan should be taken in the manner prescribed by the doctor. Taking it for longer periods or in larger amounts than recommended can cause problems in the eyes.

Wash your hands properly before using Combigan eye drops. To apply the eye drops, follow the steps mentioned below:

• Tilt your head back slightly.
• Pull down on the lower eyelid
• Hold the eye dropper above the eye. Make sure that the dropper is tipped down.
• Look up. Don’t look into the dropper, look away from it.
• Squeeze out one drop and close your eye.
• Press your fore-finger gently to the inside corner of the eye (near the nose). Do it for about a minute to prevent the liquid from draining into your tear duct.
• Wait for at least 5 minutes before using any other prescribed eye drops.

Combigan warnings and precautions

Do not use Combigan if you are allergic to brimonidine (Alphagan) or timolol (Timoptic, Cosopt). Also do not take this medicine if you have asthma or COPD (Chronic Obstructive Pulmonary Disease), slow heart beats, heart failure, heart conditions like AV block or any other heart disease.

You should not use this medicine if you have used an MAOI such as selegiline (Eldepryl, Emsam), phenelzine (Nardil), isocarboxazid (Marplan), rasagiline (Azilect), or tranylcypromine (Parnate) in the past 2 weeks.

Prior to using Combigan, tell your doctor if you have diabetes, depression, muscle disorder (myasthenia, gravis), overactive thyroid, circulation problems such as Buerger’s disease or Raynaud’s syndrome, a history of low blood pressure or fainting.

Do not touch the dropper as contaminated dropper can cause infection in the eye resulting in loss of vision or damage to the eye. Remember not to use the medicine while wearing contact lenses. Wait for at least 15 minutes before putti

What do I do if I have missed a Combigan dose?

If you have missed your Combigan dose, skip the missed dose and use it at the time for your next dose. Do not take an extra dose.

What do I do if I have taken a Combigan overdose?

If you have taken a Combigan overdose you should seek medical attention.

Combigan interactions

Before taking Combigan, consult your doctor if you take anti-depressants, blood pressure medicines,  digoxin (digitalis, Lanoxin); cimetidine (Tagamet); an antihistamine like diphenhydramine (Benadryl); HIV /AIDS medication, for example ritonavir (Norvir); an antifungal antibiotic such as terbinafine (Lamisil); medication used for the treatment of psychiatric disorders such as thioridazine (Mellaril); anti-malaria medicine such as hydroxychloroquine (Plaquenil); heart rhythm medications such as quinidine (Quinidex, Quin-Release Quin-G) or propafenone (Rythmol); a beta-blocker such as atenolol (Tenormin), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), timolol or bisoprolol; a calcium channel blocker such as diltiazem (Cartia, Tiazac, Cardizem), nifedipine (Procardia, Adalat), amlodipine (Norvasc), verapamil (Covera, Calan, Isoptin, Verelan).

Also, do not start taking any new medicine without telling your doctor.

Combigan side effects

Combigan side effects include hives, severe swelling in the eye, itching or burning in eye, pain or redness in eye, discomfort in or around eye, wheezing, breathing trouble, chest tightness, slow heart rate, pounding heartbeats, weak pulse, slow breathing, fainting, muscle weakness, numbness or cold feeling in hands or feet, confusion, hallucinations; swelling of face, tongue, lips or throat, and other allergic reactions. If you get any of these side effects after using Combigan, contact your doctor immediately.

Nausea, sore throat, cough, upset stomach, mild eye discomfort, headache, drowsiness, mild itching or burning in eyes, blurred vision, dry eyes, mild swollen or puffy eyes, unusual taste in mouth, sensitivity to light, fatigue, and dry nose are some less serious side effects of Combigan.