Generic
Brinzolamide + Timolol Eye Prep
6 brands available in the market
At a glance
Brinzolamide + Timolol Eye Prep is a combination medication used in the treatment of ocular hypertension and open-angle glaucoma, particularly when monotherapy provides insufficient IOP reduction. Brinzolamide reduces aqueous humour secretion and Timolol reduces aqueous humour formation, together lowering intraocular pressure.
Description
Brinzolamide + Timolol Eye Prep is a combination medication used for ocular hypertension and open-angle glaucoma, particularly when monotherapy provides insufficient intraocular pressure (IOP) reduction.
Brinzolamide is a potent inhibitor of human carbonic anhydrase II (CA-II), the predominant iso-enzyme in the eye. Inhibition of CA-II in the ciliary processes decreases aqueous humour secretion, presumably by slowing bicarbonate ion formation with subsequent reduction in sodium and fluid transport. Timolol is a non-selective beta-adrenergic blocking agent that reduces aqueous humour formation and slightly increases outflow facility. Together, they provide additional IOP reduction compared to either compound alone.
Indications
- Open-angle glaucoma
- Ocular hypertension - when monotherapy provides insufficient IOP reduction
Therapeutic class
Drugs for miotics and glaucoma
Pharmacological class
Carbonic Anhydrase Inhibitor + Beta-blocker Combination
Pharmacology
Brinzolamide is a carbonic anhydrase II (CA-II) inhibitor that reduces aqueous humour secretion in the ciliary processes. Timolol is a non-selective beta-adrenergic blocker that reduces aqueous humour formation and slightly increases outflow facility. These two components work through different mechanisms to reduce IOP.
Mechanism of action
Brinzolamide inhibits carbonic anhydrase in the ciliary body, reducing aqueous humour secretion. Timolol blocks beta-adrenergic receptors, reducing aqueous humour formation. Together, these mechanisms significantly lower intraocular pressure.
Dosage
Adults: Instill 1 drop in the conjunctival sac of the affected eye(s) twice daily.
Note: Apply pressure on the corner of the eye (close to the nose) for about 1 minute after instillation (to reduce systemic absorption). Use within 4 weeks of opening.
Administration
For ophthalmic use only. Wash hands before use. If using soft contact lenses, remove them before applying the drops and wait at least 15 minutes before reinserting. Do not touch the dropper tip to eyelids, surrounding areas, fingers, or other surfaces (to avoid contamination). Hold the dropper close to the eye without touching it and place the drop inside the lower eyelid. Wipe off extra liquid.
Missed dose
If you miss a dose, apply it as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not double the dose.
Side effects
Common side effects: Blurred vision, eye pain, eye irritation, foreign body sensation in eyes, itching, stinging sensation, burning sensation, eye redness, taste change.
Serious (rare): Allergic reactions, bradycardia, hypotension, respiratory distress, acid-base disturbances.
Avoid driving or operating machinery until you know how this medicine affects you.
Precautions & warnings
- May cause short-term blurring of vision after use; do not drive or operate machinery until vision is clear.
- Apply pressure on the corner of the eye (close to the nose) for about 1 minute after instillation (to reduce systemic absorption).
- Use within 4 weeks of opening the bottle.
- Remove soft contact lenses before use and wait at least 15 minutes before reinserting.
- If signs of serious reactions or hypersensitivity occur, discontinue use.
- Caution in patients with heart failure, respiratory disease (asthma, COPD), bradycardia, heart block.
Contraindications
- History of hypersensitivity to brinzolamide (including other sulphonamides), timolol, or any component
- Bronchial asthma
- Severe COPD
- Sinus bradycardia
- 2nd or 3rd degree AV block
- Overt cardiac failure
- Cardiogenic shock
- Severe allergic rhinitis
- Bronchial hyperreactivity
- Hyperchloraemic acidosis
- Severe renal impairment
Drug interactions
- Ketoconazole, itraconazole, clotrimazole, ritonavir, troleandromycin: May inhibit brinzolamide metabolism.
- Oral calcium channel blockers, guanethidine, beta-blockers, antiarrhythmics, digitalis glycosides, parasympathomimetics: Additive effects with timolol.
- Quinidine, cimetidine: Interactions may occur.
- Oral carbonic anhydrase inhibitors: Additive systemic effects.
- High-dose salicylates: May cause toxicity.
- Reserpine: May increase hypotension and bradycardia.
- NSAIDs (indomethacin, ibuprofen): May antagonize hypotensive effect.
- Clonidine (abrupt withdrawal): Rebound hypertension.
Food interactions
No food interactions found/established.
Use in pregnancy
May be unsafe during pregnancy (Category C). No adequate data on brinzolamide; animal studies have shown reproductive toxicity. Limited data on timolol eye drops show no adverse effects, but fetal bradycardia and arrhythmia have been reported. Consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
It is not known whether brinzolamide is excreted in human milk; animal studies show excretion in breast milk. Timolol appears in human milk. However, at therapeutic doses, no effects on breastfed infants are anticipated. Can be used during breastfeeding under medical supervision.
Pediatric use
Safety and efficacy in pediatric patients have not been established.
Geriatric use
No specific dose adjustment required for elderly, but caution advised (considering cardiovascular and respiratory disease).
Renal / hepatic impairment
Hepatic impairment: Caution required in liver disease; consult your doctor.
Overdose effects
Overuse may increase systemic absorption, causing bradycardia, hypotension, electrolyte imbalance. Consult your doctor if symptoms occur.
Storage conditions
Do not store above 30°C. Keep away from light and moisture. Keep out of reach of children. To prevent contamination, do not touch the dropper tip to any surface. Close the bottle tightly when not in use. Do not use after 4 weeks of first opening.
Chemical structure
Brinzolamide + Timolol