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Brimonidine Tartrate 0.2% + Timolol Maleate 0.5% Eye Prep

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At a glance

Brimonidine Tartrate 0.2% + Timolol Maleate 0.5% Eye Prep is a combination medication used in the treatment of ocular hypertension and open-angle glaucoma. Brimonidine reduces aqueous humour production and increases uveoscleral outflow, while Timolol reduces aqueous humour formation, together lowering intraocular pressure.

Description

Brimonidine Tartrate 0.2% + Timolol Maleate 0.5% Eye Prep is a combination medication used for ocular hypertension and glaucoma. It contains two medicines: Brimonidine Tartrate and Timolol Maleate.

Brimonidine is an alpha-2 adrenergic receptor agonist that reduces aqueous humour production and increases uveoscleral outflow, lowering IOP. Timolol is a non-selective beta-adrenergic receptor blocker that reduces aqueous humour formation, lowering eye pressure. Together, they significantly reduce intraocular pressure.

Indications
  • Ocular hypertension
  • Open-angle glaucoma
Therapeutic class

Ophthalmic Antiglaucoma Agent

Pharmacological class

Alpha-2 Adrenergic Agonist + Beta-blocker Combination

Pharmacology

Brimonidine Tartrate is an alpha-2 adrenergic receptor agonist that reduces IOP by decreasing aqueous humour production and increasing uveoscleral outflow. Timolol is a non-selective beta-adrenergic receptor blocker that reduces IOP by decreasing aqueous humour formation.

Mechanism of action

Brimonidine activates alpha-2 receptors in the ciliary body, reducing aqueous humour production and increasing uveoscleral outflow. Timolol blocks beta-receptors, reducing aqueous humour formation. Together, these mechanisms significantly lower intraocular pressure.

Dosage

Adults: Instill 1 drop 2 times daily (approximately 12 hours apart).

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 any surface or your eye (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: Itching, stinging sensation, foreign body sensation, burning sensation in eye, eye redness, blurred vision, tiredness, drowsiness, headache, dry mouth.

Serious: Allergic reactions, bradycardia, hypotension, respiratory distress (rare).

Avoid driving or operating machinery until you know how this medicine affects you.

Precautions & warnings
  • May cause blurred or abnormal vision after use (especially at night or in reduced lighting); 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 and minimize drug transfer to breast milk).
  • Use within 4 weeks of opening the bottle.
  • Remove soft contact lenses before use and wait at least 15 minutes before reinserting.
  • Do not use in patients receiving MAO inhibitor therapy.
  • Caution in patients with severe cardiovascular disease, respiratory disease (asthma, COPD), bradycardia, heart block.
Contraindications
  • Hypersensitivity to brimonidine tartrate, timolol maleate, or any component
  • Patients receiving MAO inhibitor therapy
  • Neonates and children (risk of systemic toxicity)
Drug interactions
  • CNS depressants (alcohol, barbiturates, opiates, sedatives, anesthetics): Additive or potentiating effects (caution required).
  • Antihypertensives, cardiac glycosides: Caution required.
  • Tricyclic antidepressants (TCAs): May affect the metabolism and uptake of circulating amines.
  • Reserpine: May increase hypotension and bradycardia.
  • Quinidine: Increased beta-adrenergic blockade (decreased heart rate).
  • 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). Limited human studies available; animal studies have shown harmful effects on the developing baby. Your doctor will weigh benefits and risks before prescribing.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Use in lactation

Probably safe during breastfeeding (if prescribed). Limited human data suggests the drug does not pose significant risk to the baby. To reduce the amount of drug reaching breast milk, apply pressure over the corner of the eye for 1 minute and remove excess solution with an absorbent tissue.

Pediatric use

Do not use in neonates and children (risk of systemic toxicity, especially drowsiness, hypotension, bradycardia from brimonidine).

Geriatric use

No specific dose adjustment required for elderly, but caution advised (considering cardiovascular and respiratory disease).

Renal / hepatic impairment

No special precautions required for patients with liver or kidney impairment (minimal systemic absorption with topical application).

Overdose effects

Overuse may increase systemic absorption, causing bradycardia, hypotension, drowsiness, dry mouth. Consult your doctor if symptoms occur.

Storage conditions

Store below 30°C, away from light and moisture. Keep out of reach of children. Use within 4 weeks of opening.

Chemical structure

Brimonidine Tartrate 0.2% + Timolol Maleate 0.5%

Common questions

What is Brimonidine + Timolol Eye Prep used for?
It is used to lower high eye pressure in ocular hypertension and glaucoma.
How should I use it?
Apply 1 drop 2 times daily (about 12 hours apart). Apply pressure on the corner of the eye for 1 minute after instillation.
What are the side effects?
Burning, redness, stinging, blurred vision, dry mouth, drowsiness, headache may occur.
What about contact lenses?
Remove contact lenses before applying drops and wait at least 15 minutes before reinserting.
Can it be used during pregnancy?
May be unsafe during pregnancy; consult your doctor.
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.