GLAUCOMA DROPS: COMBIGAN

written by Dr. William McSwain

Combigan is a combination drop containing two medications: brimonidine tartrate 0.2% and timolol maleate 0.5%.
 
Brimonidine tartrate 0.2% (alpha-2 agonist) – This medication lowers the eye pressure primarily by reducing the amount of fluid that is made in the eye. It also may lower the eye pressure by improving the ease with which the fluid drains out of the eye.
 
Timolol maleate 0.5% (beta blocker) – This medication lowers eye pressure by reducing the amount of fluid that is made inside the eye.

SIDE EFFECTS INCLUDE BUT ARE NOT LIMITED TO:

There may be some burning and stinging in the eye when this medicine is first taken. Additionally, a “dry mouth” is common if the drop is introduced into the tear duct and drained into the nose and throat. A “red eye” and crusting of the eyelids may also occur. Combigan should be used cautiously in those patients using a MAO (monoamine oxidase inhibitor), a medicine that is commonly used as an antidepressant. Consult your primary care physician if there are any questions regarding this. The beta-blocker medications may cause asthma to become worse. They also may cause shortness of breath in people with heart or lung problems. They may slow the heart rhythm and should not be used by people with a slow heart rate or heart block. Heart failure may be made worse by these medications. In rare cases, these medications may be associated with depression or impotence.

MINIMIZING THE RISK OF SIDE EFFECTS:

After administering a drop, keep the eye closed for two minutes and gently compress (with a tissue, if desired) the area over the tear duct near the inner corner of the eyelids. This will make the medication less likely to get into the bloodstream and affect other parts of the body by preventing it from draining from your eye into your nose and the back of your throat.
 
DOSAGE: 1-2 x daily