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Combigan and/or Equivalents

Drug Related Drug Names
Combigan 0.2%/0.5% and/or Equivalents Combigan

Combigan (brimonidine/timolol)

Combigan Description

Combigan is used in the form of eye drops to lower the elevated intraocular pressure in glaucoma, specifically in cases of open-angle glaucoma. It is especially used when treatment with beta-blockers alone is not tolerated or the desired results are not achieved. Its active ingredients are timolol and brimonidine. Timolol belongs to the group of non-selective beta-blockers, since it is not a specific beta-receptor binder. It also has no intrinsic sympathomimetic activity (ISA). Timolol inhibits beta-receptors in the ciliary body of the eye and therefore reduces the production of aqueous humor. The reduced aqueous humor formation leads to reduction of intraocular pressure. The relative potency of timolol is much higher compared to propranolol. The fat-soluble timolol is well absorbed after oral administration. Its bioavailability is about 50 to 60%. The plasma half-life of timolol is about 4 to 5 hours. It is metabolized up to 80% in the liver. The plasma protein binding of timolol is 60%, 30% of it is excreted by feces and 70% by urine. Brimonidine belongs to the alpha-sympatholytic group of drugs. It is used specifically to bind alpha-receptors in the eye. Alpha-receptors are specific binding sites of sympathetic fibers of the autonomic nervous system. They are normally activated by the body's own neurotransmitters (such as epinephrine and norepinephrine). Brimonidine replaces these endogenous neurotransmitters from the receptors, thereby suppressing their effect. The biological half-life of brimonidine is approximately four hours.

Conditions Treated by Combigan

Combigan is used exclusively in the form of eye drops. By binding with the alpha-receptors in the eye, it reduces the production of aqueous humor, causing a reduction of intraocular pressure. It is also known to keep the cardiac output stable, decrease plasma renin activity and inhibit the release of noradrenaline. Combigan is used in the treatment of glaucoma because it lowers intraocular pressure of the eye. The active ingredient here displaces the body's chemical messengers to suppress their activity. In the heart, the drug causes a slowing of the heartbeat, kidney and release of the rennin (a pressor hormone). Both effects contribute to lower blood pressure. However, exactly how this blockade of beta-receptors of the intraocular pressure is reduced is not yet known. The use of the drug on the eye necessitates regular monitoring of intraocular pressure and nature of the cornea.

Combigan Dosage Information

a.) Typical Dosage Recommendations

During pregnancy, the drug may be taken only if the doctor considers it absolutely necessary. Lactating women should not use the drug at all. Combigan is not recommended for newborns and children. Only under careful medical risk-benefit assessment, Combigan should be used in patients with severe or untreated cardiovascular disease, depression, vascular disease (reduced blood flow in brain arteries or coronary arteries, Raynaud's syndrome, Winiwarter-Buerger's disease) and low blood pressure upon standing (orthostatic syndrome). The same applies to the use of this drug for patients with impaired liver or kidney function.

The drug should not be used on the eye while wearing soft contact lenses. Hard contact lenses should be removed before use and Combigan should be applied only after 15-20 minutes.

b.) Missing a Dose

Take the missed dose as soon as you recall it. But if it’s too late to take the missed dose, proceed with the next one.

c.) Overdosing

Breathing problems, headaches, reduced blood pressure and dizziness are the main symptoms of a Combigan overdose. If you experience any of these after an intake, immediately seek medical attention.

Combigan Warnings

This medicine can impair psychomotor performance, and therefore caution should be exercised in driving at the time of its application. Combigan cannot be taken in pregnancy and during breast-feeding. Treatment should be stopped if the occurrence of allergic reactions such as eye redness, pain and itching are detected in a patient. The drug is not suitable for the treatment of newborns and children. The drug should be used cautiously in patients with depression and brain disorders under the careful supervision of an authorized doctor or physician. In patients with impaired cardiovascular function (lack of blood flow to the fingers and toes, dizziness, change in body position, blood vessel blockage and inflammation) the medicine should be used with caution and never without a doctor’s approval.

Appropriate prescribed amount is necessary in the treatment of patients with hepatic and renal dysfunctions. Combigan cannot be used concomitantly with MAO inhibitors, tricyclic antidepressants and mianserin because it can cause severe depression and hypersensitivity towards the interaction.

Combigan Side effects

The common side effects of Combigan usage include:

Other rare side effects are:

It is known to have a slowing down effect on the heart rate, which can then induce depression of the myocardium (the heart muscle). Combigan should be barred to those who have a history of heart failure, and only within certain limits it may be administered to people with diabetes. It is not recommended for use if there are other medicinal choices for people with past episodes of asthma and bronchospasm.

Possible Drug Interactions with Combigan

Tell your doctor about all other medicines you use, especially:

This is not a complete list of all medications that may interact with Combigan. Please notify all of your health care providers about the prescription and over-the-counter medications you currently take. This should include a complete list of all vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a treatment of a new medicine without properly notifying your primary health care professional or doctor.

If you have any questions about buying discount Combigan online or any other prescription products you can contact our team of professional Patient Service Representatives or one of our pharmacists 24-7 by calling 1-800-226-3784.

Notice: The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Combigan and/or Equivalents warnings, side-effects and general information