Brinzolamide + Timolol

Indications

Brinzolamide + Timolol is used for: Treatment of elevated IOP in open-angle glaucoma or ocular HTN when monotherapy is insufficient.

Adult Dose

1 drop into the affected eye(s) twice daily.

Child Dose

Renal Dose

Administration

Contra Indications

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.

Precautions

Control cardiac failure prior to therapy. History of severe cardiac & resp disease. Patients subject to hypoglycemia or labile insulin-dependent diabetes. May mask hyperthyroidism or worsen Prinzmetal's angina, severe peripheral & central circulatory disorders & hypotension. History of atopy or severe anaphylactic reaction to a variety of allergens. Avoid concomitant use of 2 local ?-adrenergic blockers or 2 local carbonic anhydrase inhibitors. Close monitoring of IOP in patients w/ pseudoexfoliative or pigmentary glaucoma. Narrow-angle glaucoma. Monitor patients w/ compromised corneas eg patients w/ DM or corneal dystrophies. Remove contact lenses prior to application; reinsert after 15 min. May impair ability to drive or operate machinery. Pregnancy. Childn <18 yr.

Pregnancy-Lactation

Interactions

Brinzolamide: Concurrent use w/ oral carbonic anhydrase inhibitors may lead to additive systemic effects. Concurrent use w/ high-dose salicylates may lead to toxicity. Timolol: Concomitant admin w/ reserpine may increase hypotension and bradycardia. Additive effects w/ other antihypertensives (e.g. hydralazine, methyldopa). Increased ?-adrenergic blockade (e.g. decreased heart rate) w/ quinidine. Rebound HTN due to abrupt withdrawal of clonidine. Hypotensive effect may be antagonised by NSAIDs (e.g. indomethacin, ibuprofen).

Adverse Effects

Side effects of Brinzolamide + Timolol : Dysgeusia, blurred vision, eye pain & irritation, foreign body sensation.

Mechanism of Action

Brinzolamide is a carbonic anhydrase inhibitor that decreases secretion of aqueous humor thus reducing intraocular pressure. Exact mechanism of ocular hypotensive effect is unclear, but it is thought to be related to reduction of aqueous humour formation. beta-blockade also causes lowering of BP.