Included in the formulation
АТХ:S.01.E.D.51 Timolol in combination with other drugs
S.01.E.D. Beta-blockers
Pharmacodynamics:Represents Combined drug, which includes brimonidine - adrenomimetic stimulating alpha2-adrenoceptors, and timolol - blocker of beta-adrenergic receptors. They reduce intraocular pressure and reduce the formation of intraocular fluid.
Pharmacokinetics:Brimonidine in a small amount exposed to metabolism in the eye tissues, binds to plasma proteins by 29%. The half-life is 3 hours.
About 74% is excreted by the kidneys in the form of metabolites for 5 days, unchanged drug in the urine is not detected.
80% of timolol enters the systemic circulation. Maximum concentration of substance is achieved 1-2 hours after topical application. Half-life is about 7 hours. Timolol binds to blood plasma proteins in small amounts, is metabolized in the liver and excreted by the kidneys.
Indications:- open-angle glaucoma;
- ophthalmohypertension.
VII.H40-H42.H40.1 Primary open angle glaucoma
Contraindications:- individual intolerance;
- Pincreased respiratory tract reactivity (bronchial asthma, bronchial obstruction episodes, severe chronic obstructive pulmonary disease);
- frominoculated bradycardia, atrioventricular blockade of II-III degree without implanted artificial pacemaker, heart failure, cardiogenic shock;
- aboutsimultaneous use with monoamine oxidase inhibitors, antidepressants - tricyclic and tetracyclic (including myanserin);
- atozrast to 18 years;
- gOre feeding.
Carefully:- renal / hepatic impairment;
- depression, cerebral or coronary insufficiency, Raynaud's syndrome, orthostatic hypotension, thromboangiitis obliterans;
- severe cardiovascular diseases;
- diabetes;
- metabolic acidosis;
- pheochromocytoma;
- simultaneous application of radiocontrast preparations;
- intravenous administration of lidocaine, blockers of "slow" calcium channels (verapamil, diltiazem) (increased risk of suppression of atrioventricular conduction, development of bradycardia, heart failure and lowering blood pressure);
- simultaneous administration or modification of the dose of drugs taken from groups of adrenomimetics (isoprenaline) and adrenoblockers (prazozin), as well as other means that affect adrenergic transmission - because of their possible interaction with the active components of the drug or a change in their therapeutic potential.
Pregnancy and lactation:Action category for the fetus by FDA - B. When pregnancy can be used with caution, when the potential benefit to the mother exceeds the risk to the fetus. When prescribing the drug, breastfeeding is recommended to be temporarily canceled.
Dosing and Administration:The drug is instilled in the conjunctival sac of the affected eye 1 drop 2 times a day at intervals of 12 hours.
Side effects:Nervous system: often - drowsiness, headache; infrequently, the gambling, syncope.
The cardiovascular system: often - increased blood pressure; infrequent: congestive heart failure, palpitation.
Respiratory system: infrequently: rhinitis, dryness of the nasal mucosa.
Digestive system: often - dryness of the oral mucosa; infrequently - a perversion of taste.
Leather: swelling of the eyelids, itchy eyelids, reddening of the skin of the eyelids.
Overdose:When an overdose develops CNS depression, lowering blood pressure, bradycardia, vomiting, drowsiness, sedation. Treatment is symptomatic.
Interaction:Hydralazine, ethanol and H2-histaminoblockers increase the concentration of timolol in a joint application.
Increased blood pressure as a response to a sudden withdrawal of clonidine may increase with the use of timolol.
Use with caution chlorpromazine, which affects the metabolism and action of circulating catecholamines, in combination with a combination of Brimonidine + timolol in the form of drops of the eye.
With the simultaneous use of timolol and epinephrine, the development of mydriasis is possible.
Special instructions:It is impermissible to touch the tip of the vial to any surfaces to avoid infection of the eye and the contents of the vial.