Combigan Eye Drops: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Combigan Eye Drops contain brimonidine tartrate and timolol maleate, two medicines combined in a single eye drop to lower high pressure inside the eye. It belongs to the alpha-adrenergic agonist / beta-blocker combination class of antiglaucoma preparations and is used to treat glaucoma and high eye pressure. It works by reducing the fluid the eye makes and helping more fluid drain away, and it is used in the eyes only.

What is Combigan Eye Drops

Combigan is an eye drop that combines two medicines, brimonidine and timolol, which both work to lower high pressure inside the eye. It is used to treat glaucoma and high eye pressure.

Combigan Eye Drops uses

• Lowering raised pressure in the eye
• Treating glaucoma
• Reducing high pressure in the eye when beta-blocker eye drops alone are not enough
• Ocular hypertension not adequately responding to a single medicine

Benefits of Combigan Eye Drops

• Helps control eye pressure and slow damage to the eye from glaucoma
• Combines two medicines that lower eye pressure in different ways for extra effect
• Has a rapid onset of action

How Combigan Eye Drops works

Combigan reduces the amount of fluid your eye makes and helps more fluid drain out of the eye, which lowers the pressure inside the eye.

Combigan Eye Drops dosage

Use the eye drops every day at about the same time each day unless your doctor tells you otherwise. You may find it easier to put drops in your eye while sitting or lying down. Remove soft contact lenses before using the drops and wait at least 15 minutes before putting them back in. Do not let the dropper tip touch your eye, eyelid, or any other surface.

After putting in a drop, close your eye and press a finger against the inside corner of the eye near the nose for about two minutes to reduce absorption into the body. If you use other eye drops as well, wait at least 5 to 10 minutes between using Combigan and the other drops. Wash your hands before and after using the drops.

If you forget a dose, skip the missed dose if it is almost time for the next one, and do not use a double dose. This medicine is for use in the eyes only and should not be swallowed.

Available forms and strengths

• Eye drops, solution

Side effects of Combigan Eye Drops

Common

• Redness of the eye or eyelids
• Burning or stinging sensation in the eye
• Blurry vision
• Tearing/watery eyes
• Eye dryness, irritation, or itchiness
• Headache
• Dizziness
• Drowsiness or tiredness
• Dry mouth
• Abnormal taste
• Runny or dry nose

Serious

• Severe allergic reaction, including swelling of the tongue, lips and throat, and difficulty breathing
• Heart failure
• Fast or irregular heartbeat
• High or low blood pressure
• Slow heartbeat (bradycardia)
• Fainting
• Signs of depression
• Symptoms of low blood sugar (in people with diabetes)

Warnings and precautions

• Tell your doctor if you are pregnant, think you may be pregnant, or are planning to have a baby. 
• This medicine should only be used in pregnancy if your doctor decides it is necessary, since the risks and benefits need to be weighed.
• Breastfeeding while using this medicine is not recommended because timolol can pass into breast milk and may affect a nursing baby.
• Tell your doctor if you have kidney problems, as this medicine has not been well studied in people with kidney disease and caution is needed. 
• In severe kidney impairment on dialysis, timolol has been linked to marked low blood pressure.
• Tell your doctor if you have liver problems, as this medicine has not been well studied in people with liver disease and caution is needed.
• This medicine can cause drowsiness, and drinking alcohol can make this worse.
• Wait until your vision clears after using the drops before you drive or use machines, and do not drive or operate machines if you feel tired or drowsy.
• Do not use this medicine if you have asthma, a history of asthma, or severe chronic lung disease, since it may worsen breathing problems.
• Do not use this medicine if you have certain serious heart conditions such as a very slow heartbeat, uncontrolled heart failure, or certain heart block conditions.
• Do not use this medicine if you are taking monoamine oxidase (MAO) inhibitor antidepressants.
• This medicine must not be used in children younger than 2 years old, and is usually not used in children aged 2 to 17.
• If you develop an eye infection, an eye injury, or need eye surgery, tell your doctor, since a new bottle of eye drops may be needed or treatment may need to stop.
• Contaminated eye drops can cause a serious eye infection, so never let the dropper tip touch your eye, eyelid, or any surface.
• Do not stop using this medicine without checking with your doctor, as eye pressure can rise again and may damage your eye.

Storage

• Store below 25°C.
• Protect from light.
• Keep the container tightly closed and do not touch the dropper tip to any surface.
• Contents are sterile if the seal is intact.
• Discard the bottle 4 weeks after first opening it, even if there are still some drops left.
• Keep it where young children cannot reach it.
• Do not store it in the bathroom, near a sink, in the car, or on window sills.
• Do not throw away medicines via wastewater or household waste; ask your pharmacist how to dispose of medicines you no longer use.

When to see a doctor

• Get emergency help right away if you have signs of a severe allergic reaction, such as swelling of the tongue, lips or throat, or difficulty breathing.
• Go straight to the emergency department if you notice signs of heart failure, a fast or irregular heartbeat, or high blood pressure.
• Call your doctor right away if you suspect an eye infection, such as redness, discharge, or pain.
• Call your doctor right away if you become pregnant while using this medicine.
• If this medicine is accidentally swallowed, contact your doctor or go to the emergency department right away, even if there are no signs of discomfort.
• In babies and children, signs of overdose can include sleepiness, floppiness, low body temperature, paleness and breathing difficulties; contact a doctor immediately if this happens.

Alternatives

Combigan may need to be used together with other glaucoma eye drops as directed by your doctor. Studies compared Combigan to timolol drops alone (Timoptol) and to brimonidine drops alone (Alphagan).