Combigan

Combigan treats glaucoma and high blood pressure in the eye. Allow at least 5 minutes between administering Combigan and any other eye drop products.

Combigan Overview

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Combigan is a prescription medication used to reduce elevated pressure in patients with glaucoma or ocular hypertension (higher than normal blood pressure inside the eye).

It is a single product containing two medications: brimonidine and timolol. Brimonidine belongs to a group of drugs called alpha-adrenergic agonists. These work by decreasing the amount of fluid produced in the eyes, which reduces overall pressure within the eye. Timolol belongs to a group of drugs called beta-blockers. These work by decreasing the amount of fluid produced in the eyes, which reduces overall pressure within the eye.

Combigan is available in eye drop form and is typically administered twice a day.

Common side effects of Combigan include itchy eyes, eye redness, and burning or stinging of the eyes.

Combigan can cause blurred vision, drowsiness, and dizziness. Do not drive or operate heavy machinery until you know how Combigan affects you.

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Combigan Cautionary Labels

precautionsprecautionsprecautions

Uses of Combigan

Combigan is a prescription medication used to reduce elevated intraocular pressure (IOP) in patients with glaucoma or ocular hypertension (higher than normal blood pressure inside the eye).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Manufacturer

Generics

Combigan consists of multiple generic medications. The generic medications are listed below.

Brimonidine

For more information on this medication choose from the list of selections below.

Timolol

For more information on this medication choose from the list of selections below.

Combigan Drug Class

Combigan is part of the drug class:

Side Effects of Combigan

Serious side effects have been reported with Combigan. See the “Combigan Precautions” section.

Common side effects of Combigan include the following:

  • itchy, irritated, red, stinging, or burning eyes
  • dry eyes
  • watery or runny eyes
  • red or swollen eyelids
  • sensitivity to light
  • blurred vision
  • headache

This is not a complete list of Combigan side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Combigan Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • blood pressure lowering medications or cardiac glycosides such as amlodipine, lisinopril, and digoxin
  • beta-blockers such as carvedilol, propranolol, metoprolol, or bisoprolol
  • calcium antagonists such as amlodipine, nifedipine, diltiazem, or verapamil
  • central nervous system depressants such as alcohol, barbiturates, opiates, sedatives, or anesthetics
  • tricyclic antidepressants such as amitriptyline, nortriptyline, or imipramine
  • monoamine oxidase Inhibitors such as phenelzine, selegiline, or tranylcypromine
  • medications that block the enzyme CYP2D6 such as quinidine and fluoxetine

This is not a complete list of Combigan drug interactions. Ask your doctor or pharmacist for more information.

Combigan Precautions

Serious side effects have been reported with Combigan including the following: 

  • Worsening of diseases that involve weak blood flow. Combigan may worsen diseases associated with weak blood flow. Combigan should be used with caution in patients with cerebral or coronary insufficiency, Raynaud's phenomenon, or orthostatic hypotension.
  • Worsening of heart disease. Although Combigan had minimal effect on the blood pressure of most patients in clinical studies, caution should be exercised in treating patients with severe cardiovascular disease.
  • Eye infections. There have been reports of bacterial eye infections associated with the use of eye drop products. Eyedrop containers can become inadvertently contaminated by patients who not use eye drops properly or do not store them in a clean area.
  • Severe respiratory reactions including bronchospasm in patients with asthma. Tell your physician right away if you experience difficulty breathing and stop taking Combigan.
  • Severe cardiac reactions including cardiac failure. Consult your physician and discontinue Combigan if you experience any of the following symptoms:
    • sudden difficulty breathing
    • sudden extreme fatigue
    • swelling of extremities
  • Low blood pressure during surgery. Your physician may recommend that you stop taking Combigan before a major surgery.
  • Masking of symptoms of low blood sugar. If you have diabetes and take insulin or other medications to control your blood sugar, consult with your physician about how to properly identify signs of low blood pressure while taking Combigan.
  • Masking of symptoms of hyperthyroidism. If you have hyperthyroidism, consult with you physician about how to properly identify symptoms of a thyroid emergency while taking Combigan.
  • Muscle weakness

Combigan can cause blurred vision, drowsiness, and dizziness. Do not drive or operate heavy machinery until you know how Combigan affects you.

Combigan contains benzalkonium chloride which may be absorbed by soft contact lenses. Remove contact lenses before administering Combigan. Reinsert contact lenses 15 minutes after administering Combigan. 

Do not take Combigan if you have:

  • bronchial asthma
  • a history of bronchial asthma
  • severe chronic obstructive pulmonary disease
  • sinus bradycardia
  • second or third-degree atrioventricular block
  • heart failure
  • hypersensitivity to any component of Combigan

 

Combigan Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Combigan, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before taking Combigan, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • are allergic to Combigan or to any of its ingredients
  • are planning to administer this medication to a child under 2 years of age
  • have depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, or thromboangiitis obliterans
  • have heart disease
  • have or have recently had an eye infection
  • have or have a history of bronchial asthma
  • have severe chronic obstructive pulmonary disease
  • have sinus bradycardia
  • have second or third-degree atrioventricular block
  • have heart failure
  • have major surgery coming up
  • have hyperthyroidism
  • have diabetes
  • are pregnant or plan to become pregnant
  • are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Combigan and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Combigan falls into category C. There are no well-controlled studies that have been done in pregnant women. Combigan should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

Combigan and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Combigan crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Combigan.

Combigan Usage

Use Combigan exactly as prescribed.

Combigan comes in eye drop form and is typically taken two times daily.

Combigan may be used simultaneously with other eye drop products but If more than one eye drop is to be used, the different products should be administered at least 5 minutes apart. 

You should not use two or more beta-blocking eye drop medications at the same time unless directed to by your physician.

Eyedrop containers can become inadvertently contaminated by patients who not use eye drops properly or do not store them in a clean area. To prevent contamination, always replace the cap after using.

If solution changes color or becomes cloudy, do not use. Do not use the product after the expiration date marked on the bottle. 

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Combigan at the same time.

Combigan Dosage

Use this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose of Combigan is one drop into the affected eye(s) twice a day, with administrations approximately 12 hours apart.

Combigan Overdose

If you use too much Combigan, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

Other Requirements

  • Store at 15°-25°C (59°-77°F).
  • Protect from light.
  • Keep this and all medications out of the reach of children.