About this Medication
- How does this medication work? What will it do for me?
- How should I use this medication?
- What form(s) does this medication come in?
- Who should NOT take this medication?
- What side effects are possible with this medication?
- Are there any other precautions or warnings for this medication?
- What other drugs could interact with this medication?
How does this medication work? What will it do for me?
This is a combination medication that contains brinzolamide and timolol. Brinzolamide belongs to the group of medications called carbonic anhydrase inhibitors. Timolol belongs to the group of medications called beta-blockers. This combination medication is available in eye-drop form and is used to reduce the pressure inside the eye for people with open-angle glaucoma or intraocular hypertension (increased pressure in the eye).
Fluid is constantly being formed in, and drained out of, the eye. When this fluid does not drain out of the eye properly or too much fluid is produced, pressure inside the eye increases. Brinzolamide and timolol work by reducing the amount of fluid produced by the eye.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
How should I use this medication?
The usual dose of this medication is 1 drop in the affected eye(s) 2 times a day, morning and night.
Before using this medication, shake the bottle well.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
To use the eye drops:
Do not allow the dropper tip of the bottle to touch the eye or any other surface. This can contaminate the tip with common bacteria known to cause eye infections. Serious damage to the eye may result if you use eye drop solutions that have become contaminated.
Brinzolamide - timolol eye drops should be used at least 5 minutes before or after other eye drops that are being used.
It is important that this medication be used exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication between 2°C and 30°C and keep it out of the reach of children. Discard the bottle 60 days after opening.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
What form(s) does this medication come in?
Each mL of ophthalmic suspension contains 10 mg of brinzolamide, 5 mg of timolol as timolol maleate, and the preservative benzalkonium chloride 0.01%. Nonmedicinal ingredients: carbomer 974P, edetate disodium, mannitol, purified water, sodium chloride, sodium hydroxide and/or hydrochloric acid (to adjust pH), and tyloxapol.
Who should NOT take this medication?
Do not use brinzolamide - timolol if you:
- are allergic to brinzolamide, timolol, other beta-blockers (e.g., metoprolol, atenolol), sulfonamides (e.g., sulfamethoxazole), or any of the ingredients of the medication
- have an extremely slow heart rate, second- or third-degree heart block, heart failure, or shock due to heart-related causes
- have asthma or severe chronic obstructive pulmonary disease (e.g., chronic bronchitis, emphysema)
- have hyper-reactive airways
- have severe allergic rhinitis
- have severely reduced kidney function
- have too much acidity in the blood (called hyperchloremic acidosis)
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- blurred vision
- eye discomfort, dryness, redness
- feeling of something in the eye
- increased tear production
- sensitivity to light
- taste changes
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- coughing, shortness of breath, troubled breathing, tightness in the chest, or wheezing
- decreased blood pressure
- eye pain
- itching or swelling of the eye
- lightheadedness or fainting
- skin rash
- slow heartbeat or abnormal heartbeat
- unusual tiredness or weakness
Stop taking the medication and seek immediate medical attention if any of the following occur:
- peeling or blistering skin
- severe skin rash
- symptoms of a severe allergic reaction such as hives, difficulty breathing, or swelling of the face or throat
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergies: Brinzolamide belongs to the family of medications known as sulfonamides or "sulfas." The same type of allergic reaction can occur with this medication as with other sulfonamides. Contact your doctor if you experience a skin rash while using this medication. Stop using this medication and get medical attention if you experience hives; shortness of breath; peeling or blistering skin; or swelling of the mouth, lips, tongue, or throat.
Blurred vision: This medication can cause temporary blurred vision. Do not drive or operate machinery until your vision returns to normal.
Contact lenses: The preservative used in the eye drops (benzalkonium chloride) may be absorbed by soft contact lenses. Contact lenses should be removed before using the eye drops and not reinserted for at least 15 minutes.
Drowsiness and reduced alertness: This medication may cause fatigue or drowsiness. Avoid driving, using machinery, or doing hazardous activities until you determine how the medication affects you.
Eye surgery, infections, trauma: If you have had eye surgery or trauma to the eye, or if you have symptoms of an eye infection (e.g., eye redness, itchiness, discharge, crusts on the eyelids, or the feeling of something in the eye), contact your doctor about further use of the eye drop.
General: As with other eye drops, this medication may be absorbed into the bloodstream. You may experience the same side effects reported with oral medications from the families known as beta-blockers (e.g., timolol, propranolol, metoprolol), carbonic anhydrase inhibitors (e.g., acetazolamide, methazolamide), or sulfonamides (e.g., sulfamethoxazole). These side effects may include, but are not limited to, shortness of breath, dizziness, lightheadedness, rash, or slow heartbeat. Refer to the section, "What side effects are possible with this medication?" for more information.
Heart problems: People with heart failure should have their condition controlled before starting this medication. People with severe heart disease should discuss with their doctor whether any special monitoring is needed. This medication may make angina (chest pains) worse. If you have angina, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: If you have reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Low blood sugar: If you are prone to low blood sugar or have diabetes, monitor your blood sugar closely while taking this medication, as it may mask the signs of low blood sugar.
Muscle weakness: Beta-blockers such as timolol have been reported to increase muscle weakness associated with certain conditions, such as myasthenia gravis. If you experience symptoms of muscle weakness, contact your doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.
Breast-feeding: It is not known if brinzolamide passes into breast milk. Timolol does pass into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
What other drugs could interact with this medication?
There may be an interaction between brinzolamide - timolol and any of the following:
- acetylsalicylic acid (ASA)
- alpha/beta agonists (e.g., epinephrine, norepinephrine)
- alpha blockers (e.g., alfuzosin, doxazosin, tamsulosin)
- alpha agonists (e.g., clonidine, methyldopa)
- angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
- angiotensin receptor blockers (ARBS; e.g., candasartan, irbesartan, losartan)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- beta-adrenergic blockers (e.g., atenolol, metoprolol, propranolol)
- calcium channel blockers (e.g., diltiazem, verapamil)
- diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
- ergot alkaloids (e.g., dihydroergotamine, ergonovine, ergotamine, methylergonovine)
- grass pollen extract
- HIV protease inhibitors (atazanavir, darunavir, lopinavir, ritonavir)
- other carbonic anhydrase inhibitors (e.g., acetazolamide, methazolamide, dorzolamide)
- other eye drops
- peginterferon Alfa-2b
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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