Combigan (Brimonidine/Timolol)

(℞) Prescription Required

    Combigan (Brimonidine/Timolol) Dosage and Side Effects

    COMBIGAN is used for reducing pressure in the eye (intraocular pressure, or IOP).

    Warnings and Precautions

    Severe respiratory reactions and cardiac reactions, including death due to bronchospasm in patients with asthma, and rarely death in association with cardiac failure, have been reported following systemic or ophthalmic administration of timolol.

    BEFORE you use COMBIGAN talk to your doctor or pharmacist if:

    • You have or have had kidney or liver problems in the past.

    • You have had thyroid problems in the past.

    • You have had eye problems in the past, such as choroidal detachment.

    • You have had problems or develop problems with blood flow to the brain.

    • You have any medical problems now or have had any in the past, especially asthma and other lung problems, heart problems or heart disease.

    • You have diabetes or are subject to low blood sugar levels without apparent cause.

    • You have myasthenia gravis or myasthenic symptoms (e.g., general weakness, double vision, droopy eyelid).

    • You are experiencing depression.

    • You are pregnant or intend to become pregnant.

    • You are breast-feeding or intend to breast-feed. Timolol has been detected in human breast milk. Discuss with your doctor.

    • You are planning to have major surgery. If you will be administered an anesthetic, inform your anesthetist before surgery that you are taking COMBIGAN.

    • If you have ocular surgery or develop an intercurrent ocular condition (e.g., trauma or infection). Immediately seek your physician's advice concerning the continued use of the present multidose container.

    • You have any allergies to this drug, or to similar drugs (ask your doctor) or to COMBIGAN's ingredients or components of its container.

    • You are taking or intend to take other prescription or non-prescription drugs. This is particularly important if you are taking medicine to lower blood pressure or to treat heart disease.

    • You wear contact lenses. The preservative in COMBIGAN (benzalkonium chloride) may be absorbed by and change the color of soft (hydrophilic) contact lenses. Lenses should be removed prior to application of COMBIGAN and kept out for 15 minutes after use.

    • You drive or operate heavy equipment. This medication may potentially cause fatigue and/or drowsiness in some patients. This medication may also cause blurred vision or visual disturbance upon instillation. You should wait until these symptoms have cleared before driving or using machinery.

    Side Effects

    Some common side effects which may occur include dry mouth, burning/stinging eye(s), itchy eye(s), dry eyes, eye pain, swollen/inflamed/bloodshot eyes, blurred vision, and headache. If these persist or cause you concern, consult your doctor.

    Interactions with this medication

    Drugs that may interact with COMBIGAN include:

    Heart or blood pressure medications, such as beta-blockers, calcium channel blockers, catecholamine depleting drugs such as reserpine, epinephrine, tricyclic depressants, quinidine, clonidine, alcohol, other central nervous system depressants, antiarrhythmics (e.g. amiodarone), guanethidine and digitalis glycosides.

    Proper Use of this medication

    Usual adult dose:

    The usual dose is one drop in the affected eye(s) in the morning and in the evening.

    If you are using COMBIGAN with another eyedrop, the drops should be instilled at least 10 minutes apart. Do not allow the tip of the dropper to touch your eye or any of the areas right around your eye, to avoid eye injury and contamination of eye drops. Touching other areas may contaminate the solution, and you may develop a serious eye infection.


    Symptoms of overdose include dizziness, headache, shortness of breath, low blood pressure, slow heart beat, difficulty breathing, and cardiac arrest. These symptoms may occur if the overdose is to the eyes, or if the contents of the bottle are accidentally swallowed.

    Missed dose:

    If a dose of this medication has been missed, it should be taken as soon as possible. However, if it is almost time for the next dose, skip the missed dose and go back to the regular dosing schedule. Do not double doses.

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    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.