Xalacom (Latanoprost, Timolol Maleate)

Before using XALACOM, talk to your doctor or pharmacist if:

• You are allergic to any of the ingredients in XALACOM.
• You have a respiratory disease such as asthma, have a history of asthma, or have chronic obstructive pulmonary disease (severe lung disease which may cause wheeziness, difficulty in breathing and/or long-standing cough).
• You have disturbances of heart rate such as slow heart beat (bradycardia).
• You have certain heart diseases or conditions—symptoms can include chest pain or tightness, breathlessness or choking, heart failure, low blood pressure (hypotension).
• You have problems with your blood pressure or thyroid function.
• You have poor blood circulation disease (peripheral arterial disease such as Raynaud’s disease or Raynaud’s syndrome).
• You have diabetes or have low blood sugar levels.
• You have or have had muscle weakness or have been diagnosed as having myasthenia gravis.
• You are using any other eye drops or taking any other medication.
• You are pregnant, think you might be pregnant or you are planning a pregnancy.
• You are breast feeding or planning to breastfeed.
• You have or have had herpes simplex keratitis (inflammation of the cornea caused by the herpes simplex virus).
• Your eyes are sensitive to light.
• You are planning a surgery.
• You have kidney or liver disease.

Tell your doctor before you have an operation that you are using XALACOM as Timolol Maleate may change effects of some medicines used during anaesthesia.

XALACOM contains a preservative (benzalkonium chloride) that may be absorbed by contact lenses. The preservative may form a precipitate with an ingredient (thimerosal) present in several contact lens soaking solutions. If you wear contact lenses, remove them before using XALACOM. Wait 15 minutes after applying the eye drops before putting your lenses back in. If you are using more than one type of eye drop medication, wait at least 5 minutes between each different eye drop.

In some patients, XALACOM may cause a gradual change in eye color by increasing the amount of brown pigment in the iris (the colored part of the eye). This change may not be noticeable for several months to years. This effect may be more noticeable in patients with eye colors that are mixtures of green and brown, blue/gray and brown, or yellow and brown. The brown pigment may gradually spread outward toward the outside edge of the iris. However, the entire iris or parts of it may become more brownish in appearance. This change may be more noticeable if you are only treating one eye. Therefore, there is the potential for permanent difference in the colour between the treated and the untreated eyes. Your doctor will examine you regularly to make sure that your medication is working and look for changes in eye color. If you should experience any changes in eye color, your doctor can stop treatment. However, any color change that has already occurred may be permanent, even after the medication is stopped.

XALACOM may also cause your eye lashes to darken, appear thicker and longer than they usually do. A very small number of people may notice their eye lid skin looks darker after using XALACOM for some time. These changes may be more noticeable if you are only treating one eye.

When using XALACOM, you might feel as if there is something in your eye(s). Your eye(s) might water and become red. As with other eye drops, if your vision is blurred when you first put your drops in, wait until this wears off before you drive or operate machinery. A few people using XALACOM have developed a skin rash.

A few people may experience changes in their vision, sometimes in combination with a red and sore/painful eye. These changes do not always occur right after administering the drops, and if they occur, you may find that reading and seeing fine details more difficult. Although unlikely, if you experience any of these changes, stop using XALACOM and contact your doctor immediately.

XALACOM may cause the following side effects as well.

Common side effects: eye irritation, including burning and stinging, inflammation of the eye lid and eye pain, upper respiratory tract infection.

Effects on the body: headache and skin rash, loss of appetite, sore muscles, low blood sugar in diabetics, dry eyes, nervous system effects including anxiety, nervousness, dizziness, confusion, disorientation, insomnia, hallucinations.

Be sure to tell your doctor (or pharmacist) if you notice any other unwanted side effects.

XALACOM can affect or be affected by other medicines you are using, including other eye drops for the treatment of glaucoma. Tell your doctor if you are using or intend to use medicines to lower blood pressure, heart medicine or medicines to treat diabetes or other medicines including:

• calcium channel blockers, beta-adrenergic blocking agent
• antiarrhythmics (e.g. amiodarone, quinidine)
• monoamine oxidase inhibitors
• narcotics
• digitalis, fluoxetine, paroxetine

Usual adult dose:

One drop of XALACOM should be dropped into the affected eye(s) once daily.

Do not allow the dropper tip of the bottle to touch the eye or other surrounding structures, because this could contaminate the tip with common bacteria known to cause eye infections. Serious damage to the eye with subsequent loss of vision may result if you use eye drop solutions that have become contaminated. If you experience any type of eye condition or have surgery, immediately seek your doctor's advice concerning the continued use of the bottle you are using.

If you forget to use your eye drops at the usual time, wait until it is time for your next dose. If you put too many drops in your eye(s), you may feel some slight irritation.

XALACOM is not recommended for use in children.

Overdose:

In case of drug overdose, contact a healthcare practitioner, hospital emergency department or regional poison control centre, even if there are no symptoms.

Missed dose:

If you forget one dose of XALACOM, continue with the next dose as normal. Do not double dose.