Indications 

Combigan is an ophthalmic solution prescribed to treat high pressure inside the eye due to glaucoma (open-angle type) or other eye diseases (such as ocular hypertension). 

Classified as an antiglaucoma combo, Combigan comprises two active ingredients:  

• Brimonidine, an alpha-adrenergic receptor agonist, exerts its therapeutic effect by facilitating enhanced aqueous humor outflow from the eye while reducing aqueous humor production. 
• Timolol, a beta-adrenergic receptor inhibitor, reduces the amount of fluid formed in the eye. 

Combigan is typically employed as an adjunctive therapy to other ocular medications in instances where monotherapy proves inadequate in managing intraocular pressure.  

Use of these eyedrops may serve as a preventative measure against the development of complications such as blindness. 

Uses and Dosage 

Before using Combigan and with each subsequent refill, thoroughly review its patient information leaflet and medication guide. Should any queries arise, seek guidance from a qualified healthcare professional. 

Follow all directions on the prescription label and use Combigan exactly as your doctor prescribes. Do not use this eye drop in larger or smaller amounts or longer than recommended. 

Typically, one drop of Combigan is administered in the affected eye(s) twice daily, approximately 12 hours apart. When utilizing multiple topical ophthalmic products, each product must be administered at least five minutes apart. 

If utilizing both eye drops and ointments, administer the drops before the ointment to facilitate optimal ocular absorption. 

Before use, always assess the liquid’s visual appearance for any changes in coloration or particulate matter. Should either of these conditions be observed, the medication must be discarded, and a fresh supply obtained through consultation with a pharmacist. 

Wash hands before applying Combigan and avoid touching the tip of the dropper. To prevent contamination, do not let the tip touch any surface as well as the eyes. 

Contact lenses should be removed before instilling the ophthalmic solution. Allow 15 minutes following application before reinserting the lenses. 

To properly administer the eye drop: 

1. Tilt the head slightly backward and create a small pocket beneath the lower eyelid by gently pulling it downward. 
2. Position the dropper above the eye with the tip facing downward and avert the gaze away from the dropper. 
3. Squeeze the dropper to release a single drop of the solution onto the ocular surface. 
4. Close the eyes gently and direct the gaze downward for 1 to 2 minutes. 
5. Apply slight pressure with a finger positioned at the inner corner of the eye (closer to the nose) to impede the drainage of the solution. 
6. Refrain from blinking or rubbing your eyes during this period. 
7. If instructed to do so, repeat these steps for the other eye. 

After use, do not rinse the dropper. Replace the dropper cap and keep the eye drops at room temperature. Safeguard it from exposure to moisture and heat and avoid subjecting it to freezing temperatures.  

To obtain optimal therapeutic efficacy, adhere to a regular dosing schedule. Consistency in administration timing is advised to aid in recalling dosing intervals. 

Continue using this eye drop as directed, even in the absence of symptoms, as individuals with elevated intraocular pressure or glaucoma may be asymptomatic. 

Side Effects 

The following potential adverse reactions associated with Combigan use are provided for reference. Should any of these side effects persist or worsen, promptly notify your physician. 

Common Side Effects 

• Drowsiness 
• Fatigue 
• Mild itching, redness, or irritation of the ocular surface 
• Mild stinging or burning sensation when using the eye drops 

Serious Side Effects  

• Slow or uneven heart rate 
• Pounding heartbeats 
• Fluttering in the chest 
• Shallow breathing 
• Lightheadedness 
• Significant inflammation, redness, or discomfort within or surrounding the ocular region. 
• Eye pain or increased watering 
• Numbness or tingly feeling in the hands or feet 

Get medical help right away if any of the above serious side effects occur.  

Allergic Reactions 

A very serious allergic reaction with Combigan is rare. However, get medical help right away if any of the following symptoms are observed: 

• Hives 
• Severe dizziness 
• Difficult breathing 
• Swelling of the facial area (lips, tongue, or throat) 

The list of adverse reactions provided here is incomplete. If you experience unlisted side effects, seek the advice of a healthcare professional. 

Cautions 

Before using Combigan, inform your healthcare provider or pharmacist of any known allergies. This eye drop may contain inactive ingredients that may also trigger allergic reactions or other issues. Consult with your pharmacist for additional information. 

To avoid drug interactions, tell your physician and pharmacist about any current prescription/nonprescription medications, dietary supplements, and herbal products you are presently taking or intend to take.  

Specifically, inform them if you are taking the following: 

• Beta-blockers taken orally (such as propranolol) 
• Selective serotonin reuptake inhibitors (SSRIs) (fluoxetine) and tricyclic antidepressants (amitriptyline) 
• Digoxin 
• Epinephrine 
• Antihypertensive medications (such as clonidine, methyldopa) 
• Quinidine 
• Substances that induce drowsiness including opioid analgesics 
• Cough relievers (such as codeine, hydrocodone) 
• Alcohol 
• Marijuana (cannabis) 
• Drugs prescribed for insomnia or anxiety (such as alprazolam, lorazepam, zolpidem) 
• Muscle relaxants (such as carisoprodol, cyclobenzaprine) 
• Antihistamines (such as cetirizine, diphenhydramine). 

Prior to initiating treatment with this medication, disclose your medical history to your physician or pharmacist, with particular emphasis on any conditions you may have, such as: 

• Lung disease (including current or past asthma and severe chronic obstructive pulmonary disease-COPD) 
• Certain types of abnormal heart rhythms (such as sinus bradycardia, second- or third-degree AV block) 
• Heart disease (including severe heart failure and cardiogenic shock) 
• Kidney disease 
• Liver disease 
• Blood vessel disease (such as Buerger’s disease and Raynaud’s phenomenon) 
• Blood circulation disorders (including cerebral/coronary insufficiency) 
• Orthostatic hypotension (dizziness upon standing) 
• Diabetes 
• Depression 
• Hyperthyroidism  
• Severe allergies 
• Neuromuscular disorders characterized by muscular weakness (such as myasthenia gravis) 

The potential impact of Combigan on fetal development remains uncertain. Inform your physician if you are pregnant or intend to become pregnant while utilizing this medication. 

Brimonidine and timolol can be passed into breast milk and may pose a risk to a nursing infant. Refrain from breastfeeding during treatment with Combigan.