Classes
DEA Class; Rx
Common Brand Names; Cosopt, Cosopt PF
- Antiglaucoma, Combos
Description
Combination carbonic anhydrase inhibitor and beta-blocker
Used to reduce IOP in patients with open-angle glaucoma or ocular hypertension refractory to topical beta-blockers
IOP-lowering of bid dorzolamide; timolol is slightly less than concomitant administration of 0.5% timolol bid and 2% dorzolamide administered tid
Indications
Indicated for the treatment of glaucoma or ocular hypertension in patients who are insufficiently responsive to beta-blockers.
Contraindications
Age <2 years
Hypersensitivity, asthma, severe COPD, sinus bradycardia, 2nd/3rd degree AV block (except in patients with artificial pacemaker), overt cardiac failure, cardiogenic shock
Adverse Effects
Dorzolamide
- Ocular burning, stinging, discomfort (33%)
- Bitter taste (25%)
- Superficial punctate keratitis (10-15%)
- Ocular allergic reactions (10%)
- Blurred vision
- Ocular dryness
- Photophobia
- Ocular redness
- Tearing
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
Timolol
- Arrythmia
- Bradycardia
- Syncope
- Fatigue
- Headache
- Dyspnea
- Bronchospasm
- Chest pain
- Edema
- Paresthesia
- Nausea
- Rales
- Depression
- Decreased exercise tolerance
- Raynaud’s phenomenon
Warnings
Dorzolamide (a sulfonamide) and, although administered topically, is absorbed systemically; same types of adverse reactions attributable to sulfonamides may occur with topical administration, including severe skin reactions; severe respiratory reactions, including death due to bronchospasm in patients with asthma, and rarely death in association with cardiac failure, reported following systemic or ophthalmic administration of timolol maleate
Hypersensitivity may occur; fatalities have occurred, although rarely, due to severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias; sensitization may recur when a sulfonamide is readministered irrespective of route of administration; if signs of serious reactions or hypersensitivity occur, discontinue use of this preparation
Bacterial keratitis associated with use of multiple-dose containers of topical ophthalmic products, inadvertently contaminated by patients who, in most cases, had concurrent corneal disease or disruption of ocular epithelial surface
Conjunctivitis reported with chronic administration (may resolve upon discontinuation of therapy)
Pregnancy and Lactation
Pregnancy Category: C
Lactation: Excreted in breast milk; not recommended
Maximum Dosage
2 drops/day per affected eye.
2 drops/day per affected eye.
2 drops/day per affected eye.
>= 2 years: 2 drops/day per affected eye.
< 2 years: Safe and effective use has not been established.
How supplied
Timolol maleate
tablet
- 5mg
- 10mg
- 20mg
ophthalmic solution
- 0.25%
- 0.5%
gel forming solution
- 0.25%
- 0.5%