Brinzolamide + Timolol

Generic Details

Generic Name

Brinzolamide-Timolol

Other Names

  • Azarga
  • Combigan

Drug Class

  • Carbonic anhydrase inhibitor
  • Beta-blocker

Chemical Formula

C12H21N3O5S3 (Brinzolamide) - C13H24N4O3S (Timolol)

Molecular Weight

432.5 g/mol (Brinzolamide) - 316.42 g/mol (Timolol)

Mechanism of Action

  • Brinzolamide inhibits carbonic anhydrase II in the ciliary processes of the eye, decreasing aqueous humour secretion.
  • Timolol is a non-selective beta-adrenergic antagonist that reduces intraocular pressure by decreasing aqueous humor production.

Indications

  • Treatment of ocular hypertension
  • Management of open-angle glaucoma

Common Dosage Forms

  • Ophthalmic solution

Typical Dosage

  • One drop in the affected eye(s) twice a day

Pediatric Dosage

  • Safety and efficacy not established in children

Geriatric Dosage

  • No specific dosage adjustments necessary

Side Effects

  • Blurred vision
  • Eye discomfort
  • Bitter taste in mouth
  • Headache
  • Fatigue

Contraindications

  • Hypersensitivity to brinzolamide, timolol, or any component of the formulation
  • Severe chronic obstructive pulmonary disease (COPD)
  • Severe asthma

Pregnancy Category

  • C (Brinzolamide) - C (Timolol)

Lactation Safety

  • Use with caution, may be excreted in breast milk

Drug Interactions

  • Beta-blockers, calcium channel blockers, digitalis glycosides
  • MAO inhibitors, tricyclic antidepressants, quinidine

Overdose Symptoms

  • Hypotension
  • Bradycardia
  • Cardiac failure

Antidote for Overdose

  • No specific antidote, symptomatic and supportive treatment

Storage Conditions

  • Store at room temperature (15-30°C)
  • Protect from light and moisture

Pharmacokinetics

  • Absorption: Brinzolamide: Minimal systemic absorption
  • Distribution: Timolol: Widely distributed in the body
  • Metabolism: Timolol: Extensively metabolized hepatically
  • Excretion: Timolol: Urine (60-80%)

Precautions

  • May mask hypoglycemia symptoms in diabetic patients
  • Avoid in patients with sulfa allergies

Warnings

  • May exacerbate cardiovascular and respiratory diseases