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What is Combigan
TimololThe Generic name of this drug
Treatment SummaryBrimonidine is a drug used to treat glaucoma and can be used to reduce facial redness associated with rosacea. It is a type of alpha-adrenergic agonist, which works by reducing the amount of fluid in the eye and increasing the drainage of fluid. Brimonidine is considered to be a safer alternative to beta-blockers, as it does not have significant cardiovascular side effects. It was approved by the FDA in 1996 and was later approved as Mirvaso in 2013 for rosacea treatment.
Timopticis the brand name
Combigan Overview & Background
Brand Name
Generic Name
First FDA Approval
How many FDA approvals?
Timoptic
Timolol
1978
167
Effectiveness
How Combigan Affects PatientsBrimonidine is an alpha-2 adrenergic receptor agonist, which means it is designed to target and activate the alpha-2 adrenergic receptor. This helps reduce the risk of side effects such as low blood pressure, slow heart rate, and drowsiness. Brimonidine also reduces the chances of unwanted eye effects caused by alpha-1 receptors, like blanching, pupil dilation, and eyelid retraction. After two hours, brimonidine helps reduce eye pressure, and can maintain this effect for up to a year. Additionally, it can reduce inflammation and redness in the skin, and may even have neuro
How Combigan works in the bodyBrimonidine is commonly used to treat glaucoma and facial redness. In the eye, it works by activating alpha-2 adrenoceptors, which reduces norpinephrine activity, decreases aqueous humor production, and increases uveoscleral outflow. This helps to lower intraocular pressure which reduces the risk of vision loss. When applied topically to the skin, brimonidine constricts blood vessels, reducing redness and inflammation. This makes it effective for treating facial redness caused by rosacea.
When to interrupt dosage
The recommended dose of Combigan is contingent upon the identified condition, including Open Angle Glaucoma, facial erythema and Ocular Hypertension. The extent of dosage changes as per the technique of delivery featured in the table below.Condition
Dosage
Administration
insufficient response to beta-blockers
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
Migraine
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
Open-angle glaucoma
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
Ocular Hypertension
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
inadequate response to other therapeutic measures
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
prophylaxis of migraine headaches
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
Open Angle Glaucoma
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
requiring adjunctive or replacement therapy
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
Increased Intra Ocular Pressure (IOP)
5.0 mg/mL, , 5.0 mg, 10.0 mg, 20.0 mg, 2.5 mg/mL, 6.8 mg/mL, 6.83 mg/mL, 2.56 mg/mL, 5.12 mg/mL, 0.5 %, 0.25 %, 3.4 mg/mL, 0.1 mg/mL
, Ophthalmic, Solution, Solution - Ophthalmic, Oral, Tablet, Tablet - Oral, Solution / drops, Solution / drops - Ophthalmic, Solution, gel forming, extended release, Solution, gel forming, extended release - Ophthalmic, Liquid, Liquid - Ophthalmic, Suspension / drops, Suspension / drops - Ophthalmic, Suspension, Suspension - Ophthalmic, Solution, gel forming / drops, Solution, gel forming / drops - Ophthalmic
Warnings
Combigan ContraindicationsCondition
Risk Level
Notes
Lung Diseases, Obstructive
Do Not Combine
Sinus Bradycardia
Do Not Combine
Shock, Cardiogenic
Do Not Combine
second or third degree AV block
Do Not Combine
Asthma
Do Not Combine
overt cardiac failure
Do Not Combine
Severe Hypersensitivity Reactions
Do Not Combine
Timolol may interact with Pulse Frequency
Common Combigan Drug Interactions
Drug Name
Risk Level
Description
4-Bromo-2,5-dimethoxyphenethylamine
Major
The therapeutic efficacy of 4-Bromo-2,5-dimethoxyphenethylamine can be decreased when used in combination with Timolol.
4-Methoxyamphetamine
Major
The therapeutic efficacy of 4-Methoxyamphetamine can be decreased when used in combination with Timolol.
Abediterol
Major
Timolol may decrease the bronchodilatory activities of Abediterol.
Adrafinil
Major
The therapeutic efficacy of Adrafinil can be decreased when used in combination with Timolol.
Agrostis gigantea pollen
Major
The risk of a hypersensitivity reaction to Agrostis gigantea pollen is increased when it is combined with Timolol.
Combigan Toxicity & Overdose RiskThe toxic dose of brimonidine in mice is 50 mg/kg, and in rats it is 100 mg/kg. Overdosing on brimonidine can cause low blood pressure, weakness, vomiting, drowsiness, slow heart rate, abnormal heart rhythms, narrowed pupils, difficulty breathing, low body temperature, and seizures. Treatment for a brimonidine overdose includes supportive care. Based on animal studies, brimonidine was not found to cause birth defects or fertility problems. It is not recommended to use brimonidine in pregnant or breastfeeding women, infants under the age of 2, or pediatric patients under the age of 18.
Combigan Novel Uses: Which Conditions Have a Clinical Trial Featuring Combigan?
114 active trials are underway to assess the potential of Combigan in providing relief from Open Angle Glaucoma, inadequately controlled intraocular pressure and Open Angle Glaucoma.Condition
Clinical Trials
Trial Phases
Increased Intra Ocular Pressure (IOP)
0 Actively Recruiting
Open-angle glaucoma
84 Actively Recruiting
Phase 3, Not Applicable, Phase 1, Phase 2, Phase 4, Early Phase 1
prophylaxis of migraine headaches
0 Actively Recruiting
requiring adjunctive or replacement therapy
0 Actively Recruiting
Migraine
52 Actively Recruiting
Not Applicable, Phase 1, Phase 2, Phase 3, Phase 4, Early Phase 1
inadequate response to other therapeutic measures
0 Actively Recruiting
insufficient response to beta-blockers
0 Actively Recruiting
Ocular Hypertension
22 Actively Recruiting
Phase 1, Phase 2, Not Applicable, Phase 3, Phase 4
Open Angle Glaucoma
12 Actively Recruiting
Not Applicable, Phase 3, Phase 2
Combigan Reviews: What are patients saying about Combigan?
5Patient Review
7/8/2015 My eyes are very red, is this normal? Should I seek additional treatment for the redness?
5Patient Review
7/1/2020 I have experienced some weight gain and swelling in my extremities since starting this medication, but it has been effective in keeping my blood pressure low. I take Lantus at night and Novolog 2x per day.
5Patient Review
6/29/2018 I started with an IOP of 30 in each eye. My doctor prescribed Latanoprost once daily in each eye, but after a month there was no effect. They switched me to Combigan, and after 3 weeks of using it 2X per day my IOP was down to 19 in each eye. I introduced 1 drop in each eye in the morning, and again in the evening about 12 hours later, and that did the trick!
4Patient Review
8/4/2016 I've been using Combigan for a little over a month and a half, and it's done an amazing job of reducing the pressure in my eyes. However, I have started to experience increased pain and stiffness in my muscles, which makes everyday tasks like getting out of bed or sitting in a chair for too long very painful. Has anyone else had this side effect?
4Patient Review
10/12/2014 In combination with azopt, this treatment effectively lowered my eye pressure to a normal range.
4Patient Review
2/23/2018 Combigan has been effective in reducing the pressure inside my eyes. However, I do feel tired after using it and my blood pressure drops for a few hours afterwards.
3.7Patient Review
12/21/2013 Even though this medication decreased the pressure in my eye, I stopped using it because it felt like there was a piece of glass in my eye and it hurt every time I blinked. My eye is still scratchy and irritated even though I've discontinued use over a week ago.
3.7Patient Review
2/6/2014 This medication was successful in reducing my intraocular pressure.
3.3Patient Review
5/3/2014 I experienced a significant drop in blood pressure and pulse after using Combigan. My average pulse would fall from 70 to 45-50 within two hours of application. I had to drink coffee frequently to avoid syncope. However, I developed severe allergic conjunctivitis after 8 months and my ophthalmologist advised me to discontinue use.
3.3Patient Review
6/11/2014 Though it is effective, the level of fatigue it produces has become problematic. I will look for other options.
3.3Patient Review
9/15/2021 It lowered my eye pressure, but it's quite pricey. My doctor recommended I switch to two separate drops which work just as well and cost much less.
3Patient Review
2/19/2018 I started taking Combigan under a doctor's care in April 2017. After about a month, I began feeling dizzy to the point where I couldn't stand without support. This light-headedness persisted for months. Additionally, after nine months of treatment with Combigan, my eye became very red and my eyelid drooped noticeably, changing my appearance significantly. These side effects were too much to bear so I stopped taking the medication, even though it was effectively lowering my eye pressure.
2.7Patient Review
2/9/2018 I developed macular edema after only three weeks of using this product! My doctor discontinued it immediately, but I'm still dealing with the aftermath.
2.3Patient Review
6/11/2014 Unfortunately, this medication caused my fingers, ankles and knee to swell painfully. I had to stop taking it immediately.
2.3Patient Review
10/25/2022 It did lower my blood pressure, but it was very expensive. I also experienced some pretty intense side effects, like redness and black rings around my eyes. Overall, I thought the medicine was too strong for me and stopped taking it.
1Patient Review
2/14/2014 My doctor recommended conbigan instead of timoptic xe. However, after only four days of using it, my eyes and cheeks became swollen and bloodshot. I also felt immense pain and had difficulty sleeping or seeing clearly. Needless to say, I stopped using the drops.
Patient Q&A Section about combigan
These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.How long can I use Combigan?
"eye drops expire four weeks after opening"
Answered by AI
Is Combigan a good eye drop?
"Researchers examined the effect of Combigan and brimonidine 0.2% plus a beta-blocker on increased eye pressure in children aged 2-16. They found that Combigan is safe and effective for this purpose."
Answered by AI
What is the drug Combigan used to treat?
"This combination medication lowered high pressure inside the eye due to glaucoma (open-angle type) or other eye diseases (such as ocular hypertension). By lowering high pressure inside the eye, it helps to prevent blindness. This product contains brimonidine and timolol."
Answered by AI
What is the generic for Combigan?
"- The U.S. Food and Drug Administration today approved brimonidine tartrate/timolol maleate ophthalmic solution 0.2%/0.5% (Alphagan P/Travatan Z), a generic version of AbbVie Inc.'s Combigan, for the reduction of intraocular pressure in patients with ocular hypertension or open-angle glaucoma.
The U.S. Food and Drug Administration today approved a generic version of AbbVie Inc.'s Combigan, for the reduction of intraocular pressure in patients with ocular hypertension or open-angle glaucoma."
Answered by AI