Treatment of elevated IOP in adult patients with open-angle glaucoma or ocular HTN for whom monotherapy provides insufficient IOP reduction.
Drugs for miotics and glaucoma
Brinzolamide is a potent inhibitor of human carbonic anhydrase II (CA-II), the predominant iso-enzyme in the eye. Inhibition of CA-II in the ciliary processes of the eye decreases aqueous humour secretion, presumably by slowing the formation of bicarbonate ions with subsequent reduction in sodium and fluid transport.
Timolol is a non-selective beta-adrenergic blocking agent that has no intrinsic sympathomimetic, direct myocardial depressant or membrane-stabilising activity. Tonography and fluorophotometry studies in man suggest that its predominant action is related to reduce aqueous humour formation and a slight increase in outflow facility. These two components decrease elevated intraocular pressure (IOP) primarily by reducing aqueous humour secretion, but do so by different mechanisms of action. The combined effect of these two active substances results in additional IOP reduction compared to either compound alone.
1 drop into the affected eye(s) twice daily
Ketoconazole, itraconazole, clotrimazole, ritonavir, troleandromycin; oral Ca-channel blockers, guanethidine, β-blockers, antiarrhythmics, digitalis glycosides, parasympathomimetics; quinidine, cimetidine.
Bronchial asthma, severe COPD, sinus bradycardia, 2nd or 3rd degree AV block, overt cardiac failure, cardiogenic shock, severe allergic rhinitis, bronchial hyperreactivity, hyperchloraemic acidosis, severe renal impairment. Control cardiac failure prior to therapy. History of severe cardiac & resp disease. Patients subject to hypoglycemia or labile insulin-dependent diabetes. May mask hyperthyroidism or worsen Prinzmetal's angina, severe peripheral & central circulatory disorders & hypotension. History of atopy or severe anaphylactic reaction to a variety of allergens. Avoid concomitant use of 2 local ?-adrenergic blockers or 2 local carbonic anhydrase inhibitors. Close monitoring of IOP in patients with pseudoexfoliative or pigmentary glaucoma. Narrow-angle glaucoma. Monitor patients with compromised corneas eg, patients with DM or corneal dystrophies. Remove contact lenses prior to application; reinsert after 15 min. May impair ability to drive or operate machinery. Pregnancy. Childn <18 yr.
Dysgeusia, blurred vision, eye pain & irritation, foreign body sensation.
Do not store above 30°C temperature. Keep away from light and wet place. Keep out of reach of children. To prevent contamination of the dropper tip and suspension, care should be taken, not to touch the eyelids, surrounding areas, finger or other surfaces with the dropper tip of the bottle. The bottle should be tightly closed when not in use. Do not use after 4 weeks of first opening.
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