Latanoprost & Timolol Stada

Latanoprost & Timolol Stada Special Precautions

latanoprost + timolol

Manufacturer:

Stada

Distributor:

HK Medical Supplies
/
Health Express
Full Prescribing Info
Special Precautions
Systemic effects: Like other topically applied ophthalmic agents, Latanoprost and Timolol may be absorbed systemically. Due to the beta-adrenergic component Timolol, the same types of cardiovascular and pulmonary adverse reactions as seen with systemic beta-blockers may occur.
In patients with cardiovascular diseases (e.g. coronary heart disease, Prinzmetal's angina, cardiac failure) and hypotension therapy with beta-blockers should be critically assessed and treatment with other active substances should be considered. Patients with cardiovascular diseases should be watched for signs of deterioration of these diseases and adverse reactions.
Respiratory reactions, including death due to bronchospasm in patients with asthma have been reported following administration of some ophthalmic beta-blockers.
Beta-blockers should be administered with caution in patients subject to spontaneous hypoglycaemia or to patients with labile diabetes, as beta-blockers may mask the signs and symptoms of acute hypoglycaemia.
Beta-blockers may also mask the signs of hyperthyroidism.
Anaphylactic reactions: While taking beta-blockers, patients with a history of atopy or a history of severe anaphylactic reaction to a variety of allergens may be unresponsive to the usual doses of adrenaline used to treat anaphylactic reactions.
Concomitant therapy: Timolol may react with other drugs.
The effect on intraocular pressure or the known effects of systemic beta-blockade may be potentiated when Timolol is given to patients already receiving an oral beta-blocking agent. The use of two local beta-blockers is not recommended.
Ocular effects: Latanoprost may gradually change the eye colour by increasing the amount of brown pigment in the iris. Similar to experience with Latano­prost eye drops, increased iris pigmentation was seen in 16-20% of all patients treated with Latanoprost/Timolol for up to one year (based on photographs). This effect has predominantly been seen in patients with mixed coloured irides, i.e. green-brown, yellow-brown, or blue/grey-brown, and is due to increased melanin content in the stromal melanocytes of the iris. Typically the brown pigmentation around the pupil spreads concentrically towards the periphery in the affected eyes, but the entire iris or parts of it may become more brownish. In patients with homogeneously blue, grey, green or brown eyes, the change has only rarely been seen during two years of treatment in clinical trials with Latanoprost.
The change in iris colour occurs slowly and may not be noticeable for several months to years and it has not been associated with any symptom or pathological changes. No further increase in brown iris pigment has been observed after discontinuation of treatment, but the resultant colour change may be permanent.
Neither naevi nor freckles of the iris have been affected by treatment.
Accumulation of pigment in the trabecular meshwork or elsewhere in the anterior chamber has not been observed but patients should be examined regularly and, depending on the clinical situation, treatment may be stopped if increased iris pigmentation ensues. Before treatment is instituted patients should be informed of the possibility of a change in eye colour. Unilateral treatment can result in permanent heterochromia.
Latanoprost has no or little effect on the pupil but there is no documented experience in acute attacks of closed angle glaucoma. It is recommended, therefore, that Latanoprost/Timolol should be used with caution in these conditions until more experience is obtained.
Macular edema, including cystoids macular edema, has been reported during treatment with Latanoprost. These reports have mainly occurred in aphakic patients, in pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema. Latanoprost/Timolol should be used with caution in these patients.
Choroidal detachment has been reported with administration of aqueous suppressant therapy (e.g. timolol, acetazolamide) after filtration procedures.
Use of contact lenses: Latanoprost and Timolol contains benzalkonium chloride, which is commonly used as a preservative in ophthalmic products. Benzalkonium chloride has been reported to cause punctuate keratopathy and/or toxic ulcerative keratopathy, may cause eye irritation and is known to discolour soft contact lenses. Close monitoring is required with frequent or prolonged use of Latanoprost and Timolol in dry eye patients, or in conditions where the cornea is compromised. Contact lenses may absorb benzalkonium chloride and these should be removed before instillation of the eye drops and may be reinserted after 15 minutes.
Effects on Ability to Drive and Use Machines: Instillation of eye drops may cause transient blurring of vision. Until this is resolved, patients should not drive or use machines.
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