Latanoprost + Timolol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Ophth Ocular HTN; Open-angle glaucoma As soln containing latanoprost 0.005% and timolol 0.5%: Instill 1 drop once daily.
Dosage Details
Ophthalmic
Ocular hypertension, Open-angle glaucoma
Adult: As eye preparation containing latanoprost 0.005% and timolol 0.5%: Instill 1 drop into the affected eye(s) once daily. Not to be used as an initial therapy.
Contraindications
Reactive airway diseases e.g.bronchial asthma or a history of bronchial asthma, severe COPD. Sinus bradycardia, 2nd or 3rd degree AV block, overt cardiac failure, cardiogenic shock.
Special Precautions
Monitor heart rate and signs of cardiac failure in patients with history of severe cardiac disease. May worsen Prinzmetal angina, severe peripheral and central circulatory disorders and hypotension. Monitor for signs of bronchospasm in asthmatic patients. β-blockers may mask signs and symptoms of acute hypoglycaemia and hyperthyroidism. Prolonged treatment with latanoprost may change eye colour by increasing the amount of brown pigment in the iris especially in patients with mixed coloured irides; regular eye examination is recommended. Caution when used in aphakic patients due to risk of macular oedema. Contact lenses should be removed during application and reinserted at least 15 minutes after application. May cause transient blurring of vision; patients should not drive or operate machinery until this resolves. Pregnancy and lactation.
Adverse Reactions
Increased iris pigmentation, eye irritation, eye pain, stinging and burning sensation. Rarely, bradycardia, arrhythmia, CHF, bronchospasm and allergic reactions.
Overdosage
Symptoms of systemic timolol overdose: Bradycardia, hypotension, bronchospasm and cardiac arrest. Treatment is symptomatic and supportive. Latanoprost overload can cause ocular irritation and conjunctival hyperaemia, no other ocular or systemic side effects are known. If latanoprost is accidentally ingested orally, gastric lavage may be used. Treatment is symptomatic and supportive.
Drug Interactions
Additive effect on the intraocular pressure and other systemic effects may occur when used with oral β-blockers, calcium channel blockers, guanethidine, antiarrhythmics, digitalis glycosides or parasympathomimetics. Concurrent use of ≥2 ophthalmic prostaglandin analogues may lead to paradoxical increase in intraocular pressure. Mydriasis may occur when used concurrently with epinephrine. β-blocker may increase hypoglycaemic effect of antidiabetic agents.
Action
Description: Latanoprost is an analogue of prostaglandin F; it reduces intraocular pressure (IOP) by increasing outflow of aqueous humour. Timolol is a non-selective adrenergic blocker. It lowers IOP by decreasing the formation of aqueous by the ciliary epithelium.
Pharmacokinetics:
Absorption: Latanoprost: Well-absorbed through the cornea; a prodrug that is activated by the esterases in the cornea.
Distribution: Latanoprost: Active metabolite has a small volume of distribution of 0.16 L/kg and protein binding of 87%.
Metabolism: Latanoprost: Active metabolite is mainly metabolised hepatically. Timolol: Largely metabolised in the liver.
Excretion: Latanoprost: Plasma half-life of active metabolite is about 17 minutes and the metabolites are excreted primarily in the urine. Timolol: Plasma half-life is about 6 hr and the metabolites are mainly excreted in the urine.
Storage
Store at 2-8°C. For opened bottles, may store below 25°C.
Disclaimer: This information is independently developed by MIMS based on Latanoprost + Timolol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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