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Brimonidine / timolol

Glaucoma · Rx
Trade namesCombigan
Drug classFixed combination, alpha-2 agonist + beta-blocker
StrengthBrimonidine 0.2% + timolol 0.5%
AvailabilityRx
Mechanism of actionAlpha-2 agonist (reduced production + increased uveoscleral outflow) with a beta-blocker (reduced production).
Indication / reason for useOpen-angle glaucoma / ocular hypertension needing more than one agent.
Usual adult dosing1 drop twice daily.
PreservativeBAK 0.005%
Contact lensesRemove lenses; reinsert after 15 minutes.
Common / important adverse effectsOcular allergy (brimonidine), fatigue/drowsiness, dry mouth, plus systemic beta-blocker effects.
Contraindications & cautionsChildren <2 y and caution <7 y (brimonidine); MAOIs; reactive airway disease, bradycardia/AV block/heart failure (timolol).
Pregnancy / lactationAvoid; stop brimonidine component before delivery.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.

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