Instruction for use: Pilocarpine + Timolol (Pilocarpinum+ Timololum)

Pharmacotherapeutic group:

m-Holinomimetiki in combinations

Beta-blockers in combination

Ophthalmic agents in combination

Pregnancy and breast-feeding

Category effects on the fetus by FDA - C.

Pharmacological action

Combined antiglaucoma drug for local use. Pilocarpine - m-cholinomimetic when applied topically cause contraction of smooth muscles of the circular muscle of the iris, which leads to an increase in the anterior chamber angle reconfiguration trabecular zone of intraocular fluid enhancement of the anterior chamber and to reduce intraocular pressure. Timolol - a beta-blocker, reduces the formation of intraocular fluid, reduces intraocular pressure. When systemic absorption may cause resorptive effect, characteristic of the M-cholinomimetics and beta-blockers.

Pharmacokinetics

Reduce the formation of intraocular fluid, timolol reduces the rate of excretion of pilocarpine from the eye.

Indications

Open-and-closure glaucoma, secondary glaucoma (including on the background aphakia), ocular hypertension (including postoperative period).

Contraindications

Hypersensitivity, acute iritis, COPD, bronchial asthma; sinus bradycardia, AV block II-III century., heart failure, cardiogenic shock.

Precautions

Stroke, hypoglycemia, before surgery with general anesthesia in patients receiving beta-blockers inside, pregnancy, lactation.

Dosing

1 cap 2 in the affected eye twice a day. After reaching a stable satisfactory intraocular pressure (at 4 weeks after initiation of treatment) prescribed maintenance dose - 1 cap in the affected eye once a day 1.

Side effect

The burning sensation, eye pain, spasm of the ciliary muscle, conjunctival hyperemia induced myopia; decrease in visual acuity in low light (due to miosis); rigidity of the iris, the iris cyst, retinal detachment. With prolonged use - clouding of the lens; corneal anesthesia, punctate keratitis, "dry eye" syndrome, allergic Blepharoconjunctivitis, dermatitis century; nausea, vomiting, diarrhea; increased sweating, salivation; decrease in blood pressure; headache, fatigue, redness of the mucous membrane of the nasal cavity; bronchospasm; arrhythmia; hallucinations, confusion.

Overdose

Symptoms: bradycardia, decreased blood pressure, bronchospasm, acute heart failure.

Treatment: symptomatic. Atropine (as an antidote pilocarpine). Isoprenaline - in severe bradycardia, bronchospasm; dobutamine - while lowering blood pressure; cardiac glycosides, diuretics - in acute heart failure.

Interaction

BCCI increase the risk of AV conduction disorders and hypotension.

PM violating deposit catecholamines (reserpine), - marked reduction of blood pressure (including orthostatic hypotension), bradycardia, dizziness.

Concomitant use of beta-blockers for systemic effects leads to a strengthening of their pharmacological effect.

Special instructions

Before treatment the day before cancel others. Antiglaucoma drugs.

Evaluation of the effectiveness of actions should be carried out within 4 weeks after starting treatment. Measurement of intraocular pressure is carried out at different times of the day. With long-term appointment may develop resistance.

The drug can cause a "chicken" blindness (be careful when road management in low light conditions).

In the case of the upcoming surgery with general anesthesia, it is necessary to cancel the drug 48 hours before the operation, because timolol increases the effects of muscle relaxants and general anesthetics.

Patients wearing soft contact lenses, you should remove them before using the drops and use 15 minutes after instillation.