Trade Names:Cosopt- Solution 2% dorzolamide, 0.5% timololCosopt, Preservative Free (Canada)
Inhibits carbonic anhydrase enzyme, reducing rate of aqueous humor formation thus lowering IOP (dorzolamide); reduces elevated and normal IOP via decreasing production of aqueous humor or increasing flow (timolol).
Reduction of IOP in patients with ocular hypertension or open-angle glaucoma.
Bronchial asthma; history of bronchial asthma; severe COPD; sinus bradycardia; second or third degree AV block; overt cardiac failure; cardiogenic shock; hypersensitivity to any component of product.
If using other topical ophthalmic drugs, separate each medication by at least 5 min.Adults
Ophthalmic 1 drop in affected eye(s) twice daily.
Store at controlled room temperature. Keep container tightly closed and protected from light.
Although not reported with ophthalmic use of dorzolamide, oral administration has caused acid-base and electrolyte disturbances, which may interfere with renal elimination of certain drugs (eg, salicylates).Beta-adrenergic blocking agents
Potential additive effect on beta blockade.Calcium antagonists
Possible increased risk of AV conduction disturbances, left ventricular failure, and hypotension.Carbonic anhydrase inhibitors
Potential additive effect on patients receiving an oral carbonic anhydrase inhibitor.Catecholamine-depleting drugs (eg, reserpine)
Possible additive effect with timolol, producing hypotension and bradycardia, which may result in vertigo, syncope, and postural hypotension.Clonidine
Increased risk of rebound hypertension following clonidine withdrawal may be exacerbated.Digitalis and calcium antagonists
With these agents, timolol has an additive effect in prolonging atrioventricular conduction.Quinidine
Systemic effect of timolol may be potentiated because of increased plasma levels (eg, decreased heart rate).
None well documented.
Hypertension; bradycardia; cardiac failure; cerebral vascular accident; chest pain; hypotension; MI; arrhythmias, syncope, heart block, cerebral ischemia, worsening of angina pectoris, palpitations, cardiac arrest, edema, claudication (timolol).
Dizziness; headache; depression; fatigue; signs and symptoms of myasthenia gravis, somnolence, insomnia, nightmares, behavioral changes, psychic disturbances (eg, confusion), hallucinations, anxiety, disorientation, nervousness, memory loss (timolol).
Contact dermatitis (dorzolamide); alopecia, psoriasiform rash, exacerbation of psoriasis, pruritus, urticaria (timolol).
Ocular burning and stinging; conjunctival hyperemia; blurred vision; superficial punctate keratitis; eye itching; blepharitis; cloudy vision; conjunctival discharge, edema, follicles, or infection; conjunctivitis; corneal erosion; corneal staining; cortical lens opacity; cough; dry eyes; eye debris, discharge, pain, tearing, or edema; eyelid erythema, exudates, scales, pain or discomfort; foreign body sensation; glaucomatous cupping; lens nucleus coloration; lens opacity; nuclear lens opacity; pharyngitis; post-subcapsular cataract; sinusitis; visual field defect; vitreous detachment; throat irritation, eyelid crusting, transient myopia (dorzolamide); ptosis, decreased corneal sensitivity, cystoid macular edema, visual disturbances (eg, refractive changes, diplopia), pseudopemphigoid, choroidal detachment after filtration surgery, tinnitus (timolol).
Bitter, sour, or unusual taste; abdominal pain; dyspepsia; nausea; anorexia (timolol).
UTI; urolithiasis; retroperitoneal fibrosis, impotence, Peyronie disease (timolol).
Bronchitis; influenza; upper respiratory infection; respiratory failure; pulmonary edema, bronchospasm (timolol).
Back pain; allergic hypersensitivity, asthenia (dorzolamide/timolol); systemic lupus erythematosus, Reynaud phenomenon, cold hands and feet, decreased libido (timolol).
Ensure that IOPs have been measured and documented in the patient's record.
Category C .
Excreted in breast milk.
Safety and efficacy not established.
Inhibition of beta-adrenergic receptor blockade may precipitate more severe cardiac failure in patients with diminished myocardial contractility.
Use with caution; beta-adrenergic blocking agents may mask the signs and symptoms of acute hypoglycemia.
Some patients receiving beta-adrenergic receptor blocking agents have experienced protracted severe hypotension during surgery.
Beta-adrenergic blocking agents may mask certain signs of hyperthyroidism (eg, tachycardia); abrupt withdrawal of agent may precipitate thyroid storm.
Electrolyte imbalance, acidotic state, dizziness, headache, shortness of breath, bradycardia, bronchospasm; cardiac arrest, possible CNS effects.
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