How does the drug "Azarga" (eye drops)? Instructions for this tool, its side effects, contraindications and indications for use will be presented in this article. In addition, you will learn about the pharmacological characteristics of this drug, how and in what dosages it should be used, what will happen in case of an overdose, etc.
The form of release of the local drug and its composition
In what form does the drug "Azarga" enter the pharmacy? Eye drops are the only form of release of the medication. 1 ml of the drug contains such active ingredients as timolol in the form of maleate in a volume of 5 mg and brinzolamide (in an amount of 10 mg).
It should also be noted that the mentioned medication “Azarga” includes auxiliary elements. These include mannitol, disodium edetate, sodium hydroxide, sodium chloride, 50% benzalkonium chloride tyloxapol and purified water. Drops of "Azarga" are sold in a 5 ml dropper bottle.
Pharmacological characteristics of the drops
What are the properties of the drug "Azarga" (eye drops), the instructions for which are contained in a cardboard box along with the drug? As mentioned above, the presented medication includes 2 main active components. These are timolol and brinzolamide. The latter is an inhibitor of carbonic anhydrase II. Thanks to it, the formation of bicarbonate ions in the human body slows down, and subsequently, the transportation of sodium and liquid decreases. This process leads to a decrease in the production of ocular fluid in the ciliary body of the visual organ. As a result of this, a decrease in intraocular pressure occurs.
As for timolol, it is a beta-blocker, which does not irritate the sympathetic nervous system, and does not inhibit the heart muscle. After topical use, it reduces the formation of moisture and increases its outflow.
Pharmacokinetics of the drug
Is Azarga (eye drops) absorbed? The instructions for this tool say that when used locally, active ingredients such as timolol and brinzolamide are able to penetrate the systemic circulation. The latter substance is absorbed in red blood cells after selective binding to carbonic anhydrase II. Its connection with plasma proteins is approximately 60%.
Brinzolamide is metabolized by O-dealkylation, N-dealkylation and oxidation of the N-propyl side chain. It is excreted by the kidneys unchanged in the amount of 60%. At the same time, 20% leaves the human body in the form of metabolites.
Timolol absorption period is 5 hours after topical use of the drug. The metabolism of this substance occurs in two ways: with the formation of a side ethanolamine chain on the thiadiazole ring, as well as with the formation of a side ethanol chain at morpholine nitrogen and with a carbonyl group that is connected to nitrogen.
Timolol, as well as the resulting metabolites, are excreted mainly through the kidneys. About 20% of the substance is excreted unchanged.
Indications for use of the drug
In what cases use the drug "Azarga"? Eye drops are prescribed with a decrease in increased intraocular pressure, which is formed due to open-angle glaucoma. Also, it is often prescribed to patients with intraocular hypertension. But this is only if monotherapy was not enough to lower the pressure.
Contraindications to the use of local remedies
In what cases can I not use the drug "Azarga" (eye drops)? The instruction for this tool contains a fairly large list of contraindications. Consider it right now:
- hypersensitivity of the patient to sulfonamides;
- bronchial asthma, including a history of;
- hypersensitivity to the elements of the drug;
- obstructive chronic lung disease, which is very difficult;
- hyperchloremic acidosis;
- bronchial hyperreactivity;
- hypersensitivity to beta-blockers;
- sinus bradycardia;
- children's age (up to 18 years);
- AV block II and III degree;
- lactation period;
- heart failure (severe);
- pregnancy period;
- cardiogenic shock;
- concomitant use with carbonic anhydrase inhibitors (oral);
- allergic rhinitis, which is extremely difficult;
- angle-closure glaucoma;
- severe renal failure.
Cautious medication
Now you know at what abnormalities it is not recommended to use the Azarga medication. Instructions for use of this tool contain information on when it should be prescribed with great care. Such a list includes patients with Prinzmetal angina, hyperthyroidism, impaired central, peripheral circulation and arterial hypotension.
It should also be noted that for the treatment of patients with pigmented and pseudoexfoliation glaucoma, the medication is limited. In such cases, it is necessary to regularly monitor intraocular pressure.
With caution, the drug must be prescribed to patients with anaphylactic reactions. This fact is due to the fact that such patients receiving beta-blockers become resistant to the usual dosages of adrenaline in the treatment of anaphylactic reactions.
As mentioned above, timolol and brinzolamide are able to undergo systemic absorption. In this case, the first component can cause side effects from the respiratory system, heart and blood vessels. In this regard, it is recommended to monitor the patient's condition before and during treatment.
Beta-blockers are prescribed with extreme caution to patients with diabetes and a tendency to hypoglycemia. This is due to the fact that such agents can easily mask signs of acute hypoglycemia.
Before surgery, beta-blockers should be phased out (2 days). Indeed, during general anesthesia, they are able to reduce the sensitivity of the myocardium to stimulation (sympathetic), which is extremely necessary for the work of the heart.
The drug "Azarga", reviews of which will be presented later, contains brinzolamide, which is a sulfonamide. Due to the fact that with local use, systemic absorption of the drug occurs, patients may experience adverse reactions that are characteristic of these substances.
Side effects
Eye drops “Azarga”, the price of which is quite high, have an extensive number of side effects. We will describe them in more detail.
- Local reactions of patients to the drug. In 10% of cases, patients have conjunctival hyperemia, corneal erosion, dry eye syndrome, blurred vision, irritation of the visual organs, and a feeling of a foreign body. In 1% of cases, patients have point keratitis, discharge from the eyes, allergic conjunctivitis, itching in the eye, eye pain, effusion in the anterior chamber, blepharitis, discomfort in the eyes, crusting on the edges of the eyelids, erythema of the eyelids and asthenopia.
- Systemic side effects. In 10% of cases, dysgeusia is noted, and in 1% - a decrease in blood pressure, insomnia, rhinorrhea, obstructive chronic pulmonary disease, impaired hair growth, pain in the oropharynx, lichen planus and cough.
It should also be noted that an active substance such as brinzolamide can cause the following deviations: mydriasis, keratitis, eyelid edema, keratopathy, eye swelling, increased excavation of the optic nerve head, subconjunctival cyst, corneal epithelium defect, pigmentation of the cornea, increased intraocular pressure, deposition on the cornea, allergic reactions of the eye, formation of corneal defects, visual impairment, corneal edema, conjunctivitis, increased lacrimation, inflammation of the meibomian glands, eye hypesthesia, diplopia, dry kerat conjunctivitis, photophobia, pterygium, decreased visual acuity and photopsia. Among the systemic side effects are apathy, depression, decreased libido, memory impairment, nightmares, motor dysfunctions, drowsiness, nervousness, amnesia and disorders of the central nervous system.
For the treatment of side effects, supportive and symptomatic therapy is used. In this case, rinse your eyes immediately with cool water.
The drug "Azarga" (eye drops): instructions
The price of this medicine may vary, depending on the pharmacy network. Use the drug presented only locally. Shake well before use.
At what dosage are Azarg drops prescribed? The instruction for this tool contains comprehensive information on this subject. According to her, the drug is prescribed one drop in each conjunctival sac of the eye. It is advisable to carry out this procedure twice a day.
In order to avoid the development of systemic side effects after using the medication, light pressure on the inner corner of the eye with your fingers (on the projection area of the lacrimal sacs) is recommended. Such a process should last at least two minutes. This significantly reduces the systemic absorption of the drug.
If the use of the medication was missed, then therapy should be continued on schedule with the next dose. In this case, the dose should in no case exceed one drop in each conjunctival sac twice a day.
In the event that the doctor has replaced any anti-glaucoma drug with Azarga, it is recommended to use it only the next day.
Overdose
Currently, no information on overdose cases has been reported. However, in such situations, there is a possibility of increased side effects.
Special instructions when using the medication, reviews
What features do Azarg eye drops have? Patient reviews about them are very mixed. For example, in older people, carbonic anhydrase inhibitors, which are used orally, can directly affect the ability to engage in activities that require increased coordination or attention. This effect should be taken into account by doctors when prescribing a medication.
With topical use of the drug in patients who wear contact lenses, it is necessary to monitor the condition of the cornea. This is due to the fact that carbonic anhydrase inhibitors often lead to a violation of its hydration. It is recommended to remove the lens before use. It is advisable to install them back no earlier than ¼ hours after using the drug.
It is highly recommended not to touch the tip of the bottle to any surface. Otherwise, contamination may occur. After using the medication, the dropper should be closed immediately.
Interaction with other medicines
How much are Azarg eye drops? Their price is quite high. In some pharmacy chains, such a topical preparation can be purchased for 950-1050 Russian rubles.
With the simultaneous use of the drug with oral carbonic anhydrase inhibitors (for example, Diakarb, Sulfadiurin, Fonurit, Glaupaks, Dilamox, etc.), an increase in systemic side effects is possible.
With extreme caution, this tool is combined with troleandomycin, ketoconazole, ritonavir, itraconazole and clotrimazole.
There is a possibility of increased hypotensive effect and slowed heart rate when taking the active element - timolol - with calcium channel blockers (for example, Verapamil, Amlodipine, Diltiazem, etc.), beta-blockers, guanethidine, parasympathomimetics, cardiac glycosides and agents for treating heart rhythm disturbances.
A decrease in heart rate is observed with the simultaneous use of quinidine or cimetidine with substances.
Analogue of eye drops "Azarga"
Almost all drugs have their own analogues. This makes it possible not to stop treatment of an existing disease even in the absence of a medication prescribed by a doctor.
So what is the best “Azarga” eye drop analogue? It is rather difficult to unequivocally answer the question posed. After all, all similar drugs are good in their own way. Moreover, they can have completely different side effects and contraindications. In this regard, before using them, you should definitely consult a doctor.
So what to do if the patient could not get the Azarga eye drops? An analogue of this tool can always be found in a pharmacy. To do this, you only need to remember its name.
So, the following drugs (eye drops) are analogues of the medication presented:
- Timolol-Teva.
- Oftan Timolol.
- Anaprilin.
- Duoprost.
- Arutimol.
- Betalmic EU.
- Timolol bufus.
- Timadren.
- Betoptic.
- Timolol-AKOS.
- "Betoptic C".
- "Timolol-DIA."
- "Betoftan."
- Timolol-LENS.
- Ganfort.
- Timolol-Betalek.
- Glautam.
- "Timolol pos."
- DuoTrav.
What other medicines can replace the drug "Azarga"? An analogue of this tool must necessarily include the same active components. Among these drugs, the following can be noted:
- Timolol.
- Betaxolol.
- Timolol-MEZ.
- "Okupres-E".
- "Combigan".
- "Okumol."
- “Xalac.”
- TimoHexal.
- Ophthalm Timogel Eye Gel.
- "Xonef."
- Optibetol.
- Eye gel "Niolol".
- "Xonef BK".
- "Timolollong."
- "Okucker";
- Eye drops without Timolol-Pos preservative.
- "Okamed" and so on.