Glaucoma in our time affects a large number of people, especially in old age. The disease is characterized by increased intraocular pressure and impaired visual function.
Conservative treatment of glaucoma, unfortunately, can not radically help with this disease, there is an opportunity to only slightly suspend the process of loss of vision. However, early diagnosis and regular use of drugs in accordance with the instructions and prescription of a doctor, can maintain functional eye health for a long time.
Drops for eyes "Combigan": instructions for use
To treat glaucoma and relieve symptoms, a large number of drugs have been developed, one of which is modern eye drops “Combigan”. Instructions are included in each package.
This is a combined anti-glaucoma medication designed to lower eye pressure. The main active components of the drug act together and enhance the effect of each other.
In this article, we will talk about how to use the drug correctly, are there any contraindications for use or its side effects.
Indications
Indications for the appointment of this drug are conditions such as:
- Glaucoma in an open form at the initial stage (a disease in which intraocular pressure constantly rises, which leads to a gradual atrophy of the optic nerve and affects the normal supply of nutrients to the eye tissues).
- Intraocular hypertension (in this condition, intraocular pressure is increased, but damage to the optic nerve is not observed).
- The period before and after surgery for glaucoma.
In addition, the drug is recommended for use when the use of local beta-adrenoreceptor blockers does not give the desired results. According to the instructions, “Combigan” eye drops are not recommended to be used alone; the ophthalmologist should prescribe the drug after establishing an accurate diagnosis.
Dosage
The drug is recommended for use by adult patients, including in old age. The medicine is instilled into the eyes one drop 2 times a day. Between doses of the drug should be at least 12 hours. This is best done in the morning and evening.
To reduce the penetration of the drug into the systemic circulation, after having instilled it, press the inner corner of the eye or close the eyelids tightly. This drug in combination therapy is perfectly combined with other ophthalmic drugs that reduce eye pressure.
When using several agents in treatment between their doses, a time interval of at least five minutes is necessary. This is confirmed by the instructions for use and reviews of "Combigan" in drops.
Composition and form of release
The described tool is an eye drop, produced in the form of a transparent sterile solution with a greenish-yellow tint. The medicine is packaged in plastic bottles of 3 or 5 ml, which are equipped with a built-in dropper. Glaucoma preparation "Combigan" is placed in a cardboard box with instructions for use.
The main active ingredients of the drug are timolol maleate and brimonidine tartrate. Brimonidine is an adrenergic agonist. It potentiates the outflow of intraocular fluid along the uveoscleral canal, and timolol inhibits the process of its formation. Their combined effect has a more tangible hypotensive effect than the use of these substances individually.
Auxiliary components are benzalkonium chloride, sodium hydroxide, dihydrogen phosphate sodium monohydrate, sodium hydrogen phosphate heptahydrate, water.
The components of the drug in a small amount enter the systemic circulation and are excreted by the kidneys. But even such a small amount can cause side effects.
Drug interaction
The combined use of eye drops "Combigan" (the instructions confirm this) with other drugs have not been specifically studied, so there is no detailed data on this. However, there is one group of drugs that the manufacturer warns about the interaction with, these are MAO inhibitors. Concomitant use of these drugs is contraindicated.
With caution, these drops should be used with medications that affect metabolism, since there is a risk of increased exposure to medications that inhibit the activity of the central nervous system of a person.
When taken with anesthetics, the active ingredients of Combigan can increase blood pressure. It is also not recommended to combine it with epinephrine, since it is possible to provoke a progression of mydriasis. The content of this substance in the blood increases under the influence of ethanol, cimetidine and hydralazine.
In addition, caution should be exercised while taking medications to lower blood pressure.
Contraindications
According to the instructions, the “Combigan” eye drops have a rather wide list of contraindications, as in most cases when potent drugs are used.
This medication is not prescribed for allergies to any component of the drops, for asthma, allergic rhinitis, bronchial obstruction, or severe lung pathologies. In addition, diseases of the cardiovascular system are also a contraindication, as well as the age of up to 18 years. This drug is not recommended for pregnant and lactating women. With caution, "Combigan" is used for:
- renal or liver failure;
- Raynaud's syndrome, depression, hypotension, thromboangiitis;
- diabetes accompanied by hypoglycemia;
- acidosis (metabolic);
- pheochromocytoma, the treatment of which was not performed. In this case, you need to consult a doctor about the need for the use of eye drops "Combigan", instructions and reviews confirm this.
Side effects
The most common side effects include inflammation of the conjunctiva of the eye and a burning sensation on the mucous membrane. In most cases, the symptoms are mild and do not require drug withdrawal.
This is indicated by the instruction for eye drops “Combigan”. Price and analogues will be presented below.
In addition, side effects can be expressed as:
- erosion of the cornea, pain in the eye area, visual impairment, itching of the skin, folliculosis, dry mucosa, blepharitis;
- hypertrophy, depression;
- headaches, drowsiness;
- increase in blood pressure;
- sensations of increased palpitations;
- dry mouth, rhinitis;
- taste disturbances;
- dermatitis, asthenia;
- arrhythmias, lowering blood pressure, tachycardia. This is confirmed by the instructions and reviews on eye drops "Combigan". The price interests many.
The active substance timolol also has other side effects, expressed as:
- ptosis, changes in refraction;
- decreased libido;
- sleep disturbances (many complain that they have nightmares);
- temporary loss of memory, ischemia, paresthesia, tinnitus;
- cardiac arrest;
- Raynaud's syndrome, cough, shortness of breath;
- diarrhea, as well as nausea;
- alopecia, psoriasis;
- Peyronie’s disease, peripheral edema, chest pain. What else describes the instructions for use for eye drops “Combigan”?
In case of accidental ingestion of the drug in a large dosage, the following manifestations may occur: apnea, depression of the central nervous system, dizziness, lowering blood pressure, bronchospasm, headaches, cardiac arrest.
In case of such an overdose, immediate hospitalization is required, in which the patient will be washed his stomach and prescribed intake of activated charcoal. Overdose with topical application requires only symptomatic treatment.
Storage
Storage of this medication is carried out at temperatures up to 30 degrees Celsius in a dry, dark and inaccessible place for children. The shelf life of the drug is 1 year and nine months. The open packaging of the Combigan drug (drops) does not allow storage for more than 28 days (instructions). User reviews confirm this.
"Combigan", eye drops: instructions, analogues
“Combigan” has many analogues, among which are the following:
- "Fotil." It contains an identical active substance - timolol maleate.
- Trusopt. The main component of the drug is dorzolamide.
- "Cosopt." This drug combines the two previous active ingredients: timolol and dorzolamide.
- "Pilocarpine." This is the most affordable analogue drug.
- "Azarga." The composition includes brinzolamide and timolol.
- Timolol. The main component, as the name implies, is timolol.
- Betoptic. Betaxolol predominates in the composition of this drug.
- "Travatan." The main active ingredient is travoprost.
- Xalatan. The active component of the drug is latanoprost.
Before using the drug, contact lenses must be removed. They can be installed back no earlier than in 15 minutes. This is due to the fact that the medicine has a high content of benzalkonium chloride, which can ruin the lenses and cause eye irritation.
At this time, it is better not to drive a car and not engage in other activities that require concentration, since the drug can provoke drowsiness, visual acuity and weakness.
The drug is able to penetrate into breast milk, so if the doctor has prescribed the use of "Combigan", you need to abandon natural feeding for the duration of treatment.
The drug is dispensed only by prescription. When instilled into the eyes, do not touch the cornea with the tip of the bottle. During treatment, alcohol intake should be excluded.
When a drug is canceled, drops should be stopped gradually, otherwise there may be disturbances in the heart, and there is also a risk of myocardial infarction.
Reviews about the drug
Patients who used this drug note that it is quite effective against glaucoma, and side effects from it are manifested in rare cases. True, some patients prefer cheaper analogues because of their low cost. In addition, the fact that the medicine bottle does not have a very convenient dropper is noted by many patients, which interferes with instillation.
Drops "Combigan" have an effective effect and are successfully used to treat conditions associated with increased intraocular pressure. The use of the drug should always be justified by the appropriate diagnosis and carried out only under medical supervision.
The article presented instructions for eye drops "Combigan".
Price
The drug is quite expensive - 750-780 rubles per package. Therefore, many replace it with cheaper analogues. The active substances in their composition and the principle of action are identical. But the appointment of drugs is carried out only by the attending physician.