Buy Combigan (Brimonidine Tartrate with Timolol Maleate) antiglaucoma drug
Cheap qualitative Brimonidine and Timolol 0.2% / 0.5% 5 ml eye drops online
HOW AND WHERE TO BUY COMBIGAN (BRIMONIDINE, TIMOLOL) 0.2% / 0.5% 5 ML OPHTHALMIC SOLUTION ONLINE:
COMBIGAN: PRESCRIBING INFORMATION
Combigan (Brimonidine Tartrate / Timolol Maleate ophthalmic solution) 0.2% / 0.5%, sterile, is a relatively selective alpha-2 adrenergic receptor agonist with a non-selective beta-adrenergic receptor inhibitor (topical intraocular pressure lowering agent).
Brimonidine Tartrate: 5-bromo-6-(2-imidazolidinylideneamino) quinoxaline L-tartrate; MW = 442.24
Timolol Maleate: (-)-1-(tert-butylamino)-3-[(4-morpholino-1,2,5-thiadiazol-3-yl)-oxy]-2-propanol maleate (1:1) (salt); MW = 432.50 as the maleate salt.
In solution, Brimonidine with Timolol (Combigan) 0.2% / 0.5% has a clear, greenish-yellow color. It has an osmolality of 260-330 mOsmol / kg and a pH during its shelf life of 6.5-7.3.
Brimonidine tartrate appears as an off-white, or white to pale-yellow powder and is soluble in both water (1.5 mg / mL) and in the product vehicle (3 mg / mL) at pH 7.2. Timolol maleate appears as a white, odorless, crystalline powder and is soluble in water, methanol, and alcohol.
Each mL of Combigan contains the active ingredients brimonidine tartrate 0.2% and timolol 0.5% with the inactive ingredients benzalkonium chloride 0.005%; sodium phosphate, monobasic; sodium phosphate, dibasic; purified water; and hydrochloric acid and/or sodium hydroxide to adjust pH.
INDICATIONS AND USAGE
Combigan (Brimonidine Tartrate with Timolol Maleate ophthalmic solution) 0.2% / 0.5% is an alpha-adrenergic receptor agonist with a beta-adrenergic receptor inhibitor indicated for the reduction of elevated intraocular pressure (IOP) in patients with glaucoma or ocular hypertension who require adjunctive or replacement therapy due to inadequately controlled IOP; the IOP-lowering of Combigan dosed twice a day was slightly less than that seen with the concomitant administration of 0.5% timolol maleate ophthalmic solution dosed twice a day and 0.2% brimonidine tartrate ophthalmic solution dosed three times per day.
DOSAGE AND ADMINISTRATION
The recommended dose is one drop of Combigan (Brimonidine Tartrate, Timolol Maleate) in the affected eye(s) twice daily approximately 12 hours apart. If more than one topical ophthalmic product is to be used, the different products should be instilled at least 5 minutes apart.
DOSAGE FORMS AND STRENGTHS
Solution containing 2 mg / mL Brimonidine Tartrate and 5 mg / mL timolol (6.8 mg / mL Timolol Maleate).
Reactive Airway Disease Including Asthma, COPD
Combigan (Brimonidine, Timolol) is contraindicated in patients with reactive airway disease including bronchial asthma; a history of bronchial asthma; severe chronic obstructive pulmonary disease.
Sinus Bradycardia, AV Block, Cardiac Failure, Cardiogenic Shock
Brimonidine with Timolol (Combigan) is contraindicated in patients with sinus bradycardia; second or third degree atrioventricular block; overt cardiac failure; cardiogenic shock.
Neonates and Infants (Under the Age of 2 Years)
This medication is contraindicated in neonates and infants (under the age of 2 years).
Local hypersensitivity reactions have occurred following the use of different components of Combigan. This drug is contraindicated in patients who have exhibited a hypersensitivity reaction to any component of this medication in the past.
WARNINGS AND PRECAUTIONS
Combigan warnings and precautions
Combigan adverse reactions
Combigan drug interactions
USE IN SPECIFIC POPULATIONS
Combigan use in specific populations
There have been reports of inadvertent overdosage with timolol ophthalmic solution resulting in systemic effects similar to those seen with systemic beta-adrenergic blocking agents such as dizziness, headache, shortness of breath, bradycardia, bronchospasm, and cardiac arrest. With the exception of hypotension, very limited information exists on accidental ingestion of brimonidine in adults. Symptoms of brimonidine overdose have been reported in neonates, infants, and children receiving brimonidine ophthalmic solutions as part of medical treatment of congenital glaucoma or by accidental oral ingestion. Treatment of an oral overdose includes supportive and symptomatic therapy; a patent airway should be maintained.
Combigan clinical pharmacology
Combigan nonclinical toxicology
Clinical studies were conducted to compare the IOP-lowering effect over the course of the day of Combigan (Brimonidine Tartrate, Timolol Maleate ophthalmic solution) administered twice a day (BID) to individually-administered brimonidine tartrate ophthalmic solution, 0.2% administered three times per day (TID) and timolol maleate ophthalmic solution, 0.5% BID in patients with glaucoma or ocular hypertension.
Combigan BID provided an additional 1 to 3 mm Hg decrease in IOP over brimonidine treatment TID and an additional 1 to 2 mm Hg decrease over timolol treatment BID during the first 7 hours post dosing. However, the IOP-lowering of Combigan BID was less (approximately 1-2 mm Hg) than that seen with the concomitant administration of 0.5% timolol BID and 0.2% brimonidine tartrate TID. This medication administered BID had a favorable safety profile versus concurrently administered brimonidine TID and timolol BID in the self-reported level of severity of sleepiness for patients over age 40.
HOW SUPPLIED / STORAGE AND HANDLING
Combigan (Brimonidine Tartrate, Timolol Maleate) is supplied sterile, in white opaque plastic LDPE bottles and tips, with blue high impact polystyrene (HIPS) caps as follows:
5 mL in 10 mL bottle
10 mL in 10 mL bottle
15 mL in 15 mL bottle
Storage: Store at 15°-25°C (59°-77°F). Protect from light.
Manufactured and distributed by Allergan pharmaceutical company and its divisions.
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