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Timolol/Dorzolamide

    DEA Class;  Rx

    Common Brand Names; Cosopt, Cosopt PF

    • Antiglaucoma, Combos

    Combination carbonic anhydrase inhibitor and beta-blocker
    Used to reduce IOP in patients with open-angle glaucoma or ocular hypertension refractory to topical beta-blockers
    IOP-lowering of bid dorzolamide; timolol is slightly less than concomitant administration of 0.5% timolol bid and 2% dorzolamide administered tid

    Indicated for the treatment of glaucoma or ocular hypertension in patients who are insufficiently responsive to beta-blockers.

    Age <2 years

    Hypersensitivity, asthma, severe COPD, sinus bradycardia, 2nd/3rd degree AV block (except in patients with artificial pacemaker), overt cardiac failure, cardiogenic shock

    Dorzolamide

    • Ocular burning, stinging, discomfort (33%)
    • Bitter taste (25%)
    • Superficial punctate keratitis (10-15%)
    • Ocular allergic reactions (10%)
    • Blurred vision
    • Ocular dryness
    • Photophobia
    • Ocular redness
    • Tearing
    • Stevens-Johnson syndrome
    • Toxic epidermal necrolysis

    Timolol

    • Arrythmia
    • Bradycardia
    • Syncope
    • Fatigue
    • Headache
    • Dyspnea
    • Bronchospasm
    • Chest pain
    • Edema
    • Paresthesia
    • Nausea
    • Rales
    • Depression
    • Decreased exercise tolerance
    • Raynaud’s phenomenon

    Dorzolamide (a sulfonamide) and, although administered topically, is absorbed systemically; same types of adverse reactions attributable to sulfonamides may occur with topical administration, including severe skin reactions; severe respiratory reactions, including death due to bronchospasm in patients with asthma, and rarely death in association with cardiac failure, reported following systemic or ophthalmic administration of timolol maleate

    Hypersensitivity may occur; fatalities have occurred, although rarely, due to severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias; sensitization may recur when a sulfonamide is readministered irrespective of route of administration; if signs of serious reactions or hypersensitivity occur, discontinue use of this preparation

    Bacterial keratitis associated with use of multiple-dose containers of topical ophthalmic products, inadvertently contaminated by patients who, in most cases, had concurrent corneal disease or disruption of ocular epithelial surface

    Conjunctivitis reported with chronic administration (may resolve upon discontinuation of therapy)

    Pregnancy Category: C

    Lactation: Excreted in breast milk; not recommended

    Adults

    2 drops/day per affected eye.

    Elderly

    2 drops/day per affected eye.

    Adolescents

    2 drops/day per affected eye.

    Children

    >= 2 years: 2 drops/day per affected eye.
    < 2 years: Safe and effective use has not been established.

    Timolol maleate

    tablet

    • 5mg
    • 10mg
    • 20mg

    ophthalmic solution

    • 0.25%
    • 0.5%

    gel forming solution

    • 0.25%
    • 0.5%