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Brimonidine/timolol is a combination eye drop that pairs an alpha-2 agonist with a beta-blocker to lower elevated intraocular pressure in glaucoma or ocular hypertension.
Reviewed by:
Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Brimonidine/timolol (Combigan) combines brimonidine, an alpha-2 adrenergic agonist, with timolol, a non-selective beta-blocker, to reduce elevated intraocular pressure in patients with glaucoma or ocular hypertension. Brimonidine decreases aqueous humor production and increases its outflow, while timolol also decreases aqueous humor production; together they provide additive pressure-lowering effect. The typical dose is one drop in the affected eye(s) twice daily, approximately 12 hours apart. Common side effects include eye redness, stinging, or irritation, as well as dry mouth and drowsiness from brimonidine. Because timolol is absorbed systemically, it can cause slowed heart rate, low blood pressure, or worsened breathing in patients with asthma or COPD; use caution in these patients and in those with bradycardia, heart block, or decompensated heart failure. Contact lenses should be removed before instillation and can be reinserted 15 minutes later.
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Brimonidine/timolol is a combination eye drop used to lower elevated intraocular pressure in glaucoma or ocular hypertension. Brimonidine, an alpha-2 agonist, decreases fluid production in the eye and increases outflow; timolol, a beta-blocker, further decreases fluid production, providing an additive pressure-lowering effect.
Common side effects include eye redness, stinging, or irritation, as well as dry mouth and drowsiness from the brimonidine component.
Important: Timolol is absorbed into the bloodstream and can slow heart rate, lower blood pressure, or worsen breathing problems in patients with asthma or COPD. Use with caution in patients with bradycardia, heart block, or decompensated heart failure.
Remove contact lenses before instilling and wait at least 15 minutes before reinserting them.