Timolol Maleate 0.5% + Travoprost 0.004% Eye prep

Indications

Timolol Maleate 0.5% + Travoprost 0.004% Eye prep is used for: Open-angle glaucoma, Ocular hypertension

Adult Dose

Ophthalmic Ocular hypertension, Open-angle glaucoma Adult: Instill 1 drop in the conjunctival sac of the affected eye(s) once daily, given at the same time each day.

Child Dose

The efficacy and safety below the age of 18 years have not been established.

Renal Dose

Administration

Contra Indications

Reactive airway disease including existing or history of bronchial asthma; severe COPD; sinus bradycardia, sick sinus syndrome including sino-atrial block, 2nd- or 3rd-degree AV block (not controlled by pacemaker); overt cardiac failure, cardiogenic shock; severe allergic rhinitis, corneal dystrophies. Pregnancy.

Precautions

Patient w/ 1st degree heart block, severe peripheral circulatory disorders (e.g. severe forms of Raynaud's disease/syndrome), mild/moderate COPD, corneal disease, labile diabetes or those who are subject to spontaneous hypoglycaemia. Aphakic patients, pseudoaphakic patients w/ torn posterior lens capsule or anterior chamber lenses or to those at risk for cystoid macular oedema. Lactation.

Pregnancy-Lactation

Interactions

Potential additive effect w/ oral Ca channel blockers, β-adrenergic blockers, antiarrhythmics, digitalis glycosides, parasympathomimetics, guanethidine. May potentiate hypertensive reaction to sudden withdrawal of clonidine. May potentiate systemic β-blockade w/ CYP2D6 inhibitors (e.g. quinidine, paroxetine). Risk of mydriasis w/ epinephrine. May increase the hypoglycaemic effect of antidiabetic agents.

Adverse Effects

Side effects of Timolol Maleate 0.5% + Travoprost 0.004% Eye prep : The most frequently reported treatment-related undesirable effect was ocular hyperaemia. Other common side-effects may be keratitis, anterior chamber flare, eye pain, photophobia, eye swelling, conjunctival haemorrhage, corneal staining, ocular discomfort, visual acuity reduced, visual disturbance, blurred vision etc.

Mechanism of Action

Exact mechanism of ocular hypotensive effect is unclear, but it is thought to be related to reduction of aqueous humour formation. beta-blockade also causes lowering of BP. Travoprost, a prodrug and synthetic analogue of dinoprost (prostaglandin F2alpha), reduces intraocular pressure by increasing uveoscleral outflow of aqueous humour.