This preparation is indicated for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to β-blockers, prostaglandins, or other IOP lowering agents.

This medicine contains two active ingredients: Latanoprost and Timolol Maleate. Latanoprost is a prostaglandin analogue. It works by increasing the drainage of aqueous humour out of the eyeball. This decreases the pressure within the eye. Timolol is a beta-blocker. This medicine blocks beta-receptors in various parts of the body. Blocking the beta receptors in the eye reduces the amount of aqueous humour that is produced. Timolol therefore reduces the inflow of aqueous humour into the eyeball and so decreases the pressure within the eyeball.

Latanoprost is an analogue of prostaglandin F₂α; it reduces intraocular pressure (IOP) by increasing the outflow of aqueous humour.

Timolol is a non-selective adrenergic blocker. It lowers IOP by decreasing the formation of aqueous humour by the ciliary epithelium.

Adult or elderly: The recommended adult (including the elderly) dosage of is one drop in the affected eye(s) once daily. If one dose is missed, treatment should continue with the next dose as normal.

Children: Safety and effectiveness in children has not been established. This is therefore is not recommended for use in children.

No specific interaction studies have been performed with this preparation. Patients who are receiving treatment with this preparation and an oral β-adrenergic blocking agent should be observed for potential additive effects of β-blockade, both systemic and on intraocular pressure. The concomitant use of two topical β-adrenergic blocking agents is not recommended. Although this preparation alone has little or no effect on pupil size, mydriasis has occasionally been reported when Timolol is given with epinephrine. β-blockers may increase the hypoglycemic effect of antidiabetic agents. In vitro studies have shown that precipitation occurs when eye drops containing thimerosal are mixed with benzalkonium chloride, the preservative used in this preparation. If such drugs are used, they should be administered with an interval of at least 5 minutes between applications. Similarly, several contact lens soaking solutions contain thimerosal.

This combination is contraindicated in patients with known hypersensitivity to Latanoprost, Timolol, benzalkonium chloride, or any other ingredient in the product. This combination is also contraindicated in the following conditions: reactive airway disease including bronchial asthma, history of bronchial asthma or severe chronic obstructive pulmonary disease, sinus bradycardia, second or third degree atrioventricular block, overt cardiac failure, or cardiogenic shock.

This combination is generally well tolerated. The most frequent finding of increased iris pigmentation occurred in patients with green-brown, yellow-brown, and blue/grey/brown irides. In patients with homogeneously blue, grey, green, or brown eyes, the change was only rarely seen. Darkening, thickening, and lengthening of the eyelashes have been reported. The most frequently reported undesirable effects in clinical trials were irritation of the eye, including stinging, burning, and itching; eye hyperemia; corneal disorders; conjunctivitis; blepharitis; eye pain; headache; and skin rash.

No reproductive toxicity studies have been conducted with this combination. This combination should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Latanoprost and its metabolites may pass into breast milk. Timolol maleate has been detected in human milk following ocular administration. Because of the potential for serious adverse reactions in nursing infants, this preparation should be used with caution in nursing women.

This preparation should be used with caution in patients with macular edema, aphakic patients, pseudophakic patients with a torn posterior lens capsule, or in patients with known risk factors for macular edema. It should be administered with caution in patients subject to spontaneous hypoglycemia or in diabetic patients who are receiving insulin or oral hypoglycemic agents. Caution should also be exercised in patients wearing contact lenses or who drive and use machines.

There is no human data available on overdosage with this preparation. Symptoms of systemic Timolol overdosage are bradycardia, hypotension, bronchospasm, and cardiac arrest. If such symptoms occur, treatment should be symptomatic and supportive. The ocular effects of Latanoprost administered at high doses are not known. If overdosage with this preparation occurs, treatment should be symptomatic.

Drugs for miotics and glaucoma

Store at 2-8°C. For opened bottles, may store below 25°C.