Dorzolamide and Timolol Ophthalmic

WHY is this medicine prescribed?

The combination of dorzolamide and timolol is used to treat eye conditions, including glaucoma and ocular hypertension, in which increased pressure can lead to a gradual loss of vision. Dorzolamide and timolol is used for patients whose eye condition has not responded to another medication. Dorzolamide is in a class of medications called topical carbonic anhydrase inhibitors. Timolol is in a class of medications called topical beta blockers. Dorzolamide and timolol lowers pressure in the eye by decreasing the production of natural fluids in the eye.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

The combination of dorzolamide and timolol comes as a solution (liquid) to instill in the eye. It is usually instilled in the affected eye(s) twice a day. To help you remember to use dorzolamide and timolol, use it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use dorzolamide and timolol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Dorzolamide and timolol combination controls glaucoma and ocular hypertension but does not cure them. Continue to use dorzolamide and timolol even if you feel well. Do not stop using dorzolamide and timolol without talking to your doctor.

To instill the eye drops, follow these steps:

1. Wash your hands thoroughly with soap and water.
2. Check the dropper tip to make sure that it is not chipped or cracked.
3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
6. Brace the remaining fingers of that hand against your face.
7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
9. Place a finger on the tear duct and apply gentle pressure.
10. Wipe any excess liquid from your face with a tissue.
11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
13. Wash your hands to remove any medication.

What SPECIAL PRECAUTIONS should I follow?

Before using dorzolamide and timolol eye drops,

• tell your doctor and pharmacist if you are allergic to dorzolamide (Trusopt), timolol (Timoptic), sulfa drugs, or any other medications.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using dorzolamide and timolol eye drops. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• if you are using another topical eye medication, instill it at least 10 minutes before or after you instill dorzolamide and timolol.

• the following nonprescription products may interact with dorzolamide and timolol eye drops: salicylate pain relievers such as aspirin, choline magnesium trisalicylate, choline salicylate (Arthropan), magnesium salicylate (Doan's, others), and salsalate (Argesic, Disalcid, Salgesic). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking dorzolamide and timolol eye drops. Do not start any of these medications while taking dorzolamide and timolol eye drops without discussing with your healthcare provider.

• tell your doctor if you have or have ever had asthma, lung disease (including chronic bronchitis and emphysema), heart disease, diabetes, an overactive thyroid gland (hyperthyroidism), severe allergic reactions, myasthenia gravis, and kidney or liver disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using dorzolamide and timolol, call your doctor.

• you should know that dorzolamide and timolol solution contains benzalkonium chloride, which can be absorbed by soft contact lenses. If you wear contact lenses, remove them before applying dorzolamide and timolol and put them back in 15 minutes later.

• if you have an eye injury, infection, or surgery while using dorzolamide and timolol, ask your doctor if you should continue using the same eye drops container.

• you should know that if you have allergic reactions to different substances, your reactions may be worse while you are using dorzolamide and timolol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Instill the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Dorzolamide and timolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• taste changes (bitter, sour, or unusual taste)
• eye burning or stinging
• itchy eyes
• dry eyes
• eye tearing
• dizziness

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• blurred vision
• skin rash
• swelling of the hands, feet, ankles, or lower legs
• shortness of breath
• pink eye
• redness or swelling of the eyelid
• muscle weakness

Dorzolamide and timolol may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• dizziness
• headache
• shortness of breath
• difficulty breathing or swallowing
• chest pain
• confusion

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.