Brimonidine-timolol ophthalmic

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not use this medication while wearing contact lenses. Brimonidine and timolol ophthalmic may contain a preservative that can discolor soft contact lenses. Wait at least 15 minutes after using this medicine before putting in your contact lenses.

Wash your hands before using the eye drops.

To apply the eye drops:

• Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye with the tip down. Look up and away from the dropper and squeeze out a drop.
• Close your eyes for 2 or 3 minutes with your head tipped down, without blinking or squinting. Gently press your finger to the inside corner of the eye for about 1 minute, to keep the liquid from draining into your tear duct.
• Use only the number of drops your doctor has prescribed. If you use more than one drop, wait about 5 minutes between drops.
• Wait at least 10 minutes before using any other eye drops your doctor has prescribed.

Do not touch the tip of the eye dropper or place it directly on your eye. A contaminated dropper can infect your eye, which could lead to serious vision problems.

Do not use the eye drops if the liquid has changed colors or has particles in it. Call your pharmacist for new medicine.

Tell your doctor right away if you have any eye injury or infection, or if you need to have any type of surgery, especially eye surgery.

Store at room temperature away from moisture and heat. Do not freeze. Keep the bottle tightly closed when not in use.

An overdose of brimonidine and timolol ophthalmic is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Temporary blurred vision, temporary burning/stinging/itching/redness of the eye, watery eyes, dry eyes, dry mouth, feeling as if something is in the eye, headache, dizziness, or drowsiness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects. Many people using this medication do not have seriousside effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: vision changes, eye sensitivity to light, eye pain/swelling/discharge, slow/irregular heartbeat, muscle weakness, unusual tiredness, mental/mood changes, coldness/numbness/pain in the hands or feet, swelling ankles/feet, sudden unexplained weight gain, shortness of breath.

Seek immediate medical attention if any of these rare but very serious side effects occur: trouble breathing, chest pain, weakness on one side of the body, slurred speech, confusion, persistent dizziness, fainting.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using this product, tell your doctor or pharmacist if you are allergic to brimonidine or timolol; or to apraclonidine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: lung disease (e.g., current or past asthma, severe chronic obstructive pulmonary disease-COPD), certain types of irregular heartbeats (sinus bradycardia, second- or third-degree AV block), certain types of heart disease (severe heart failure, cardiogenic shock).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, heart disease, blood vessel disease (e.g., thromboangiitis obliterans, Raynaud's phenomenon), blood circulation disorders (cerebral/coronary insufficiency), dizziness after standing (orthostatic hypotension), diabetes, depression, overactive thyroid (hyperthyroidism), muscle weakness disorders (e.g., myasthenia gravis), severe allergies.

If you develop an eye infection or injury, or have eye surgery, check with your doctor about whether you should continue to use your current bottle of this medication. You may be advised to start using a new bottle.

Before having surgery, tell your doctor or dentist that you are using this medication.

If you have diabetes, this product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness and sweating, are unaffected by this drug.

This drug may make you dizzy or drowsy or temporarily blur your vision. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: beta blockers taken by mouth (e.g., propranolol), certain antidepressants (SSRIs such as fluoxetine, tricyclics such as amitriptyline), digoxin, epinephrine, fingolimod, high blood pressure medications (e.g., clonidine, reserpine, methyldopa), quinidine.

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.