Latanoprost / Timolol

What it is and how it works

Latanoprost is a prostaglandin F2-alpha analogue that lowers intra-ocular pressure by increasing uveoscleral outflow of aqueous humour. Timolol is a non-selective beta-adrenoceptor blocker that reduces aqueous humour production; the combination has an additive pressure-lowering effect.

Indications

Reduction of intra-ocular pressure in open-angle glaucoma and ocular hypertension in adults insufficiently responsive to topical beta-blockers or prostaglandin analogues.

Dosage and administration (summary)

1 drop in the affected eye(s) once daily; nasolacrimal occlusion reduces systemic absorption.

Contraindications

Reactive airway disease including bronchial asthma or a history of asthma, severe COPD; sinus bradycardia, sick sinus syndrome, second- or third-degree AV block, overt cardiac failure, cardiogenic shock; hypersensitivity to the components.

Warnings and precautions

Latanoprost may gradually and permanently increase brown iris pigmentation and cause eyelash and periocular changes; cystoid macular oedema and iritis may occur, particularly in aphakic or pseudophakic patients. Systemic beta-blockade may cause bradycardia, hypotension, bronchospasm, masked hypoglycaemia and thyrotoxicosis signs, and may potentiate myasthenia. Remove contact lenses before instillation (benzalkonium chloride).

Pregnancy

Should not be used in pregnancy unless clearly necessary.

Storage and supply

Unopened: store at 2–8 °C, protected from light. After opening: store below 25 °C and use within 4 weeks.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.