Azarga

The usual dose of Azarga is 1 drop in the affected eye(s) 2 times a day, morning and night.

Before using Azarga, shake the bottle well.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

To use the eye drops:

1. Wash your hands before using the eye drops.
2. Remove the cap and place it in a clean location. To avoid possible contamination, keep the tip of the container away from contact with any surface.
3. Tilt the head back and look towards the ceiling.
4. With your index finger, gently pull the lower eyelid down and away from the eye to form a pouch.
5. Apply one drop into the pouch by gently pressing on the base of the bottle (do not squeeze the bottle). Do not allow the tip of the container to touch the eye or areas around the eye.
6. Gently apply pressure to the inner corner of the eye (at the bridge of the nose) for about 30 seconds. This prevents the medication from dripping down through the tear duct and entering the bloodstream, which could cause you to experience some side effects.
7. Repeat with the other eye, if prescribed by your physician.
8. Wash your hands again to remove any medication.

Do not allow the dropper tip of the bottle to touch the eye or any other surface. This can contaminate the tip with common bacteria known to cause Eye Infections. Serious damage to the eye may result if you use eye drop solutions that have become contaminated.

Brinzolamide - timolol eye drops should be used at least 5 minutes before or after other eye drops that are being used.

It is important that Azarga be used exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not use a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Azarga between 2°C and 30°C and keep it out of the reach of children. Discard the bottle 60 days after opening.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause eye pain; it may cause eye discomfort; it may alter your sense of taste; it may cause blurred vision; it may irritate your eyes. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Each mL of ophthalmic suspension contains 10 mg of brinzolamide, 5 mg of timolol as timolol maleate, and the preservative benzalkonium chloride 0.01%. Nonmedicinal ingredients: carbomer 974P, edetate disodium, mannitol, purified water, sodium chloride, sodium hydroxide and/or hydrochloric acid (to adjust pH), and tyloxapol.

Do not use brinzolamide - timolol if you:

• are allergic to brinzolamide, timolol, other beta-blockers (e.g., Metoprolol, Atenolol), sulfonamides (e.g., sulfamethoxazole), or any of the ingredients of the medication
• have an extremely slow heart rate, second- or third-degree heart block, heart failure, or shock due to heart-related causes
• have Asthma or severe COPD (Chronic Obstructive Pulmonary Disease) (e.g., chronic Bronchitis, emphysema)
• have hyper-reactive airways
• have severe Allergic Rhinitis
• have severely reduced kidney function
• have too much acidity in the blood (called hyperchloremic acidosis)

There may be an interaction between brinzolamide - timolol and any of the following:

• Abiraterone
• acetylsalicylic acid (Asa)
• Aldesleukin
• Aliskiren
• alpha/beta agonists (e.g., Epinephrine, norepinephrine)
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• alpha agonists (e.g., Clonidine, methyldopa)
• Amiodarone
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• angiotensin receptor blockers (ARBS; e.g., candasartan, Irbesartan, Losartan)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• beta-adrenergic blockers (e.g., atenolol, metoprolol, propranolol)
• boceprevir
• brimonidine
• Bromocriptine
• Bupropion
• calcium channel blockers (e.g., Diltiazem, Verapamil)
• chloroquine
• Cimetidine
• clarithromycin
• Clobazam
• clonidine
• Cobicistat
• conivaptan
• delaviridine
• Digoxin
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Dronedarone
• epinephrine

• ergot alkaloids (e.g., Dihydroergotamine, ergonovine, ergotamine, methylergonovine)
• Fingolimod
• formoterol
• Galantamine
• grass pollen extract
• Guanfacine
• HIV protease inhibitors (atazanavir, darunavir, lopinavir, ritonavir)
• Indacaterol
• isoniazid
• levodopa
• lopinavir
• Methadone
• Mirabegron
• nefazodone
• other carbonic anhydrase inhibitors (e.g., acetazolamide, methazolamide, Dorzolamide)
• Octreotide
• olodaterol
• other eye drops
• peginterferon Alfa-2b
• Primaquine
• quinidine
• quinine
• rifampin
• Rivastigmine
• salbutamol
• salmeterol
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Duloxetine, Fluoxetine, Paroxetine, Sertraline)
• Stiripentol
• telaprevir
• terbinafine
• terbutaline
• Theophylline
• tipranivir
• Topiramate
• vilanterol

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Azarga. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Azarga.

Allergies: Brinzolamide belongs to the family of medications known as sulfonamides or "sulfas." The same type of allergic reaction can occur with Azarga as with other sulfonamides. Contact your doctor if you experience a skin rash while using Azarga. Stop using Azarga and get medical attention if you experience hives; shortness of breath; peeling or blistering skin; or swelling of the mouth, lips, tongue, or throat.

Blurred vision: This medication can cause temporary blurred vision. Do not drive or operate machinery until your vision returns to normal.

Contact lenses: The preservative used in the eye drops (benzalkonium chloride) may be absorbed by soft contact lenses. Contact lenses should be removed before using the eye drops and not reinserted for at least 15 minutes.

Drowsiness and reduced alertness: Azarga may cause fatigue or drowsiness. Avoid driving, using machinery, or doing hazardous activities until you determine how the medication affects you.

Eye surgery, infections, trauma: If you have had eye surgery or trauma to the eye, or if you have symptoms of an eye infection (e.g., eye redness, itchiness, discharge, crusts on the eyelids, or the feeling of something in the eye), contact your doctor about further use of the eye drop.

General: As with other eye drops, this medication may be absorbed into the bloodstream. You may experience the same side effects reported with oral medications from the families known as beta-blockers (e.g., timolol, Propranolol, metoprolol), carbonic anhydrase inhibitors (e.g., Acetazolamide, Methazolamide), or sulfonamides (e.g., sulfamethoxazole). These side effects may include, but are not limited to, shortness of breath, dizziness, lightheadedness, rash, or slow heartbeat. Refer to the section, "What side effects are possible with this medication?" for more information.

Heart problems: People with heart failure should have their condition controlled before starting this medication. People with severe heart disease should discuss with their doctor whether any special monitoring is needed. Azarga may make Angina (chest pains) worse. If you have angina, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Azarga, and whether any special monitoring is needed.

Liver function: If you have reduced liver function, discuss with your doctor how Azarga may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Azarga, and whether any special monitoring is needed.

Low blood sugar: If you are prone to low blood sugar or have Diabetes, monitor your blood sugar closely while taking Azarga, as it may mask the signs of low blood sugar.

Muscle weakness: Beta-blockers such as timolol have been reported to increase muscle weakness associated with certain conditions, such as Myasthenia Gravis. If you experience symptoms of muscle weakness, contact your doctor.

Pregnancy: Azarga should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using Azarga, contact your doctor immediately.

Breast-feeding: It is not known if brinzolamide passes into breast milk. Timolol does pass into breast milk. If you are a breast-feeding mother and are using Azarga, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Azarga have not been established for children.

This medication is for the eye. To use: Wash your hands as well as the skin surrounding the affected eye. Shake the container. Gently pull down the lower lid of the affected eye. Apply 1 drop of the medication. Unless your condition prevents you from doing so, close the eye for at least 1 minute, while gently pressing on the inner corner of the eye, near the nose. To avoid contaminating the medication, do not let the tip of the applicator touch your fingers or any part of your eye. Close the container tightly after each use. This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, apply it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed one. Do not apply more to try to catch up.