Cosopt

The recommended adult dose of dorzolamide - timolol eye drops is one drop in the affected eye(s) twice daily.

Dorzolamide - timolol eye drops should be used at least 10 minutes before or after other eye drops that are being used.

Wash your hands thoroughly before using eye drops. To prevent contamination of the eye drops with bacteria, do not allow the tip of the container to touch the eye, fingers, or other surfaces. Serious damage to the eye may result if you use eye drop solutions that have become contaminated.

If you are using the preservative-free solution, also avoid touching the eye area with the fins (plastic pieces at the sides of the unit dose eye dropper), as the fins can scratch or cut your eye, causing serious eye injury. To avoid scratching or cutting your eye, line up the "fins" of the container with the inside and outside corners of your eye. If possible, ask a caregiver to put the drops in for you.

When using the preservative-free solution, the container and remaining solution must be discarded after each treatment. Refer to the package insert for instructions on how to administer these eye drops properly.

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.

It is important that Cosopt be used exactly as prescribed by your doctor. If you miss a dose, instill 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 instill 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 Cosopt at room temperature, protect it from light and moisture, and keep it out of the reach of children.

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 alter your sense of taste; it may cause the eyes to become more sensitive to light - wear sunglasses if necessary; when used, it may cause a temporary burning sensation; it may cause a stinging sensation. 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.

Cosopt

Each mL of clear, colourless-to-nearly-colourless ophthalmic solution contains 20 mg of dorzolamide (as 22.3 mg of dorzolamide hydrochloride) and 5.0 mg of timolol (as 6.83 mg of timolol maleate). Nonmedicinal ingredients: benzalkonium chloride (0.0075%), sodium citrate, hydroxyethyl cellulose, sodium hydroxide, mannitol, and water for injection.

Cosopt, Preservative-Free

Each mL of clear, colourless-to-nearly-colourless ophthalmic solution contains 20 mg of dorzolamide (as 22.3 mg of dorzolamide hydrochloride) and 5.0 mg of timolol (6.83 mg of timolol maleate). Nonmedicinal ingredients: sodium citrate, hydroxyethyl cellulose, sodium hydroxide, mannitol, and water for injection.

Do not use dorzolamide - timolol eye drops if you:

• are allergic to dorzolamide, timolol, or any ingredients of the medication
• have bronchospasm, including bronchial Asthma, or a history of bronchial asthma or COPD (Chronic Obstructive Pulmonary Disease) (e.g., chronic Bronchitis, emphysema)
• have heart problems that include an extremely low heart rate, second or third degree heart block, overt heart failure or cardiogenic shock (shock due to heart-related causes)
• have severely reduced kidney function
• take carbonic anhydrase inhibitors (e.g., Acetazolamide, Topiramate) by mouth

There may be an interaction between dorzolamide - timolol (eye drops) and any of the following:

• Abiraterone
• acetylcholine
• alpha agonists (e.g., Clonidine, methyldopa)
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• Aminophylline
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, lisdexamphetamine)
• 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)
• barbiturates (e.g., butalbital, pentobarbital Phenobarbital)
• beta-2 agonists (e.g., salbutamol, formoterol, terbutaline)
• brimonidine
• Bupropion
• calcium channel blockers (e.g., Diltiazem, Verapamil, Nifedipine, Amlodipine)
• carbachol
• Celecoxib
• chloroquine
• Cinacalcet
• Clobazam
• clonidine
• darunavir
• Desipramine
• diazoxide
• Digoxin
• Diphenhydramine
• Dipyridamole
• Disopyramide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Donepezil
• Dronedarone
• Duloxetine
• Epinephrine
• ergot alkaloids (e.g., Dihydroergotamine, ergonovine, ergotamine, methylergonovine)
• Fentanyl
• Galantamine
• Guanfacine
• high doses of acetylsalicylic acid (Asa)
• hydroxychloroquine
• imatinib
• Imipramine
• insulin
• isoniazid
• ketoconazole
• lidocaine
• lopinavir
• lumefantrine
• Methadone
• Methylphenidate
• Midodrine
• Mirabegron
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, duloxetine, Fluoxetine, Paroxetine, Sertraline)
• Nilotinib
• nonsteroidal anti-inflammatory medications (e.g., Diclofenac, Ibuprofen, Ketoprofen, Naproxen)
• other beta-blockers (e.g., propranolol, Atenolol, metoprolol)
• other carbonic anhydrase inhibitors (e.g., acetazolamide)
• Pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pilocarpine
• Primaquine
• Propafenone
• quinidine
• quinine
• rifampin
• ritonavir
• sulfonamide diabetes medications (e.g., chlorpropamide, Gliclazide, Glyburide)
• terbinafine
• Theophylline
• Ticlopidine
• Yohimbine

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 Cosopt. 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 Cosopt.

Allergies: Some people who are allergic to sulfonamide (or "sulfa") medications may experience a similar allergic reaction to dorzolamide. Before you use dorzolamide - timolol eye drops, inform your doctor about any previous adverse reactions you have had to medications, especially sulfonamide antibiotics or Diabetes medications. Contact your doctor if you experience a skin rash while using Cosopt. Stop using Cosopt and get medical attention if you experience hives; shortness of breath; peeling or blistering skin; or swelling of the mouth, lips, tongue, or throat.

Blurry vision: Side effects such as blurred vision may affect the ability to drive and operate machinery. Avoid driving, operating machinery, or performing other tasks which require you to see clearly until your vision has cleared.

Choroidal detachment: Anyone with chronic or recurrent choroidal detachment should talk to their doctor about further use of the eye drop.

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. The preservative-free eye drops have not been studied for use by people who wear contact lenses.

Eye surgery, eye (corneal) defect, infections, trauma: Anyone using Cosopt who has had eye surgery, preexisting long-term eye (corneal) defect, trauma to the eye, or who has symptoms of an eye infection (e.g., eye redness, itchiness, discharge, crusts on the eyelids, or the feeling of something in the eye) should contact their doctor concerning further use of the eye drop.

General: As with other topically applied eye drops, Cosopt may be absorbed into the bloodstream. The same side effects reported with oral medications from the families known as beta-blockers (e.g., timolol, Propranolol, Metoprolol) or sulfonamides (e.g., sulfamethoxazole) may occur with the eye drops. 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 Cosopt?" for more information.

Liver function: Cosopt has not been studied in people with liver function impairment. If you have liver problems, discuss with your doctor how Cosopt may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cosopt, and whether any special monitoring is needed.

Low blood sugar: People who are prone to low blood sugar and people with diabetes should closely monitor their blood sugar while using Cosopt as it may mask the signs of low blood sugar.

Medical conditions: Timolol belongs to the family of medications known as beta-blockers. Although timolol is given as an eye drop, small amounts may be absorbed into the bloodstream. For this reason, it should not be used by anyone who must avoid internal use of beta-blockers. This includes those with abnormally low heart rate, certain abnormal heart rhythms, uncontrolled Congestive Heart Failure, asthma, or severe chronic obstructive pulmonary disease.

Muscle weakness: Beta-blockers such as timolol have been reported to increase muscle weakness associated with certain symptoms, such as double vision or generalized weakness. If you experience these symptoms, contact your doctor.

Overactive Thyroid: Timolol may mask the signs of overactive thyroid. If you have an overactive thyroid gland (Hyperthyroidism), discuss with your doctor how Cosopt may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cosopt, and whether any special monitoring is needed. People who have this condition or are prone to developing it should be carefully monitored by their doctors.

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

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

Children: The safety and effectiveness of Cosopt 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. 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.