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Brimonidine/Timolol (Into the eye)

Treats increased eye pressure from glaucoma or ocular hypertension.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Brimonidine and timolol ophthalmic (eye) drops are used to treat increased pressure in the eye caused by glaucoma or a condition called hypertension of the eye. Both conditions are caused by high pressure in your eye and can lead to pain from pressure in your eye and then can eventually harm your vision. This medicine can help you keep your sight by reducing the pressure in your eye and stopping… Read more
Brand names include
Combigan
Drug classes About this
Antiglaucoma Combination

What works? Research summarized

Evidence reviews

Neuroprotection (medicines to protect nerves involved in sight) for treatment of glaucoma in adults

The aim of this Cochrane review was to find out if neuroprotective medications (which aim to protect the nerves and cells in the eye) are effective for treating glaucoma in adults. We searched for all relevant studies to answer this question and found one study.

Efficacy and tolerability of fixed combination of brimonidine 0.2%/timolol 0.5% compared with fixed combination of dorzolamide 2%/timolol 0.5% in the treatment of patients with elevated intraocular pressure: a meta-analysis of randomized controlled trials

OBJECTIVE: To evaluate the efficacy and tolerability of the fixed-combination brimonidine 0.2%/timolol 0.5% (FCBT) compared with the fixed-combination dorzolamide 2%/timolol 0.5% (FCDT) in the treatment of patients with elevated intraocular pressure (IOP).

Meta-analysis of randomized controlled trials comparing timolol with brimonidine in the treatment of glaucoma

The authors concluded that timolol and brimonidine were equally effective in lowering intraocular pressure. Brimonidine was associated with a higher rate of allergy. The review was mostly well conducted but, in view of unexplained heterogeneity in the analyses, the authors' conclusions may need to be regarded with some caution.

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Summaries for consumers

Neuroprotection (medicines to protect nerves involved in sight) for treatment of glaucoma in adults

The aim of this Cochrane review was to find out if neuroprotective medications (which aim to protect the nerves and cells in the eye) are effective for treating glaucoma in adults. We searched for all relevant studies to answer this question and found one study.

Medicines given before, during, or after surgery to prevent short spikes of eye pressure after laser surgery for glaucoma

The aim of this Cochrane Review was to find out whether medicines given before, during, or after laser trabeculoplasty (LTP), a surgical method to reduce eye pressure, can prevent increased eye pressure shortly after surgery.

Medical interventions for primary open angle glaucoma and ocular hypertension

Ocular hypertension (OHT) is a condition with raised intraocular pressure (IOP) without visual field changes or discernible pathology of the optic nerve head. Ocular hypertension with IOP above 21 mmHg untreated is a major risk factor for development of primary open angle glaucoma, which is progressive nerve fibre loss and damage to the optic disc so that the visual field develops characteristic defects. Topical medications are given to reduce the IOP as a way of preventing the onset or progression of damage and associated visual field loss. These medications may have local and systemic side effects that may be severe enough for the treatment to be stopped and include local irritation, drowsiness, shortage of breath and cardiovascular side effects, particularly in the elderly. The results of this review support the current practice of topical medication to lower IOP and clearly demonstrate a visual field protective effect. The review authors identified a total of 26 controlled trials that randomised 4979 people with OHT or open angle glaucoma to receive topical medication or a placebo, another topical medication or no treatment for at least a year. Meta‐analysis of 10 trials testing different topical medications against placebo or untreated controls showed reduced incidence of glaucomatous visual field defects with treatment for people with OHT. The odds ratio (OR) was 0.62 (range 0.5 to 0.8). The class of beta‐blockers (including timolol) had positive but weak evidence for a beneficial effect in protecting against visual field defects (OR 0.7, range 0.5 to 1.0). No single drug showed significant visual field protection in OHT with the evidence available. Medications included beta‐blockers, dorzolamide, brimonidine, pilocarpine and epinephrine. From the reports, the majority of trials were of low methodological quality. Local and systemic side effects leading to treatment being stopped were often poorly reported and did not appear to differ between treatment groups. Drop‐outs due to side effects occurred with similar frequency in people treated with beta‐blocker or placebo and appeared to be less with timolol compared to brimonidine, in three trials.

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