A number of combination drugs are on the market that combine drugs for a more encompassing effect. Combigan (Allergan) is one such drug that combines an alpha-agonist (brimonidine) with a beta-blocker (timolol); dosing is twice daily and it is highly efficacious. Dr. Zaman uses it as an additive drug. In some patients this drug can cross the blood-brain barrier resulting in sleepiness. Another combination drug is Cosopt (Merck & Co.), which is comprised of a beta-blocker (timolol) and a CAI (dorzolamide). This also is doses twice daily and lowers IOP well. Systemic side effects include, for example, low blood pressure and fatigue. Simbrinza (Alcon) combines a CAI (brinzolamide) and alpha-agonist (brimonidine). combination medication consisting of (alpha-agonist). Without a beta-blocker, this drug is indicated for patients with asthma and is dosed three times daily.
Shaking the bottle is mandatory because the active ingredient sinks to the bottom.
“The glaucoma medications have improved over time with increased efficacy,” Dr. Zaman concluded. “Patients are achieving lower pressures recently with a resultant fewer glaucoma surgeries.”
Fiaz Zaman, MD
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Dr. Zaman is a speaker for Aerie Pharmaceuticals and Allergan.