Latanoprost + Timolol: Brands, Price & Uses in Bangladesh

Latanoprost + Timolol ophthalmic solution is a fixed-dose combination of a prostaglandin F2-alpha analogue and a non-selective beta-adrenergic blocker used to lower elevated intraocular pressure (IOP).

Established use

• Open-angle glaucoma and ocular hypertension: Latanoprost + Timolol is indicated for reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to topical beta-blockers or topical prostaglandin analogues used alone (i.e., patients requiring more than one topical IOP-lowering agent).

Important note on use

Latanoprost + Timolol is a combination product intended for patients who need dual-mechanism therapy; it is not typically used as a first-line, single agent when monotherapy has not yet been tried, unless a physician determines combination therapy is appropriate from the outset.

Standard adult dosing

Administration instructions

• For topical ophthalmic use only. Do not inject or swallow.
• Wash hands before use. Tilt the head back, pull down the lower eyelid, and instil one drop into the pocket formed, then close the eye gently for 1-2 minutes.
• Apply gentle pressure on the inner corner of the eye (nasolacrimal occlusion) for about 1-2 minutes after instillation to reduce systemic absorption of the timolol component.
• Do not let the tip of the dropper touch the eye, eyelid, or any surface, to avoid contamination.
• If wearing contact lenses, remove them before instillation (the preservative benzalkonium chloride may be absorbed by soft lenses) and wait at least 15 minutes before reinserting.
• If using other topical ophthalmic medicines at the same time, space administration at least 5 minutes apart.
• If a dose is missed, continue with the next scheduled dose; do not instil an extra dose to make up for a missed one.
• Do not exceed one dose per day; more frequent dosing may reduce the IOP-lowering effect.

See Use in Special Populations for renal/hepatic impairment and elderly use, and Pediatric Uses for children.

The following adverse effects have been reported with Latanoprost + Timolol; most are ocular and localized to the eye.

Common

• Ocular hyperemia (eye redness), stinging/burning on instillation, eye irritation, foreign body sensation
• Blurred vision, itching, punctate keratitis
• Gradual, permanent increase in brown pigmentation of the iris and periocular skin (more likely with mixed-color irises, e.g., blue-brown, green-brown)
• Growth changes to eyelashes (increased length, thickness, number, and pigmentation)

Less common / systemic (mainly from the timolol component)

• Bradycardia, hypotension, palpitations
• Headache, dizziness, fatigue
• Bronchospasm/dyspnea in susceptible individuals (see Contraindications)

Rare

• Iritis/uveitis (mainly in patients with predisposing risk factors), cystoid macular edema (mainly in aphakic/pseudophakic eyes with disrupted posterior lens capsule), corneal disorders