- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Journal: A stability-indicating RP-HPLC method for the simultaneous quantification of brimonidine tartrate and timolol maleate in bulk drug substances and pharmaceutical dosage forms. (Pubmed Central) - Jan 28, 2026
A robust, rapid, and reproducible reversed-phase high-performance liquid chromatography (RP-HPLC) method was developed and validated for the simultaneous quantification of Brimonidine Tartrate and Timolol Maleate (Combigan) in ophthalmic dosage forms...The AGREE evaluation yielded a score of 0.57 (out of 1.0), indicating moderate greenness. Overall, this method effectively quantified both active pharmaceutical ingredients without interference from excipients or degradation products, supporting its suitability for routine quality control and stability testing of combined ophthalmic formulations.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Journal: Severe intraocular pressure rise after implantable collamer lens implantation. (Pubmed Central) - Aug 26, 2024
Prednisolone acetate 0.1% ophthalmic suspension eye drops and ofloxacin 0.3% ophthalmic solution eye drops 4 times daily were prescribed prophylactically 2 days preoperatively...The patient was instructed to reduce prednisolone to 2 times a day, discontinue brimonidine, and start brimonidine/timolol (Combigan) 2 times a day and latanoprost at bedtime in both eyes...The patient was instructed to reduce prednisolone to once a day, continue brimonidine/timolol 2 times a day and latanoprost at bedtime, and start acetazolamide (Diamox) 250 mg 2 times a day...What is the most likely mechanism underlying this patient's elevated IOP? What additional diagnostic workup would aid you in making the correct diagnosis?
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Journal: Understanding the treatment paradigm and the sequencing of antiglaucoma fixed-dose combinations in a tertiary center in South India. (Pubmed Central) - Apr 16, 2024
Study patients that received instillations of brimonidine-timolol combination of one drop into the conjunctival sac 1 day before the injection and on the day of the injection showed the maximum decrease in IOP compared to patients of the other groups. This study is a fairly large study with a minimum of a 5-year follow-up of patients with POAG and OHT and gives insights into the treatment patterns, use of FDCs, and the need for multiple medications over time.
- |||||||||| Simbrinza (brinzolamide/brimonidine tartrate ophthalmic suspension) / Novartis, Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Journal: Glaucoma Drug Prescription Pattern in North India: Public vs Private Sector Hospitals. (Pubmed Central) - Apr 8, 2024
Brimonidine and brinzolamide (14.17%) was the most prescribed combination in group II, while Brimonidine with Timolol (7.87%) in group I. In group I, Timolol and Travoprost were the most prescribed medications for both PACD and POAG...Bhartiya S, Ichhpujani P, Parmar UPS, et al.Glaucoma Drug Prescription Pattern in North India: Public vs Private Sector Hospitals. J Curr Glaucoma Pract 2024;18(1):16-22.
- |||||||||| Rocklatan (latanoprost/netarsudil) / Aerie Pharma, Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Journal: Managing primary open-angle glaucoma in the setting of suboptimal surgical outcomes in the fellow eye. (Pubmed Central) - Jul 4, 2023
The addition of acetazolamide lowered the pressure to 19 mm Hg in both eyes, but she tolerated it poorly...However, by postoperative week 3, IOP returned to 27 mm Hg, and despite restarting latanoprost-netarsudil and finishing her steroid taper, IOP remained at 27 mm Hg by postoperative week 6...Knowing her postoperative course in the left eye, how would you manage the right eye? In addition to currently available options, would you consider a supraciliary shunt such as the MINIject (iSTAR) if such a device were U.S. Food and Drug Administration (FDA)-approved?
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Enrollment change, Trial withdrawal: Prophylaxis for Anti-VEGF-induced IOP Elevation (clinicaltrials.gov) - May 22, 2023
P=N/A, N=0, Withdrawn,
In addition to currently available options, would you consider a supraciliary shunt such as the MINIject (iSTAR) if such a device were U.S. Food and Drug Administration (FDA)-approved? N=107 --> 0 | Unknown status --> Withdrawn
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Journal, Adverse events: Underreporting and Triggering Factors for Reporting ADRs of Two Ophthalmic Drugs: A Comparison between Spontaneous Reports and Active Pharmacovigilance Databases. (Pubmed Central) - Nov 16, 2022
(1) Aims of the study: calculating the underreporting ratio for two different medications, a fixed combination of 0.5% timolol + 0.2% brimonidine + 2.0% dorzolamide (antiglaucoma) and a fixed combination of sodium hyaluronate 0.1% + chondroitin sulfate 0.18% (artificial tears) for characterizing the features influencing the reporting of adverse drug reactions (ADRs) in spontaneous reporting...(4) The underreporting ratio of ADRs related to ophthalmic medications indicates worry since the cornerstone of pharmacovigilance focuses on spontaneous reporting. Additionally, since underreporting seems to b selective, the role of certain aspects, such as gender, seriousness, severity, and unexpected ADRs, must be considered in future research.
- |||||||||| Rocklatan (latanoprost/netarsudil) / Aerie Pharma, Combigan (brimonidine tartrate/timolol maleate) / AbbVie, Rhopressa (netarsudil) / Aerie Pharma
A Deep Learning–Based Smartphone Application Increases Patient's Medication Identification Speed and Accuracy: A Clinical Case Series (S405) - Aug 26, 2022 - Abstract #AAO2022AAO_1719;
An iOS app-embedded CNN (MobileNetV3) was trained with 9860 images and tested on 1088 images of 8 medications: Pred Forte, Vigamox, Rocklatan, Rhopressa, Xalatan, Trusopt, Combigan, and Alphagan. Utilization of an iOS application integrated with MobileNetV3 architecture is a promising tool to help visually-impaired patients quickly and accurately identify their ophthalmic medication bottles.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Trial completion date, Trial primary completion date: BREMEN Eye Drops Versus Combigan for Open-angle Glaucoma or Intraocular Hypertension (clinicaltrials.gov) - Aug 5, 2022
P3, N=384, Recruiting,
Utilization of an iOS application integrated with MobileNetV3 architecture is a promising tool to help visually-impaired patients quickly and accurately identify their ophthalmic medication bottles. Trial completion date: Feb 2023 --> Dec 2023 | Trial primary completion date: Aug 2022 --> Jun 2023
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
The effect of antiglaucomatous drugs on central corneal thickness in patients with primary openangle glaucoma: 5-year results of 1152 patients. Retroprospective study (Poster Area) - May 24, 2022 - Abstract #EGS2022EGS_366;
Patients who used the same and monotherapeutic antiglaucoma drugs regularly were divided into 7 groups; AA: brimonidine tartrate 0.2%, combined AA: brimonidine tartrate 0.2% timolol maleate 0.5% fixed combination, SAI: dorzolamide hydrochloride, Combined SAI: dorzolamide hydrochloride 0.2%/timolol maleate 0.5% fixed combination, PG: latanoprost, Combined PG: latanoprost % 0.005/timolol maleate 0.5% fixed combination BB: patients who used timolol maleate 0.5%... According to the results of our study, we suggest that PG and its derivatives should not be selected in patients with thin CCT, in the selection of PG and combined PG, in addition, caution should be exercised in the use of CAI in patients with low endothelial number, and that CCT measurement should be repeated at certain time intervals in long-term use of Antiglaucoma.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Bilateral Acute Angle Closure and Myopic Shift after Using a Weight Loss Medication (WEWCC) - Apr 26, 2022 - Abstract #ASCRSASOA2022ASCRS-ASOA_333;
Purpose To report a case of drug induced bilateral angle closure following ingestion of weight loss medication containing hydrochlorothiazide, topiramate and fluoxetineMethodsCase report of a 37-year-old, healthy man who presented with decreased vision, bilateral acute angle closure, iris boewing as measured with pentacam, induced myopia 1 week after starting a weight loss medication, composed of hydrochlorothiazide 6mg qd, topiramate 25mg bid, pseudoephedrine 15mg tid, diazepam 2mg qd, and fluoxetine 10mg tid...At the 2-day follow-up visit, vision, intraocular pressure, and angle anatomy had returned to normal and anterior chamber depth was 2.44mm in his right eye and 2.44mm in left eye. Conclusion Bilateral acute angle closure may develop after ingestion of weight loss drugs containing topiramate.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Journal: Tube Obstruction of a Non valved Glaucoma Drainage Device by a Dislocated Soemmering's Ring. (Pubmed Central) - Oct 13, 2021
The IOP in the left eye was 22 mm Hg with 3 topical IOP-lowering medications (timolol 0.5%, brimonidine 0.2%, and latanoprost 0.005%)...The IOP spike was initially controlled with oral acetazolamide and topical IOP-lowering medications (fixed combination of timolol 0.5% and brimonidine 0.2%)...In aphakic eyes undergoing non valved glaucoma drainage device implantation, a complete pars plana vitrectomy combined with any lens remnant removal may be considered. It helps to avoid tube obstruction due to these lens remnants which can migrate anteriorly along with the aqueous currents.
- |||||||||| Lumigan (bimatoprost) / Senju, AbbVie
Preclinical, Journal: Efficacy, Drug Sensitivity, and Safety of a Chronic Ocular Hypertension Rat Model Established Using a Single Intracameral Injection of Hydrogel into the Anterior Chamber. (Pubmed Central) - May 21, 2021
Response to 5 common drugs (brimonidine, timolol, benzamide, pilocarpine, and bimatoprost) were each tested on 6 rats and assessed using difference in IOP...CECs at 2, 4, and 8 weeks showed no significant differences from control groups in results of histological analysis, TUNEL, and CCK-8 assays. CONCLUSIONS A single injection of hydrogel into the anterior chamber is effective for modeling COH, can respond to most commonly used hypotensive drugs, and is non-toxic to the eyes.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Clinical, Journal, Adverse events: Active Pharmacovigilance in Peruvian Population: Surveillance of a Timolol/Brimonidine/Dorzolamide Ophthalmic Fixed Combination. (Pubmed Central) - Feb 25, 2021
We found an increased risk of ADRs with a Relative Risk (RR) for simultaneous use of TBD + ophthalmic ciprofloxacin and TBD + oral atorvastatin; 2.0309 (95% CI, 1.2467-3.3083) and 1.8864 (95% CI, 1.0543-3.3754), respectively...Three safety signals were identified, two of them corresponded to an increase in the incidence of ADRs and the last one is associated with 2 unexpected ADR. Nevertheless, we found a good tolerability profile for TBD in the study population.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Enrollment open, Trial completion date, Trial primary completion date: BREMEN Eye Drops Versus Combigan for Open-angle Glaucoma or Intraocular Hypertension (clinicaltrials.gov) - Feb 24, 2021
P3, N=384, Recruiting,
Nevertheless, we found a good tolerability profile for TBD in the study population. Not yet recruiting --> Recruiting | Trial completion date: Feb 2022 --> Feb 2023 | Trial primary completion date: Aug 2021 --> Aug 2022
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Clinical, Journal: Pressure-Induced Interlamellar Stromal Keratitis After Small-Incision Lenticule Extraction Procedure: A Case Report. (Pubmed Central) - Nov 19, 2020
Clinicians should be aware that PISK is a potential complication of SMILE. Postoperative intraocular pressure measurements are an important aspect of the management of postcorneal refractive surgery patients because the differentiation of PISK from diffuse lamellar keratitis, as well as the early detection and treatment of PISK, can avoid severe complications.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
[VIRTUAL] Pigmentary Dispersion Syndrome and Pigmentary Glaucoma (Track 1 - Academy at Home) - Oct 14, 2020 - Abstract #AAOPT2020AAOPT_740;
The patient was prescribed latanoprost QHS OU and dorzolamide-timolol BID OS; the patient will return in for follow up in one month for IOP check, pachymetry, and automated Humphrey visual fields. Conclusion Pigment dispersion syndrome and pigmentary glaucoma represent a spectrum of the same disease1. In addition to complete clinical evaluation, careful examination of the anterior segment including gonioscopy is necessary for accurate diagnosis.
- |||||||||| Avastin (bevacizumab) / Roche
[VIRTUAL] Long-Term Sustained IOP Elevation following Eyelea Injections (Track 1 - Academy at Home) - Oct 14, 2020 - Abstract #AAOPT2020AAOPT_664;
The pressure is unresponsive to topical ophthalmic drops and only significantly decreases with use of oral Acetazolamide. Case History 84 yo White male is referred to the VA for increased IOP OD for one week following Eyelea injections OUPrimary Open Angle Glaucoma, mild stage OU on Latanoprost OU since 2014History of Avastin injections OU with no increased IOP, switched to Eyelea due to poor response with AvastinPre-injections moderate compliance with drop therapy, IOP usually ranges in the mid to high teens with dropsAfter injection, was prescribed Brimonidine TID OD and Timolol BID ODIOP was mid 30’s for 2 days but then elevated to 41 on the day of referral where in office pressure lowering took place Pertinent Findings First Visit 5/5/20: IOP 56/17...IOP lowered in office to 32 with Dorzolamide, Combigan, and Acetazolamide...If able, patients should be treated with Acetazolamide 250mg BID-QID as tolerated to lower pressure significantly and avoid glaucomatous damage. More studies need to be done to investigate the cause for sustained IOP increase after injections.
- |||||||||| Lumigan (bimatoprost) / Senju, AbbVie
[VIRTUAL] Not the Usual Suspect, Culturing Rare Bacteria in a Severe Corneal Ulcer (Track 1 - Academy at Home) - Oct 14, 2020 - Abstract #AAOPT2020AAOPT_355;
She also has associated symptoms of headaches and watery discharge.She has history of open angle glaucoma controlled with Combigan and Lumigan and has significant vision loss right eye (OD) secondary to proliferative diabetic retinopathy...At the following visit she received an intrastromal injection of fortified vancomycin and topical moxifloxacin was added...Although endothelial plaques are most commonly associated with fungi, cultures proved otherwise in this case. Uncommon pathogens that progress aggressively require a multiprong approach in treatment.
- |||||||||| timolol / Generic mfg.
Preclinical, Journal: Ocular co-Delivery of Timolol and Brimonidine from a Self-Assembling Peptide Hydrogel for the Treatment of Glaucoma: In Vitro and Ex Vivo Evaluation. (Pubmed Central) - Jun 28, 2020
The in-situ gel forming self-assembling peptide ac-(RADA)-CONH was evaluated as carrier for the ocular co-delivery of timolol maleate (TM) and brimonidine tartrate (BR)...Rapid and complete release of both drugs was achieved within 8 h, while a 2.8-fold and 5.4-fold higher corneal permeability was achieved for TM and BR, respectively. No significant alterations were induced in the structural integrity of the corneas treated with the hydrogel formulation, suggesting that self-assembling peptide hydrogels might serve as promising systems for combination anti-glaucoma therapy.
- |||||||||| Azopt (brinzolamide ophthalmic suspension 1%) / Novartis
[VIRTUAL] Severe Limbal Stem Cell Deficiency and Cicatricial Conjunctivitis Secondary to Preserved Glaucoma Eyedrops (VM) - May 23, 2020 - Abstract #ASCRSASOA2020ASCRS-ASOA_1973;
The patient was using brinzolamide, bimatoprost, and brimonidine-timolol...Results All eyedrops were stopped, and the patient was started on non-preserved dorzolamide-timolol and tafluprost...BAK disrupts cells, which is responsible not only for its antimicrobial actions, but also its toxicity. Management involves removal of the offending agent and monitoring for progression.
- |||||||||| timolol / Generic mfg., Combigan (brimonidine tartrate/timolol maleate) / Allergan, Istalol (timolol maleate ophthalmic solution) / Bausch Health
Clinical, Journal: Effect of brimonidine tartrate on basophil activation in glaucoma patients. (Pubmed Central) - Apr 21, 2020
Basophil activation was suppressed by the presence of β-blockers in patients hypersensitive to brimonidine and in healthy individuals. This finding indicates that timolol suppress brimonidine drug reaction by a different mechanism.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Trial completion date, Trial primary completion date: BREMEN Eye Drops Versus Combigan for Open-angle Glaucoma or Intraocular Hypertension (clinicaltrials.gov) - Apr 2, 2020
P3, N=384, Not yet recruiting,
This finding indicates that timolol suppress brimonidine drug reaction by a different mechanism. Trial completion date: Oct 2021 --> Feb 2022 | Trial primary completion date: Apr 2021 --> Aug 2021
- |||||||||| Review, Journal: Drugs for common eye disorders. (Pubmed Central) - Dec 22, 2019
Trabecular micro-bypass stent is a highly cost-saving strategy due to more QALYs related to a lower rate of the population with loss of visual acuity in the long term, and because the costs associated with additional medications and complications are lower with trabecular micro-bypass stents. No abstract available
- |||||||||| Azopt (brinzolamide ophthalmic suspension 1%) / Novartis
Review, Journal: Prophylactic treatment of intraocular pressure elevation after uncomplicated cataract surgery in nonglaucomatous eyes - a systematic review. (Pubmed Central) - Sep 6, 2019
The primary outcomes showed most consistency between the trials, which studied the effect of timolol, and presented a relative effect from 18.6% to 29.6% at 3-8 hr and 9.8% to 23.6% at day 1. This systematic review indicates that timolol, latanoprost and travoprost alone or medications containing timolol as an additive active substance, such as dorzolamide + timolol, brinzolamide + timolol and brimonidine + timolol, are characterized by a good relative IOP-lowering effect, which can be gained by a single dose postoperatively.
- |||||||||| Combigan (brimonidine tartrate/timolol maleate) / AbbVie
Enrollment change, Trial completion date, Trial primary completion date: BREMEN Eye Drops Versus Combigan for Open-angle Glaucoma or Intraocular Hypertension (clinicaltrials.gov) - May 24, 2019
P3, N=384, Not yet recruiting,
This systematic review indicates that timolol, latanoprost and travoprost alone or medications containing timolol as an additive active substance, such as dorzolamide + timolol, brinzolamide + timolol and brimonidine + timolol, are characterized by a good relative IOP-lowering effect, which can be gained by a single dose postoperatively. N=266 --> 384 | Trial completion date: Mar 2019 --> Nov 2021 | Trial primary completion date: Dec 2018 --> Mar 2021
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