Latanoprost and Timolol Maleate

Miotic, Antiglaucoma Preps · Beta-blocker/Prostaglandin analogue

Indications

Ocular hypertension and open angle glaucoma where other treatments have failed or are not tolerated.

Dosage

Adults: 1 drop in affected eye(s) once daily, preferably in the evening. Children: Not recommended.

Adverse Effects

Darkening of mixed coloured irides; inform patient. Darker, longer or thicker lashes. Blurred vision, conjunctival hyperaemia, foreign body sensation, transient punctate epithelial erosion, periorbital oedema. Rarely macular oedema, iritis, uveitis, darkening of palpebral skin, exacerbation of asthma, dyspnoea, cardiac failure. Systemic beta blocker effects.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Asthma or history of asthma, severe COPD, sinus bradycardia, 2nd or 3rd degree AV block, sick sinus syndrome, sino-atrial block, uncompensated cardiac failure, cardiogenic shock. Active herpetic keratitis. Precautions: Diabetes, thyrotoxicosis. cardiovascular disease, 1st degree heart block, severe peripheral circulatory disorders, mild to moderate COPD. Inflammatory neovascular, angle closure or congenital glaucoma, pigmentary glaucoma, open angle glaucoma in pseudophakia patients. Severe asthma. Risk factors for iritis, uveitis or cystoid macular oedema. Aphakia, pseudophakia in patients with torn posterior lens capsule or anterior chamber lenses. Peri-op period of cataract surgery. History of herpetic keratitis. Monitor for keratopathy. Warn patient of possible eyelash growth,…

Interactions

Hypertensives, calcium antagonists, antidiabetic agents, clonidine, adrenaline, CYP2D6 inhibitors, antiarrhythmics, cardiac glycosides, parasympathomimetic. Additive effects with other glaucoma treatments. Leave interval of at least 5 min with other topical eye preps.

Advice to Patient

Wash hands properly before use. Remove contact lenses before use. Wait 15 minutes before reinserting. To instill medication into eyes, tilt head back, look upward, instill drops into the eye. Close eye and roll eyeball in all directions. Do not blink for 30 seconds. Apply gentle pressure to inner corner of eye for 30 seconds. Contact prescriber if there is eye pain; eye infection; redness, burning, watering, puffiness around eyes; changes in vision; no improvement or worsening of condition. Avoid touching tip of applicator with eye. Do not share medication with anyone else. Wait 5 minutes before instilling any other medication.

Pharmacokinetics

LATANOPROST: Onset: 2-4 hrs. Absorption: Rapidly absorbed in the cornea. Small amount of the drug is systemically absorbed. Metabolism: Hydrolyzed by esterases in the cornea to the biologically active acid. Active acid is metabolized via hepatic route. Half-life elimination: Plasma: 17 mins. Time to peak: 8-12 hrs. Excretion: Urine (88%). Faeces (15%). TIMOLOL: Onset: 30 mins. Duration: 12-24 hrs. Absorption: Significant systemic absorption when administered to the eye. Metabolism: Hepatic. Half-life elimination: 4 hrs. Time to peak: 1-2 hrs. Excretion: Urine (mainly).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.