Dorzolamide and Timolol Ophthalmic (patient information)

# Why this medication is prescribed
The combination of dorzolamide and timolol is used to treat eye conditions, including glaucoma and ocular hypertension, in which increased pressure can lead to a gradual loss of vision. Dorzolamide and timolol is used for patients whose eye condition has not responded to another medication. Dorzolamide is in a class of medications called topical carbonic anhydrase inhibitors. Timolol is in a class of medications called topical beta blockers. Dorzolamide and timolol lowers pressure in the eye by decreasing the production of natural fluids in the eye.

# How this medication should be used
The combination of dorzolamide and timolol comes as an eyedrop to apply to the eye. It is usually applied to the affected eye(s) twice a day. To help you remember to use dorzolamide and timolol, use it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use dorzolamide and timolol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Dorzolamide and timolol controls glaucoma and ocular hypertension but does not cure them. Continue to use dorzolamide and timolol even if you feel well. Do not stop using dorzolamide and timolol without talking to your doctor.
To apply the eyedrops, follow these steps:
- Wash your hands thoroughly with soap and water.
- Use a mirror or have someone else put the drops in your eye.
- Before using the eyedrops bottle for the first time, make sure the safety strip on the front of the bottle is unbroken.
- Tear off the safety strip to break the seal.
- To open the bottle, unscrew the cap by turning as indicated by the arrows.
- Avoid touching the dropper against your eye or anything else.
- Lie down or tilt your head back.
- Holding the bottle between your thumb and index finger, place the dropper as near as possible to your eyelid without touching it.
- Brace the remaining fingers of that hand against your cheek or nose.
- With the index finger of your other hand, pull the lower lid of the eye down to form a pocket.
- Press lightly with the thumb or index finger over the Finger Push Area until a single drop is dispensed into the pocket made by the lower lid and the eye. Placing the drops on the surface of the eyeball can cause stinging.
- Close your eye and press lightly against the lower lid with your finger for 2-3 minutes to keep the medication in the eye. Do not blink.
- Replace and tighten the cap right away. Do not wipe or rinse it off.
- Wipe off any excess liquid from your cheek with a clean tissue. Wash your hands again.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before using dorzolamide and timolol:
- tell your doctor and pharmacist if you are allergic to dorzolamide (Trusopt), timolol (Timoptic), sulfa drugs, or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Isoptin, Verelan); carbonic anhydrase inhibitors such as acetazolamide (Diamox), dichlorphenamide (Danaride), and methazolamide (GlaucTabs, Neptazane); clonidine (Catapres, Catapres-TTS); digoxin (Lanoxin); diuretics ('water pills'); quinidine (Quinidex); reserpine (Serpalan, Serpasil, Serpatabs); and salicylate pain relievers such as aspirin, choline magnesium trisalicylate, choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others), and salsalate (Argesic, Disalcid, Salgesic). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- if you are using another topical eye medication, apply it at least 10 minutes before or after dorzolamide and timolol.
- tell your doctor if you have or have ever had asthma, lung disease (including chronic bronchitis and emphysema), heart disease, diabetes, an overactive thyroid gland (hyperthyroidism), severe allergic reactions, myasthenia gravis, and kidney or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using dorzolamide and timolol, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using dorzolamide and timolol.
- you should know that dorzolamide and timolol solution contains benzalkonium chloride, which can be absorbed by soft contact lenses. If you wear contact lenses, remove them before applying dorzolamide and timolol and put them back in 15 minutes later.
- if you have an eye injury, infection, or surgery while using dorzolamide and timolol, ask your doctor if you should continue using the same eyedrops container.
- you should know that if you have allergic reactions to different substances, your reactions may be worse while you are using dorzolamide and timolol, and your allergic reactions may not respond to the usual doses of injectable epinephrine.

# Special dietary instructions
Unless your doctor tells you otherwise, continue your normal diet.

# What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects

## Minor side effects
Dorzolamide and timolol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- taste changes (bitter, sour, or unusual taste)
- eye burning or stinging
- itchy eyes
- dry eyes
- eye tearing
- dizziness

## Severe side effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- blurred vision
- skin rash
- swelling of the hands, feet, ankles, or lower legs
- shortness of breath
- pink eye
- redness or swelling of the eyelid
- muscle weakness
Dorzolamide and timolol may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- dizziness
- headache
- shortness of breath
- difficulty breathing or swallowing
- chest pain
- confusion

# Other information
Keep all appointments with your doctor.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Cosopt