Of elevated intraocular pressure reduction with open-angle glaucoma and ocular hypertension in patients resistant to monotherapy with beta-blockers or prostaglandin analogues.
Hypersensitivity to the drug.
Bronchial asthma, bronchial asthma, a history of severe chronic obstructive pulmonary disease, bronchial hyperreactivity, sinus bradycardia, atrioventricular block degree II-III, decompensated chronic heart failure, cardiogenic shock, allergic trenbolone hex rhinitis, severe course, corneal dystrophy, hypersensitivity to the group of beta blockers, pregnancy, lactation, children under 18 years.
Neovascular, closure, narrow-angle glaucoma, pigmentary and congenital glaucoma, open-angle glaucoma with psevdoafakiey, pseudoexfoliation glaucoma; inflammatory ophthalmic diseases; aphakia, psevdofakiya a posterior lens capsule rupture, patients with the risk of cystoid macular edema, iritis, uveitis.
Anaphylactic reactions. Patients with atopy or serious anaphylactic reactions to different allergens in history, receiving beta-blockers may be resistant to the usual doses of epinephrine in the treatment of anaphylactic reactions. Systemic effects. Travoprost and timolol are subjected to systemic absorption. Timolol for topical use can cause the same side effects to the cardiovascular and respiratory systems, as well as systemic beta-blockers. It is necessary to monitor the patient’s condition prior to and during therapy with timolol. Cases of severe respiratory and cardiovascular disorders, including the death of bronchospasm in patients with asthma and death from heart failure by using timolol.
Beta-blockers should be used with caution in patients with a tendency to hypoglycemia or diabetes (especially labile course of diabetes) because these drugs can mask the symptoms of acute hypoglycemia.
beta-blockers may mask the symptoms of hyperthyroidism and cause peripheral and central circulatory disorders and hypotension, as well as deterioration in Prinzmetal angina.
Before elective surgery beta-blockers should be gradually (not simultaneously!) abolished for 48 hours prior to general anesthesia, as during general anesthesia may reduce myocardial sensitivity to sympathetic stimulation necessary for the heart.
Dosing and Administration
The drug instilled 1 drop into the conjunctival eye bag 1 time per day in the evening or in the morning at the same time.
Recommended after installation preparation pinch nasolacrimal duct by pushing in its projection from trenbolone hex the inner to reduce the risk of systemic side effects corner of the eye.
If the dose was missed, the treatment should be continued with the next dose. The daily dose should not exceed 1 drop in the conjunctival sac eyes 1 time per day.
Side effects Local. In 10% of cases, there is eye irritation and redness of the conjunctiva. In 1-10% of cases – punctate keratitis, exudate in the anterior chamber, the pain and itching in the eyes, photophobia, conjunctival hemorrhage, corneal erosion, discomfort and foreign body sensation, blurred vision, blurred vision, feeling of blurred vision, dry eyes , the development of allergic conjunctivitis, increased lacrimation, irritation of the eyelid, erythema of eyelid, dermatitis eyelid, skin hyperpigmentation (periorbital), asthenopia, darkening, thickening and lengthening eyelashes, blepharitis. In 0.1-1% of cases – pain, itching and swelling of the eyelids, allergic reactions, swelling of the conjunctiva, keratitis. Systemic side effects. in 1-10% of cases – general anxiety, dizziness, headache, increased or decreased blood pressure, bradycardia, arrhythmia, bronchospasm, rash, pain in the limbs. The 0.1- 1% – shortness of breath, cough, throat irritation, increased levels of alanine aminotransferase and aspartate aminotransferase, contact dermatitis, the change in color of urine, thirst, the occurrence of postnasal drip syndrome. Possible side effects (frequency not known) include: corneal lesion, tachycardia, chest pain. Travoprost: macular edema, uveitis, iritis, conjunctivitis, folliculosis conjunctiva, crusting on the edges of the eyelids, increased pigmentation of the iris, bronchial asthma, skin exfoliation. Timolol: diplopia, conjunctivitis, ptosis century, hypoglycemia, depression, cerebrovascular disorders, cerebral ischemia, syncope, paresthesia, myasthenia gravis, heart failure, arrhythmias, heart failure, atrioventricular block, palpitations, respiratory failure, nasal congestion, diarrhea, nausea, rash, alopecia , chest pain, asthenia.
Overdose Symptoms: irritation of the mucous membrane of the eye, conjunctival hyperemia or episclera, bradycardia, decreased blood pressure, bronchospasm, and cardiac arrest. Treatment. It is recommended to immediately wash with water groove and symptomatic therapy. Hemodialysis is ineffective.
Interaction with other drugs
interaction studies were not conducted with other drugs. There is a chance of increasing the hypotensive action and the development of bradycardia during concomitant use of timolol with calcium channel blockers for ingestion, guanethidine, beta-blockers, antiarrhythmic drugs, cardiac glycosides and parasympathomimetics. The development of hypertension after abrupt withdrawal of clonidine may be enhanced while taking beta-blockers.
Beta-blockers may increase the hypoglycemic effect of antidiabetic agents. Beta-blockers may mask symptoms of hypoglycemia.
DuoTrav ® may be used in combination with other topical ophthalmic preparations for reducing intraocular pressure. In this case, the interval between their application should be at least 5 minutes.
It is not recommended the simultaneous use of two local beta-blockers or two local prostaglandins analogs!
Cautions Local Action travoprost trenbolone hex may cause a gradual change in eye color by increasing the amount of brown pigment in melanocytes. Prior to treatment, patients should be informed about the possibility of changing eye color. Treatment of only one eye can result in permanent heterochromia. The long-term effects on the melanocytes and the consequences of this effect are currently unknown. Change the color of the iris eyes slowly and can remain undetected for a number of months or years. This effect is detected predominantly in patients with mixed colored irises, eg, blue-brown, gray-brown, green-brown or yellow-brown; but it can also be observed in patients with brown eyes. Typically brown pigmentation extends concentrically around the periphery of the iris pupil eye with all or part of the iris can acquire a more intense brown color. After discontinuation of the drug was observed to further increase the amount of brown pigment, but has evolved color change may be irreversible. The drug can cause darkening, thickening and lengthening eyelashes / or increase their number; rarely – skin darkening of the eyelids. The mechanism of these changes is not currently installed. The product contains the preservative benzalkonium chloride, which may be absorbed by contact lenses. Before using the product of the lens must be removed and set back no earlier than 15 minutes after treatment. If the patient after treatment temporarily reduced vision sharpness to its recovery is not recommended to drive and engage in activities that require attention. Do not touch the tip of the bottle dropper to any surface to avoid contamination of the vial-dropper and its contents. The vial must be closed after each use.
Product form Eye drops. According to 2.5 ml in a bottle-dropper «Droptainer ™» polypropylene with a polypropylene cap. 1 bottle in a bag of foil with instruction on the medical application in paper cartons.
Do not use after the expiration date printed on the package. Use within 4 weeks after opening the bottle.
At a temperature of 2-25 ° C, out of reach of children.
Conditions of supply: according to the recipe. balkan pharmaceuticals