Alpha-2 agonist + beta-blocker eye drops
Brimonidine with timolol
Brand names: Combigan
Adult dose
Dose: 1 drop BD
Route: Ophthalmic
Frequency: BD
Clinical pearls
- NICE NG81 glaucoma combination drops
- RCOphth
Contraindications
- Severe asthma
- Bradyarrhythmia / heart block
- Heart failure
- Concurrent MAOI / TCA
- Hypersensitivity
Side effects
- Hyperaemia
- Dry mouth
- Bronchospasm
- Bradycardia
- Fatigue
- Depression
Interactions
- Systemic beta-blockers
- MAOIs
- Verapamil/diltiazem
- Insulin/oral hypoglycaemics
Monitoring
- IOP
- HR / BP
- Asthma
- Mood
Reference: BNF; NICE NG81; RCOphth; https://bnf.nice.org.uk/drugs/brimonidine-with-timolol/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- MAGGIC Heart Failure Risk Score · Heart Failure
- Long QT Syndrome (Schwartz Score) · Channelopathy / Sudden Cardiac Death
- C-Peptide to Glucose Ratio · Diabetes Classification
- International Staging System (ISS) for Multiple Myeloma · Multiple Myeloma
- Revised ISS (R-ISS) for Multiple Myeloma · Haematological Malignancy
- International Staging System for Multiple Myeloma (ISS) · Oncology
Pathways
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme