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Prostaglandin analogue + β-blocker

Latanoprost with timolol

Brand names: Xalacom

This is a topical ophthalmic fixed combination of latanoprost, a prostaglandin analogue, and timolol, a non-selective beta-blocker, used to reduce intraocular pressure in open-angle glaucoma and ocular hypertension where monotherapy is inadequate.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Latanoprost enhances uveoscleral outflow of aqueous humour, while timolol reduces aqueous production via beta-adrenergic blockade, producing additive intraocular pressure lowering.

Prescribing in practice

  • The systemically absorbed timolol component means the combination is contraindicated in asthma, a history of bronchospasm, severe COPD, sinus bradycardia, heart block and uncontrolled heart failure.
  • Latanoprost may cause permanent iris darkening, periocular skin pigmentation and increased eyelash growth, especially with unilateral treatment.
  • Use once daily and apply nasolacrimal occlusion after instillation to limit systemic beta-blocker absorption.

Monitoring

Check intraocular pressure to assess response and review for systemic beta-blockade such as bradycardia and bronchospasm, alongside local prostaglandin effects on the iris and lashes.

Counselling the patient

  • Use the drop once daily, usually in the evening, and press on the inner corner of the eye afterwards.
  • The eye colour may darken and eyelashes may grow longer, which can be permanent.
  • Report wheeze, breathlessness, a slow heartbeat or unusual tiredness.

Evidence & guidelines

NICE glaucoma guidance (NG81) supports fixed-combination topical therapy, including a prostaglandin analogue with a beta-blocker, when single-agent treatment does not reach target intraocular pressure.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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