On October 30, the FDA approved brimonidine tartrate/timolol maleate 0.2%/0.5% topical ophthalmic solution to reduce intraocular pressure (IOP) in patients with glaucoma or ocular hypertension who require adjunctive or replacement therapy because of inadequately controlled IOP.
The recommended dosing for the alpha-adrenergic–receptor agonist plus beta-adrenergic–receptor inhibitor topical solution is 1 drop in the affected eye approximately every 12 hours; at least 5 minutes should elapse before and after administration of another topical product.
Use in children aged younger than 2 years is not recommended.
Approval of the combination product was based on data from 12-month pivotal trials, showing its use provided an additional decrease of 1 to 3 mm Hg in IOP vs brimonidine alone and an additional decrease of 1 to 2 mm Hg vs timolol alone during the first 7 hours after dosing.
Although the IOP-lowering effect of the combination product was slightly less than that of combination therapy with twice-daily timolol 0.5% solution and 3 times daily brimonidine 0.2% solution, it was associated with a decreased level of self-reported sleepiness in patients aged older than 40 years.
Adverse events reported in approximately 5% to 15% of patients using brimonidine/timolol solution included allergic conjunctivitis, conjunctival folliculosis, conjunctival hyperemia, eye pruritis, ocular burning, and stinging.