Brimonidine Tartrate /Timolol 2 Mg/Ml + 5 Mg/Ml Eye Drops, Solution
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Brimonidine Tartrate; Brinzolamide
Contains Nonbinding Recommendations Draft Guidance on Brimonidine Tartrate ; Brinzolamide This draft guidance, when finalized, will represent the current thinking of the Food and Drug Administration (FDA, or the Agency) on this topic. It does not establish any rights for any person and is not binding on FDA or the public. You can use an alternative approach if it satisfies the requirements of the applicable statutes and regulations. To discuss an alternative approach, contact the Office of Generic Drugs. Active Ingredient: Brimonidine tartrate; Brinzolamide Dosage Form; Route: Suspension/drops; ophthalmic Strength: 0.2%; 1% Recommended Studies: One study Type of study: Bioequivalence (BE) study with clinical endpoint Design: Randomized (1:1), double-masked, parallel, two-arm, in vivo Strength: 0.2%; 1% Subjects: Males and females with chronic open angle glaucoma or ocular hypertension in both eyes. Additional comments: Specific recommendations are provided below. ______________________________________________________________________________ Analytes to measure (in appropriate biological fluid): Not applicable Bioequivalence based on (95% CI): Clinical endpoint Additional comments regarding the BE study with clinical endpoint: 1. The Office of Generic Drugs (OGD) recommends conducting a BE study with a clinical endpoint in the treatment of open angle glaucoma and ocular hypertension comparing the test product to the reference listed drug (RLD), each applied as one drop in both eyes three times daily at approximately 8:00 a.m., 4:00 p.m., and 10:00 p.m. for 42 days (6 weeks). 2. Inclusion criteria (the sponsor may add additional criteria): a. Male or nonpregnant females aged at least 18 years with chronic open angle glaucoma or ocular hypertension in both eyes b. -
Table 1. Glaucoma Medications: Mechanisms, Dosing and Precautions Brand Generic Mechanism of Action Dosage/Avg
OPTOMETRIC STUDY CENTER Table 1. Glaucoma Medications: Mechanisms, Dosing and Precautions Brand Generic Mechanism of Action Dosage/Avg. % Product Sizes Side Effects Warnings Reduction CHOLINERGIC AGENTS Direct Pilocarpine (generic) Pilocarpine 1%, 2%, 4% Increases trabecular outflow BID-QID/15-25% 15ml Headache, blurred vision, myopia, retinal detachment, bronchiole constriction, Angle closure, shortness of breath, retinal narrowing of angle detachment Indirect Phospholine Iodide (Pfizer) Echothiophate iodide 0.125% Increases trabecular outflow QD-BID/15-25% 5ml Same as above plus cataractogenic iris cysts in children, pupillary block, Same as above, plus avoid prior to any increased paralysis with succinylcholine general anesthetic procedure ALPHA-2 AGONISTS Alphagan P (Allergan) Brimonidine tartrate 0.1%, 0.15% with Purite Decreases aqueous production, increases BID-TID/up to 26% 5ml, 10ml, 15ml Dry mouth, hypotension, bradycardia, follicular conjunctivitis, ocular irritation, Monitor for shortness of breath, dizziness, preservative uveoscleral outflow pruritus, dermatitis, conjunctival blanching, eyelid retraction, mydriasis, drug ocular redness and itching, fatigue allergy Brimonidine tartrate Brimonidine tartrate 0.15%, 0.2% Same as above Same as above 5ml, 10ml Same as above Same as above (generic) Iopidine (Novartis) Apraclonidine 0.5% Decreases aqueous production BID-TID/up to 25% 5ml, 10ml Same as above but higher drug allergy (40%) Same as above BETA-BLOCKERS Non-selective Betagan (Allergan) Levobunolol 0.25%, 0.5% Decreases -
Fluid Ophthalmic Composition Based on Lipid Microparticles Containing at Least One Active Principle
Europaisches Patentamt J European Patent Office Office europden des brevets (11) Publication number : 0 437 368 A1 EUROPEAN PATENT APPLICATION (21) Application number: 91300181.4 ® int. ci.5 : A61K 9/06, A61K 9/16 @ Date of filing : 10.01.91 © Priority : 12.01.90 FR 9000340 (72) Inventor : Rozier, Annouk 23 Bd Lafayette F-63000 Clermont-Ferrand (FR) @ Date of publication of application : 17.07.91 Bulletin 91/29 74) Representative : Hesketh, Alan, Dr. et al European Patent Department Merck & Co., @ Designated Contracting States : Inc. Tertings Park Eastwick Road CH DE FR GB IT LI NL Harlow Essex, CM20 2QR (GB) © Applicant : LABORATOIRES MERCK, SHARP & DOHME-CHIBRET 3, Avenue Hoche F-75008 Paris (FR) (S) Fluid ophthalmic composition based on lipid microparticles containing at least one active principle. (57) There is described a fluid ophthalmic composition which comprises a suspension in a fluid dispersant medium of lipid microparticles containing at least one active principle. The composition enables improved availability of the active principle to be obtained as a result of high intraocular levels. 00 <0 CO Q. UJ Jouve, 18, rue Saint-Denis, 75001 PARIS EP 0 437 368 A1 FLUID OPHTHALMIC COMPOSITION BASED ON LIPID MICROPARTICLES CONTAINING AT LEAST ONE ACTIVE PRINCIPLE The present invention relates to a fluid ophthalmic composition. Many ophthalmic compositions are currently available in liquid or solid form, but none of them is, in fact, completely satisfactory. In effect, liquid ophthalmic compositions, although easy to use, have some drawbacks ; in particular, it is 5 difficult to obtain a sustained or delayed action of the active principle which they contain. -
ALPHAGAN® 0.2% Safely and Effectively
NDA 20613/S-031 Page 4 HIGHLIGHTS OF PRESCRIBING INFORMATION ___________ ___________ ADVERSE REACTIONS Most common adverse reactions occurring in These highlights do not include all the information needed approximately 10 to 30% of patients receiving brimonidine to use ALPHAGAN® 0.2% safely and effectively. See full ophthalmic solution 0.2% included oral dryness, ocular prescribing information for ALPHAGAN® 0.2%. hyperemia, burning and stinging, headache, blurring, foreign body sensation, fatigue/drowsiness, conjunctival ALPHAGAN® (brimonidine tartrate ophthalmic solution) follicles, ocular allergic reactions, and ocular pruritus. (6.1) 0.2% For Topical Ophthalmic Use To report SUSPECTED ADVERSE REACTIONS, Initial U.S. Approval: 1996 contact Allergan at 1-800-433-8871 or the FDA at 1 800-FDA-1088 or www.fda.gov/medwatch. _________ _________ INDICATIONS AND USAGE ___________ ____________ DRUG INTERACTIONS ALPHAGAN® 0.2% is an alpha adrenergic agonist indicated Antihypertensives/cardiac glycosides may lower blood for lowering intraocular pressure (IOP) in patients with open- pressure. (7.1) angle glaucoma or ocular hypertension. (1) ________ ________ Use with CNS depressants may result in an additive or DOSAGE AND ADMINISTRATION potentiating effect. (7.2) One drop in the affected eye(s), three times daily, Tricyclic antidepressants may potentially blunt the approximately 8 hours apart. (2) hypotensive effect of systemic clonidine. (7.3) _______ _______ DOSAGE FORMS AND STRENGTHS Monoamine oxidase inhibitors may result in increased Solution containing 2 mg/mL brimonidine tartrate. (3) hypotension. (7.4) _________ _____________ _______ ______ CONTRAINDICATIONS USE IN SPECIFIC POPULATIONS Neonates and infants (under the age of 2 years). (4.1) Use with caution in children > 2 years of age. -
New Medicines Committee Briefing March 2015 Simbrinza
New Medicines Committee Briefing March 2015 Simbrinza® (Brinzolamide 10mg + Brimonidine tartrate 2mg/ml) for treatment of elevated intraocular pressure (IOP) in adult patients with open-angle glaucoma or ocular hypertension. Simbrinza® is to be reviewed for use within: Primary Care Secondary Care Summary: Simbrinza® is a combination of brinzolamide which is a carbonic anhydrase (CA-II) inhibitor and brimonidine which is an alpha-2 adrenergic agonist. Simbrinza® is licensed for the treatment of elevated IOP in adult patients with open-angle glaucoma or ocular hypertension whom failed on mono-therapy. Simbrinza® is administered twice daily in the affected eye(s). Simbrinza® is the first combination therapy which does not contain a beta-blocker. SMC has accepted Simbrinza® for use within NHS Scotland, as there is no significant additional cost associated with the combination product compared with its individual components. One trial indicated that fixed combination of Simbrinza® administered BD had a significantly greater IOP lowering effect compared to either brinzolamide 1% or brimonidine 0.2% alone and displayed a safety profile consistent with its individual components. Another trial noted Simbrinza® to be non-inferior to separate administration of brimonidine and brinzolamide less than 10 min apart to prevent wash out. 1 Formulary application: Opthamology department: Consultant submitting application: Mr Lynval Jones (Consultant Ophthalmologist, Glaucoma) Clinical Director supporting application: Gareth Rowland (Clinical Director of Specialised Surgery) Mr Jones has requested for Simbrinza® to be considered for inclusion in the North Staffordshire Joint Formulary for the treatment of elevated intraocular pressure (IOP) in adult patients with open-angle glaucoma or ocular hypertension who have not responded to monotherapy. -
View Board, Austin, Texas, As Well As the Ethics Com- Pendent Examiner in the Same Room with the Same Instru- Mittee of Eye Center and Research, Aseer, Saudi Arabia
Abdelkader and Kaufman Eye and Vision (2016) 3:31 DOI 10.1186/s40662-016-0065-3 RESEARCH Open Access Clinical outcomes of combined versus separate carbachol and brimonidine drops in correcting presbyopia Almamoun Abdelkader1* and Herbert E. Kaufman2 Abstract Background: To test and compare in a masked fashion the efficacy of using a parasympathomimetic drug (3% carbachol) and an alpha-2 agonist (0.2% brimonidine) in both combined and separate forms to create optically beneficial miosis to pharmacologically improve vision in presbyopia. Methods: A prospective, double-masked, randomized, controlled clinical trial was conducted. Ten naturally emmetropic and presbyopic subjects between 42 and 58 years old with uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion. All subjects received 3% carbachol and 0.2% brimonidine in both combined and separate forms, 3% carbachol alone and 0.2% brimonidine (control) alone in their non-dominant eye in a crossover manner with one week washout between tests. The subjects’ pupil sizes and both near and distance visual acuities will be evaluated pre- and post-treatment at 1, 2, 4, and 8 h, by a masked examiner at the same room illumination. Results: Statistically significant improvement in mean near visual acuity (NVA) was achieved in all subjects who received combined 3% carbachol and 0.2% brimonidine in the same formula compared with those who received separate forms or carbachol alone or brimonidine alone (P < 0.0001). Conclusion: Based on the data, the combined solution demonstrated greater efficacy than the other solutions that were tested. -
NEW CONCEPTS in GLAUCOMA CARE TREATMENT Proceedings of the Fifteenth Annual Meeting & of the Optometric Glaucoma Society
NEW CONCEPTS IN GLAUCOMA CARE TREATMENT Proceedings of the Fifteenth Annual Meeting & of the Optometric Glaucoma Society INSIDE: • Virtual Reality Uses in Glaucoma • Questions Glaucoma Patients Ask • Pathogenesis of Glaucoma • Glaucoma Progression • Real-Time Aqueous Humor Outfl ow Imaginging APRIL 2017 REVIEW OF OPTOMETRY/APRIL 2017 1 0217_OGS_ja_3.22.indd 1 3/24/17 3:36 PM ro0417ogs_vyzulta.indd 1 3/20/17 1:57 PM NEW CONCEPTS IN GLAUCOMA CARE TREATMENT TABLE OF CONTENTS INTRODUCTORY REMARKS The 15th Annual Scientifi c Meeting of the Optometric Glaucoma Society (OGS), held Nov. 15 and 16, 2016, in Anaheim, Calif., brought 3 together some of the country’s top luminaries INTRODUCTORY REMARKS in the areas of glaucoma diagnosis, treatment, Highlights From the Annual Scientifi c assessment, and management. These individu- Meeting als shared groundbreaking research and the BY MURRAY FINGERET, OD latest clinical knowledge about glaucoma—con- sidered to be the top global eye burden by the World Health Organization. 4 Kicking things off in the President’s Lecture, PRESIDENT’S LECTURE Felipe A. Medeiros, MD, PhD, highlighted potential clinical applications for More Than a Video Game: Virtual virtual reality devices. These devices, being tested in simulation laboratories, Reality and Its Uses in Glaucoma could one day assist clinicians in assessing patients at risk for glaucoma and BY FELIPE A. MEDEIROS, MD, PHD in danger of falls and motor vehicle accidents due to visual fi eld loss. Make no mistake: These cutting-edge tools are not your techie’s virtual reality. Dr. Medeiros, in a separate lecture about glaucoma progression, unveiled 6 an innovative metric developed by his research group to measure functional PATIENT CARE and structural vision loss in glaucoma patients. -
Efficacy and Safety of the Fixed Combinations of Tafluprost/Timolol
www.nature.com/scientificreports OPEN Efcacy and safety of the fxed combinations of tafuprost/timolol and latanoprost/carteolol Received: 4 February 2019 Masahiro Fuwa, Atsushi Shimazaki, Masafumi Mieda, Naoko Yamashita, Takahiro Akaishi, Accepted: 7 May 2019 Takazumi Taniguchi & Masatomo Kato Published: xx xx xxxx In this study, we made a comparative efcacy and safety assessment of two diferent fxed combinations of drugs, viz., tafuprost/timolol (TAF/TIM) and latanoprost/carteolol (LAT/CAR), by determining their efects on intraocular pressure (IOP) in ocular normotensive monkeys and examining their toxic efects on ocular surface using human corneal epithelial cells. TAF/TIM was found to be more efective in lowering IOP for a longer duration compared to LAT/CAR. We found that the diference in the intensity of IOP-lowering efect was because of the diferences in the strength of timolol compared with that of carteolol as a beta-adrenergic antagonist and strength of tafuprost compared with that of latanoprost as a prostaglandin analogue. In addition, TAF/TIM showed much less cytotoxic efects compared to LAT/CAR on the human corneal epithelial cells. Our fndings showed that TAF/TIM is better than LAT/CAR with regard to the IOP-lowering efect in monkeys and toxicity on ocular surface. Glaucoma is a neurodegenerative disease of the eyes characterised by selective retinal ganglion cell loss, fol- lowed by progressive defects in visual feld, resulting in the principal cause of irreversible blindness worldwide1–4. Elevated intraocular pressure (IOP) is an important contributor for the progression of glaucoma, for which the current treatment primarily involves IOP reduction1,5–8. -
Generic Drugs and Trade Name Equivalents: Alphabetized by Generic Name
GENERIC DRUGS AND TRADE NAME EQUIVALENTS: ALPHABETIZED BY GENERIC NAME Generic Trade Generic Trade Generic Trade acetaminophen Tylenol escitalopram Lexapro niacin, nicotinic acid Niaspan, Slo-Niacin acetaminophen-codeine Tylenol #3 estrogen Premarin nitroglycerin Nitro-bid acetazolamide Diamox eszopiclone Lunesta nystatin Mycostatin acyclovir Zovirax ethambutol Myambutol ofloxacin Ocuflox albuterol Proventil, Ventolin eye vitamin supplement Ocuvite PreserVision olopatadine Patanol alendronate Fosamax famciclovir Famvir omeprazole Prilosec allopurinol Zyloprim felodipine Plendil paraffin-mineral oil Lacri-Lube alprazolam Xanax fexofenadine Allegra paroxetine Paxil aminocaproic acid Amicar fexofenadine-pseudoephedrine Allegra-D pegaptanib Macugen amiodarone Cordarone finasteride Propecia, Proscar peginterferon alfa-2a Pegasys amitryptyline Elavil fluconazole Diflucan peginterferon alfa-2b PegIntron amlodipine Norvasc flunisolide AeroBid pemirolast potassium Alamast amoxicillin Amoxil, Dispermox fluorometholone FML phenytoin Dilantin amoxicillin-clavulanate Augmentin fluorouracil Efudex pilocarpine IsoptoCarpine, Pilocar apraclonidine Iopidine fluoxetine Prozac piroxicam Feldene AREDS formula PreserVision flutamide Eulexin polymyxin B-bacitracin Polysporin atenolol Tenormin fluticasone Flovent, Flonase polymyxin B-bacitracin-neomycin Neosporin (ointment) atorvastatin Lipitor folinic acid Folixor polymyxin B-neomycin-gramicidin Neosporin (suspension) azathioprine Imuran foscarnet Foscavir potassium chloride Micro-K, K-Dur, Klor-Com azelastine -
Estonian Statistics on Medicines 2016 1/41
Estonian Statistics on Medicines 2016 ATC code ATC group / Active substance (rout of admin.) Quantity sold Unit DDD Unit DDD/1000/ day A ALIMENTARY TRACT AND METABOLISM 167,8985 A01 STOMATOLOGICAL PREPARATIONS 0,0738 A01A STOMATOLOGICAL PREPARATIONS 0,0738 A01AB Antiinfectives and antiseptics for local oral treatment 0,0738 A01AB09 Miconazole (O) 7088 g 0,2 g 0,0738 A01AB12 Hexetidine (O) 1951200 ml A01AB81 Neomycin+ Benzocaine (dental) 30200 pieces A01AB82 Demeclocycline+ Triamcinolone (dental) 680 g A01AC Corticosteroids for local oral treatment A01AC81 Dexamethasone+ Thymol (dental) 3094 ml A01AD Other agents for local oral treatment A01AD80 Lidocaine+ Cetylpyridinium chloride (gingival) 227150 g A01AD81 Lidocaine+ Cetrimide (O) 30900 g A01AD82 Choline salicylate (O) 864720 pieces A01AD83 Lidocaine+ Chamomille extract (O) 370080 g A01AD90 Lidocaine+ Paraformaldehyde (dental) 405 g A02 DRUGS FOR ACID RELATED DISORDERS 47,1312 A02A ANTACIDS 1,0133 Combinations and complexes of aluminium, calcium and A02AD 1,0133 magnesium compounds A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 811120 pieces 10 pieces 0,1689 A02AD81 Aluminium hydroxide+ Magnesium hydroxide (O) 3101974 ml 50 ml 0,1292 A02AD83 Calcium carbonate+ Magnesium carbonate (O) 3434232 pieces 10 pieces 0,7152 DRUGS FOR PEPTIC ULCER AND GASTRO- A02B 46,1179 OESOPHAGEAL REFLUX DISEASE (GORD) A02BA H2-receptor antagonists 2,3855 A02BA02 Ranitidine (O) 340327,5 g 0,3 g 2,3624 A02BA02 Ranitidine (P) 3318,25 g 0,3 g 0,0230 A02BC Proton pump inhibitors 43,7324 A02BC01 Omeprazole -
COMBIGAN® EYE DROPS (Brimonidine Tartrate 2.0 Mg Per Ml and Timolol (As Maleate) 5.0 Mg Per Ml)
COMBIGAN® EYE DROPS (brimonidine tartrate 2.0 mg per mL and timolol (as maleate) 5.0 mg per mL) Consumer Medicine Information What is in this leaflet aware of this gradual loss of sight. any of the ingredients listed at Sometimes even normal eye the end of this leaflet, some This leaflet answers some common pressure is associated with damage symptoms of an allergic reaction questions about COMBIGAN® eye to the back of the eye. include skin rash, itching, drops. It does not contain all the There are usually no symptoms of shortness of breath or swelling available information. It does not glaucoma. The only way of of the face, lips or tongue, which take the place of talking to your knowing that you have glaucoma is may cause difficulty in doctor or pharmacist. to have your eye pressure, optic swallowing or breathing All medicines have risks and nerve and visual field checked by an • you are taking monoamine benefits. Your doctor has weighed eye specialist or optometrist. If oxidase antidepressant the risks of you using glaucoma is not treated it can lead medication COMBIGAN® eye drops against to serious problems, including total • you have bronchospasm, the benefits they expect it will have blindness. In fact, untreated bronchial asthma or have a for you. glaucoma is one of the most history of bronchial asthma or common causes of blindness. other lung disease If you have any concerns about using this medicine, ask your doctor COMBIGAN® eye drops lower the • you have a severe or unstable or or pharmacist. pressure in the eye by decreasing uncontrolled heart condition Keep this leaflet with the the fluid produced and helping the • the seal around the cap is broken medicine. -
Glaucoma Medical Treatment: Philosophy, Principles and Practice
Glaucoma medical CLIVE MIGDAL treatment: philosophy, principles and practice Abstract assessment of these parameters. Indeed There have been numerous recent advances in compounds are under evaluation that affect the the management of glaucoma, not least the function of the optic nerve (via improved blood development of new drugs to help manage supply or improved neuronal cell physiology) raised intraocular pressure. In addition, the but may or may not lower lOP. It may even be concepts of improving blood flow to the optic possible in the future to therapeutically alter the nerve head and neuroprotection are currently human genome, genetically deliver provoking considerable interest. This article neuroprotective substances or aid regeneration considers the aims and philosophy of of the optic nerve axons. glaucoma drug therapy, summarises some of The main aim of glaucoma therapy must still the basic facts and principles of modem be the preservation of visual function. At the glaucoma medications, and suggests a same time, the therapy should not have adverse practical approach to the choice of therapy. side effects and should not affect the quality of life of the patient (by causing either side effects Key words Blood flow, Intraocular pressure, or inconvenience and disruption of daily Neuroprotection, Primary open angle glaucoma, Topical medications lifestyle). The cost of the therapy, both direct and indirect, must also be taken into consideration.s Currently, typical glaucoma management Philosophy consists of lowering the lOP to a satisfactory Primary open-angle glaucoma is a complex and safe target leve1.6 To determine the success disease for which a number of risk factors have of this treatment, the patient must be followed been identified, including intraocular pressure, long-term with routine assessment of lOP, discs age, race and family history.l,2 Due to our and fields to exclude progressive damage.