clomid

Timolol maleate is rapidly clomid penetrates the cornea of the eye tissue. The small amount reaches the systemic circulation by absorption through the conjunctiva, the mucous membranes of the nose and the lachrymal tract. Excretion of metabolites – the kidneys. In infants and young children the concentration of the active substance greatly exceeds its maximum plasma concentration in adults.

Indications

– Primary open-angle glaucoma;
– secondary glaucoma (uveal, afakicheskaya, posttraumatic)
– congenital glaucoma (with the ineffectiveness of other therapeutic measures);
– a sharp rise in intraocular pressure;
– primary angle-closure glaucoma (in combination with miotikami).

Contraindications

– Chronic obstructive pulmonary disease, severe course including – asthma,
– sinus bradycardia (slow heartbeat)
– atrioventricular block II and III level;
– acute and chronic heart failure II and III level;
– cardiogenic shock;
– degenerative corneal disease;
– severe vasomotor rhinitis;
– hypersensitivity to the drug.

Application with caution : sinoatrial block, hypotension, children, especially the newborn period, cerebrovascular insufficiency, diabetes, hypoglycemia, hyperthyroidism, myasthenia gravis, concurrent administration of other beta-blockers.

Pregnancy and lactation:

In pregnancy, the drug is used, if the expected benefit to the mother outweighs the potential risk to the fetus. During the use of the drug should stop breastfeeding.

Dosing and Administration

Before each instillation necessary to remove the protective cap clomid.
Prior to the first use of the drug vial flip the dropper vertically downwards and push its base (bottom) several times, until the tip of the dropper is not the first drop appears (see. Fig. 2) . Thereafter the vial is ready for use.
When the drug instillation hold the dropper bottle down quickly and forcefully pressing on his base (bottom). Thus, a mechanism is actuated only extracted a dropper and one drop of formulation. A special valve design of the system provides a dropper always the same size drops and extracted the same rate of its extraction even with a very strong pressure on the vial bottom. Tilt the head back slightly, slightly pull the lower eyelid with your finger and drip one drop into the conjunctival sac, as described above. Slowly close your eyes.
After the procedure immediately tightly put on a drip .
When backfilling should avoid contact with the surface of the dropper tip eyes and skin.

Side effect

Local reactions:
irritation of the eyes, which manifests itself in the form of conjunctivitis, blepharitis, keratitis (hyperemia of the eyelid skin, burning and itching in the eyes, conjunctival hyperemia, tearing or decrease lacrimation, photophobia, edema of the corneal epithelium, a short break in visual acuity, prolonged use may develop superficial keratopathy point (decrease the transparency of the cornea) and reduction in the sensitivity of the cornea), ptosis, diplopia;

Systemic reactions:
Cardio-vascular system: decrease in blood pressure, bradycardia, bradyarrhythmia, atrioventricular block, heart failure, heart failure, decreased myocardial contractility, chest pain, transient ischemic attack, collapse,
part of the respiratory system: dyspnea, bronchospasm , pulmonary insufficiency,
the part of the central nervous system: dizziness, headache, drowsiness, hallucinations, slow the speed of psychomotor reactions;
Other side effects: allergic reactions (including hives), rhinitis, nasal congestion, nosebleeds, nausea, vomiting , diarrhea, paresthesia, muscle weakness, sexual dysfunction, depression.

Overdose

When applied topically in the recommended dose overdose symptoms are not observed. In case of accidental ingestion may develop the following symptoms: nausea, vomiting, dizziness, headache, decreased blood pressure, bronchospasm, bradycardia. In case of overdose symptomatic treatment clomid of symptoms. Isoprenaline can be administered intravenously to correct bradycardia or bronchospasm, dobutamine to treat hypotension.

Interaction with other drugs

Epinephrine, pilocarpine, systemic beta-blockers increase the effect. When applied with reserpine – may develop bradycardia or hypotension (this combination requires careful medical supervision); with calcium channel blockers or cardiac glycosides – may impair atrioventricular conduction, acute left ventricular failure or hypotension. It enhances the action of muscle relaxants (timolol should be canceled 48 hours before the expected general anesthesia with the use of peripheral muscle relaxants). You can not simultaneously be used with antipsychotic drugs (neuroleptics) and anxiolytic drugs (tranquilizers).During treatment is not recommended to take ethanol (perhaps a sharp decrease in blood pressure). With caution in conjunction with antihypertensive drugs, other beta-blockers, insulin or oral hypoglycemic drugs, corticosteroids, psychoactive drugs.

Special instructions:

Efficiency control should be about 3-4 weeks after initiation of therapy. During treatment at least 1 time in 6 months should monitor the function of tearing, the integrity of the cornea, the field of view. During the period of treatment must be careful when driving and other activities potentially hazardous activities that require high concentration and psychomotor speed reactions and good vision (for 0.5 hours after instillation of the eye).
Contact lenses should be removed prior to instillation and put no earlier than 15 minutes after it.
with prolonged use of timolol may weaken the effect.
Before the upcoming surgery with general anesthesia -. 48 hours preparation cancel
original design of bottle-dropper, which operates on the principle of airless pump does not allow outside air to penetrate into bottle and thus provides sterile eye drops in the absence of their composition a preservative.
the use of “timolol-PIC eye drops [without preservative] avoids the undesirable effects of preservative to external ocular tissue, conjunctiva and cornea, and – eliminates the risk of allergic reactions to the preservative .
After opening the bottle, and the first instillation of timolol eye drops, PIC [without preservative] the drug can be used for 12 weeks. To do this, mark on the vial and / or a cardboard bundle the date when
you first dripped drug. On the bottle label and the carton pack, a special graph to fill the patient: “The date of the first application.”

After using the vial contents clomid should buy a new vial; used bottle is not suitable for re-use and must be disposed of (discard the used bottle in the trash)