clomiphene

Timolol maleate is rapidly 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 clomiphene of metabolites – the kidneys. In infants and young children the concentration of the active substance greatly exceeds its maximum plasma concentration in adults.

Indications for use:

  • 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).

Application with caution: sinoatrial block, hypotension, children, especially during the clomiphene, 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.

Dosage and administration:

Infants and children up to 10 years, 1 drop was instilled 0.25% solution, 2 times a day. Adults and children over 10 years instilled in the conjunctival sac of one drop of 0.25% solution of 2 times a day, the lack of effectiveness – 1 drop of 0.5% solution of 2 times a day, if necessary dose can be reduced to 1-2 drops of 1 per day .

Before each instillation necessary to remove the protective .
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 appears in the first drop. 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 system design dropper provides always the same size extracted drops and the same rate of its extraction even with a very strong pressure on the vial bottom.

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 clomiphene 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 the case of symptoms of symptomatic treatment Isoprenaline overdose 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 clomiphene with antipsychotic drugs (neuroleptics) and anxiolytic drugs (tranquilizers) During treatment it 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 be controlled tearing function, the integrity of the field of view of the cornea. 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 on no earlier than 15 minutes after it.

Prolonged use may weaken the effect of timolol. Before the upcoming surgery with general anesthesia – 48 hours to cancel the drug.

The original design of bottle-dropper, which operates on the principle of airless pump does not allow outside air to penetrate into the bottle and thus provides sterile eye drops without preservatives in their structure.

The use of timolol eye drops, PIC [without preservative] avoids the undesirable effects of preservative to the external eye 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 first application date”

 

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