Combigan (brimonidine/timolol) is a brand-name drug prescribed for high eye pressure in adults and some children with certain eye conditions. Combigan comes as an eye drop that’s typically used twice per day.

Combigan is approved by the Food and Drug Administration (FDA) to treat increased eye pressure from the following conditions:

Combigan is approved for these uses in adults and children ages 2 years and older. The medication is typically prescribed when an additional or different treatment is needed to manage the condition.

Combigan is a combination of two active ingredients: brimonidine and timolol. Brimonidine belongs to a drug class called alpha-adrenergic receptor agonists. Timolol belongs to a drug class called beta-adrenergic receptor blockers. While these two ingredients work differently, they both help reduce elevated eye pressure.

Combigan is available in a generic version.

Keep reading for specific information about the dosage of Combigan, including its strength and how to use the medication. For a comprehensive look at Combigan, see this article.

Note: This article describes the typical dosage for Combigan provided by the drug’s manufacturer. When using Combigan, follow the dosage prescribed by your doctor.

Below is information about Combigan’s form, strength, and dosage.

Combigan form

Combigan comes as a clear, liquid ophthalmic solution (eye drop) in a dropper bottle.

Combigan strength

Combigan comes in one strength of 0.2% brimonidine/0.5% timolol. There are 2 milligrams (mg) of brimonidine tartrate and 5 mg of timolol maleate in each milliliter (mL) of liquid.

Combigan is usually available as 5-mL and 10-mL bottles.

Typical dosage

The information below describes the dosage that’s commonly prescribed or recommended for adults using Combigan. However, be sure to use the dosage your doctor prescribes for you. Your prescriber will determine the best dosage to fit your individual needs.

Dosage for increased eye pressure from glaucoma or ocular hypertension

Doctors routinely prescribe Combigan to lower elevated intraocular pressure (IOP). Note that your doctor may prescribe Combigan with other drugs.

The typically recommended dosage of Combigan for reducing high IOP is one drop in the affected eye, twice per day. The doses are best spaced about 12 hours apart.

IOP is the pressure of fluid within the eyeball. High IOP can occur in both open-angle glaucoma and ocular hypertension. IOP that’s too high and left untreated or inadequately managed over time can damage the eye and may cause blindness in some cases.

For more information about your specific dosage, talk with your doctor.

Children’s dosage

Combigan is approved to treat high IOP in children ages 2 years and older with open-angle glaucoma or ocular hypertension. It must be used with caution in this age group. Combigan is not to be used in children younger than 2 years of age.

The dosage of Combigan for children ages 2 years and older is one drop in the affected eye, twice per day. The recommended schedule for dosing is approximately every 12 hours.

Talk with your child’s doctor if you have questions about their dosage.

Long-term treatment

Combigan is usually meant to be used as a long-term treatment. It’s considered a “maintenance medication.” This means it’s a medication used at regular intervals to manage a condition over time. If you and your doctor decide that Combigan is safe and effective for your use, you’ll likely use it long term.

Prior to you starting Combigan, your doctor will discuss your expected treatment plan with you.

Combigan comes as a solution you use as eye drops. Combigan is available in a dropper bottle. Your doctor will tell you whether to use Combigan in only one eye or both eyes. Always follow your doctor’s instructions for using Combigan.

It’s important to practice good hygiene when using Combigan. Improper handling of the bottle, bottle tip, or your eye, during use can cause harm, such as eye infections.

Before handling the dropper bottle, wash your hands with soap and warm water. Do not let the bottle tip touch your eye or eyelids during application of the eye drops. Touching the bottle tip to other surfaces can transfer bacteria to the bottle and your eye, possibly causing an eye infection. With good hygiene, you can help prevent infection and other harmful effects.

If you wear contact lenses, remove them before each dose of Combigan. After instilling a dose, wait at least 15 minutes before reinserting your lenses. If you use other types of medicated eye drops, tell your doctor. They’ll likely advise you to wait at least 5 minutes in between eye drops. Doing so will ensure there’s enough time for each medication to be absorbed.

You’ll store Combigan at 15–25°C (59–77°F), which is about room temperature. Be sure to protect it from light. If the liquid becomes cloudy instead of clear, or if the color of the medication changes or looks different, do not use it. Pay close attention to the expiration date on the bottle, as well. Do not use Combigan if it’s expired.

If you have questions about how to use Combigan, talk with your doctor or pharmacist. You can also review the step-by-step instructions on the manufacturer’s website.

ACCESSIBLE DRUG LABELS AND CONTAINERS

Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

The prescribing information for Combigan doesn’t state what to do for a missed dose. If you miss a dose, ask your pharmacist or doctor directly for advice on how to proceed. The timing of your next dose will depend on your usual dosing schedule and how much time has passed since the missed dose. (Combigan doses are usually 12 hours apart.) Typically, if it hasn’t been long since your missed dose, they’ll advise you to administer the missed dose as soon as you remember.

If it’s been more than a few hours past your usual dose time, your doctor may recommend skipping the missed dose. In that case, administer your next dose at the regularly scheduled time. Do not “double up” or administer two doses at once to make up for the missed dose. If you’re not certain whether to administer a missed dose or skip it, talk with your doctor for guidance before acting.

For help staying consistent with your medication, try using a medication reminder. Reminders may include setting an alarm. You could also download a reminder app on your tablet or phone. If these options don’t suit you, consider writing a note where you’ll see it, such as on your bathroom mirror, kitchen counter, or bedside table.

It’s important not to use more Combigan than your doctor prescribes. Using more than the recommended amount may cause harmful effects.

Symptoms of an overdose

Overdose symptoms of Combigan can include:

If you use more than the recommended amount of Combigan

Call your doctor right away if you believe you’ve used too much Combigan. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Below are questions and answers for some of the frequently asked questions pertaining to Combigan.

Is the dosage of Combigan similar to the dosage of Lumigan?

No, these drugs have different dosages, but there are some similarities. Both Combigan and Lumigan (bimatoprost) come as eye drops prescribed to reduce high eye pressure in some situations.*

However, Combigan’s dosing schedule is one drop in the affected eye twice per day, about 12 hours apart. The dosing schedule for Lumigan (bimatoprost) is one drop in the affected eye once per day in the evening.

In addition, the strength for each drug differs because these medications have different active ingredients. Your doctor will prescribe the drug and the dosage that’s best for your particular condition.

For more information on how these drugs compare, talk with your pharmacist or doctor.

* For details about Combigan’s uses, see the “Combigan dosage” section above.

How long does it take for Combigan to start working?

Combigan starts to work quickly after your first dose. Both active ingredients in Combigan work rapidly to lower pressure within the eye. However, you may not feel the medication working in your eye or know whether it’s effective. So your eye doctor will monitor your eye pressure throughout your treatment. Try to keep your doctor appointments during treatment. This will help your doctor know whether Combigan is working as usual.

For more information about Combigan, or if you have questions regarding what to expect from treatment, consult your doctor.

The dosage covered in this article is the typical dosage provided by the drug’s manufacturer. If your doctor recommends Combigan for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

If you feel that Combigan isn’t working for your situation, talk with your doctor. They may be able to find a solution or recommend a different treatment option.

As with any drug, never change your dosage of Combigan without your doctor’s recommendation. If you have questions or concerns about the Combigan dosage that’s appropriate for you, talk with your doctor.

Besides learning about dosage, you may want other information about Combigan. These additional articles might be helpful:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.