latanoprost + timolol maleate: clinical use

Prescribing considerations

• Confirm insufficient response to an appropriate topical beta blocker or prostaglandin analogue.
• Assess cardiovascular, respiratory and systemic beta-blocker risks.
• Use caution with first-degree heart block, cardiovascular disease, hypotension, peripheral circulatory disorders, diabetes prone to hypoglycaemia, hyperthyroidism, corneal disease and mild-to-moderate COPD.
• Review macular-oedema and herpetic-keratitis risks and glaucoma types with limited experience.
• Inform the anaesthetist before surgery.

Contraindications and cautions

• Current or previous bronchial asthma, other reactive airway disease, or severe COPD
• Sinus bradycardia, sick sinus syndrome or sinoatrial block
• Unpaced second- or third-degree atrioventricular block
• Overt cardiac failure or cardiogenic shock
• Hypersensitivity to an active ingredient or formulation excipient

Monitoring

• Intraocular pressure, optic-nerve status and visual function
• Pulse, blood pressure and cardiac or respiratory symptoms in at-risk patients
• Ocular surface health
• Iris pigmentation, eyelash changes and periocular changes
• Signs of macular oedema in susceptible patients

Clinical pharmacology

Latanoprost is a selective FP-receptor agonist that increases aqueous-humour outflow. Timolol is a non-selective beta1/beta2 antagonist that reduces aqueous-humour formation and can be absorbed systemically.

Formulation and product differences

• Xalacom contains benzalkonium chloride. Unopened bottles require refrigeration; opened bottles have product-specific temperature and light-protection requirements.
• Vizilatan Duo is a preservative-free multidose pump requiring priming before first use and has no special storage conditions.
• Both selected products should be discarded four weeks after opening. Follow the supplied leaflet.

Eye drops

Route: Ophthalmic

Strengths: 50 micrograms/mL + 5 mg/mL