Xalacom
Generic Name
Latanoprost + Timolol
Manufacturer
Pfizer Inc.
Country
USA (originator), various (generics)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xalacom 0005 05 eye drop | ৳ 781.94 | N/A |
Description
Overview of the medicine
Xalacom is an ophthalmic solution used to reduce elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. It is a fixed combination of latanoprost (a prostaglandin F2α analog) and timolol maleate (a non-selective beta-adrenergic receptor blocker).
Uses & Indications
Dosage
Adults
One drop in the affected eye(s) once daily, in the morning or evening. More frequent administration may decrease the IOP-lowering effect.
Elderly
No specific dosage adjustment is required for elderly patients.
Renal_impairment
No specific dosage adjustment is required for patients with renal impairment.
How to Take
Administer one drop into the conjunctival sac of the affected eye(s). If using other ophthalmic medications, wait at least 5 minutes between applications. Remove contact lenses before administration and wait 15 minutes before reinserting.
Mechanism of Action
Latanoprost increases the outflow of aqueous humor primarily through the uveoscleral pathway. Timolol reduces aqueous humor production by blocking beta-adrenergic receptors in the ciliary body. The combination provides a synergistic effect in reducing IOP.
Pharmacokinetics
Onset
Latanoprost: 3-4 hours; Timolol: 20 minutes
Excretion
Latanoprost metabolites are primarily excreted in the urine. Timolol and its metabolites are excreted renally.
Half life
Latanoprost acid: approx. 17 minutes (in aqueous humor); Timolol: approx. 6-7 hours (systemic)
Absorption
Latanoprost is a prodrug, absorbed through the cornea where it is hydrolyzed to its active acid form. Timolol is absorbed systemically after topical ocular administration.
Metabolism
Latanoprost is metabolized in the liver to inactive metabolites. Timolol is metabolized in the liver.
Side Effects
Contraindications
- Hypersensitivity to latanoprost, timolol, or any component of the formulation.
- Reactive airway disease including bronchial asthma, a history of bronchial asthma, severe chronic obstructive pulmonary disease.
- Sinus bradycardia, second or third degree atrioventricular block, overt cardiac failure, cardiogenic shock.
Drug Interactions
Oral beta-blockers
Potential for additive systemic beta-blockade, resulting in hypotension and/or marked bradycardia.
Other prostaglandin analogs
Paradoxical increase in IOP may occur if two prostaglandin analogs are used concurrently.
CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine)
Enhanced systemic beta-blockade (timolol).
Calcium channel blockers, antiarrhythmics (e.g., amiodarone), digitalis glycosides, parasympathomimetics
Potential for additive effects leading to hypotension and/or marked bradycardia.
Storage
Store unopened bottles in a refrigerator (2°C to 8°C). Once opened, store at room temperature (below 25°C) and protect from light.
Overdose
Systemic overdose symptoms may include bradycardia, hypotension, bronchospasm, and cardiac arrest. Ocular overdose may cause ocular irritation and hyperemia. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Timolol and its metabolites have been detected in human milk. Caution should be exercised when Xalacom is administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to latanoprost, timolol, or any component of the formulation.
- Reactive airway disease including bronchial asthma, a history of bronchial asthma, severe chronic obstructive pulmonary disease.
- Sinus bradycardia, second or third degree atrioventricular block, overt cardiac failure, cardiogenic shock.
Drug Interactions
Oral beta-blockers
Potential for additive systemic beta-blockade, resulting in hypotension and/or marked bradycardia.
Other prostaglandin analogs
Paradoxical increase in IOP may occur if two prostaglandin analogs are used concurrently.
CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine)
Enhanced systemic beta-blockade (timolol).
Calcium channel blockers, antiarrhythmics (e.g., amiodarone), digitalis glycosides, parasympathomimetics
Potential for additive effects leading to hypotension and/or marked bradycardia.
Storage
Store unopened bottles in a refrigerator (2°C to 8°C). Once opened, store at room temperature (below 25°C) and protect from light.
Overdose
Systemic overdose symptoms may include bradycardia, hypotension, bronchospasm, and cardiac arrest. Ocular overdose may cause ocular irritation and hyperemia. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Timolol and its metabolites have been detected in human milk. Caution should be exercised when Xalacom is administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 months (unopened). Discard 4 weeks after opening.
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Generic versions available, original patent expired
Clinical Trials
Numerous clinical trials have demonstrated the efficacy and safety of Xalacom in reducing IOP in patients with glaucoma and ocular hypertension.
Lab Monitoring
- Regular monitoring of intraocular pressure.
- Periodic eye examinations for signs of iris pigmentation changes.
Doctor Notes
- Emphasize proper instillation technique to patients.
- Monitor for systemic beta-blocker side effects, especially in patients with cardiac or respiratory conditions.
- Warn patients about potential iris color changes.
Patient Guidelines
- Use regularly as prescribed, even if you feel fine.
- Do not allow the dropper tip to touch the eye or any other surface to avoid contamination.
- Inform your doctor about all other medications, especially other eye drops.
Missed Dose Advice
If a dose is missed, continue with the next dose as scheduled. Do not double the dose to make up for a missed dose.
Driving Precautions
Temporary blurred vision, dizziness, or fatigue may occur after instillation. Patients should be advised not to drive or operate machinery until their vision clears and these symptoms subside.
Lifestyle Advice
- Avoid driving or operating machinery if you experience blurred vision or dizziness after administration.
- Regular exercise and a balanced diet can support overall eye health.
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