Xalacom
Generic Name
Latanoprost 0.005% + Timolol 0.5%
Manufacturer
Pfizer
Country
USA / Multiple (Global)
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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 eye drop used to lower high eye pressure. It contains two active ingredients: latanoprost, a prostaglandin analogue, and timolol, a beta-blocker. These work together to reduce the fluid production in the eye and increase fluid outflow.
Uses & Indications
Dosage
Adults
One drop in the affected eye(s) once daily, in the evening.
Elderly
Same as adult dosage.
Renal_impairment
No dosage adjustment required.
How to Take
For ocular use only. Instill one drop into the conjunctival sac of the affected eye(s) once daily in the evening. If using other ophthalmic medications, separate administrations by at least 5 minutes. Remove contact lenses before administration and wait 15 minutes before reinserting.
Mechanism of Action
Latanoprost increases uveoscleral outflow of aqueous humor. Timolol reduces the production of aqueous humor. Together, they effectively reduce intraocular pressure.
Pharmacokinetics
Onset
Latanoprost: 3-4 hours, peak effect at 8-12 hours. Timolol: 30 minutes, peak effect at 1-2 hours. Combined effect typically within 3-4 hours.
Excretion
Latanoprost: Primarily renally excreted. Timolol: Primarily renally excreted as metabolites and unchanged drug.
Half life
Latanoprost acid: ~17 minutes in aqueous humor. Timolol: Systemic half-life ~4-6 hours.
Absorption
Latanoprost: Well absorbed through the cornea, hydrolyzed to active acid. Timolol: Systemically absorbed after topical ocular administration.
Metabolism
Latanoprost: Primarily metabolized in the liver to inactive metabolites. Timolol: Extensively metabolized in the liver.
Side Effects
Contraindications
- Hypersensitivity to latanoprost, timolol, or any component of the eye drop.
- Bronchial asthma or a history of bronchial asthma.
- Severe chronic obstructive pulmonary disease (COPD).
- Sinus bradycardia, second- or third-degree atrioventricular block, overt cardiac failure, cardiogenic shock.
Drug Interactions
Quinidine
Potentiation of beta-blockade.
Oral beta-blockers
Additive systemic effects (e.g., lower heart rate, blood pressure).
Adrenaline (epinephrine)
Mydriasis has been reported occasionally.
Other prostaglandin analogues
Paradoxical increases in IOP. Avoid concomitant use.
Oral calcium channel blockers, antiarrhythmics (including amiodarone), digitalis glycosides, parasympathomimetics, guanethidine
Potentiation of systemic effects.
Storage
Store unopened bottles at 2°C to 8°C (refrigerate). After opening, store at or below 25°C and use within 4 weeks. Protect from light.
Overdose
Systemic overdose of latanoprost is unlikely with ocular administration. Overdose of timolol can cause bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy: Use only if the potential benefit justifies the potential risk to the fetus. Lactation: Timolol is excreted in human milk. Latanoprost and its metabolites may be excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug.
Side Effects
Contraindications
- Hypersensitivity to latanoprost, timolol, or any component of the eye drop.
- Bronchial asthma or a history of bronchial asthma.
- Severe chronic obstructive pulmonary disease (COPD).
- Sinus bradycardia, second- or third-degree atrioventricular block, overt cardiac failure, cardiogenic shock.
Drug Interactions
Quinidine
Potentiation of beta-blockade.
Oral beta-blockers
Additive systemic effects (e.g., lower heart rate, blood pressure).
Adrenaline (epinephrine)
Mydriasis has been reported occasionally.
Other prostaglandin analogues
Paradoxical increases in IOP. Avoid concomitant use.
Oral calcium channel blockers, antiarrhythmics (including amiodarone), digitalis glycosides, parasympathomimetics, guanethidine
Potentiation of systemic effects.
Storage
Store unopened bottles at 2°C to 8°C (refrigerate). After opening, store at or below 25°C and use within 4 weeks. Protect from light.
Overdose
Systemic overdose of latanoprost is unlikely with ocular administration. Overdose of timolol can cause bradycardia, hypotension, bronchospasm, and acute cardiac insufficiency. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy: Use only if the potential benefit justifies the potential risk to the fetus. Lactation: Timolol is excreted in human milk. Latanoprost and its metabolites may be excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 years unopened, 4 weeks after opening.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA and local regulatory bodies
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Xalacom's efficacy and safety were established in clinical trials comparing it to monotherapies of latanoprost and timolol. These trials consistently demonstrated superior IOP reduction with the combination therapy.
Lab Monitoring
- Routine systemic lab monitoring is generally not required for topical ophthalmic use unless systemic side effects are suspected.
- Regular IOP monitoring is essential.
Doctor Notes
- Emphasize systemic absorption of timolol and contraindications related to cardiovascular and respiratory conditions.
- Counsel patients regarding potential permanent iris color change and eyelash growth, and that these are generally cosmetic and not harmful.
- Ensure proper instillation technique to minimize systemic absorption and contamination, advising to compress the nasolacrimal duct briefly after instillation.
- Monitor for signs of increased pigmentation or other ocular adverse events during long-term use.
Patient Guidelines
- Follow the doctor's instructions exactly.
- Do not touch the dropper tip to any surface to avoid contamination.
- Remove contact lenses before use and wait 15 minutes before reinserting.
- Do not share your eye drops with anyone.
- Inform your doctor about all other medications you are using, especially other eye drops.
Missed Dose Advice
If a dose is missed, continue with the next scheduled dose. Do not use an extra dose to make up for the missed one.
Driving Precautions
May cause transient blurred vision or other visual disturbances. Patients should be warned about driving or operating machinery until their vision clears.
Lifestyle Advice
- Attend regular eye check-ups to monitor IOP and overall eye health.
- Report any changes in vision or eye discomfort to your doctor immediately.
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Global Brand Names
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