Combigan Eye Drop
Combigan (brimonidine 0.2% + timolol 0.5%) — fixed-combination alpha-2 agonist + beta-blocker. Twice-daily IOP control for open-angle glaucoma. Paediatric apnoea warning.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Combigan Eye Drop?
Combigan Eye Drop combines brimonidine 0.2% (alpha-2 agonist) with timolol 0.5% (beta-blocker) in one bottle for advanced glaucoma. Twice daily. Avoid in asthma, severe COPD, bradycardia, AV block, and children < 2 years.
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What is Combigan Eye Drop?
Combigan Eye Drop is a fixed-dose combination eye drop manufactured by Allergan, containing brimonidine tartrate 0.2% and timolol maleate 0.5% in a 5 mL bottle. The two ingredients reduce aqueous humour production through complementary mechanisms — alpha-2 agonism and beta-adrenergic blockade — for additive ~25–28% IOP reduction in twice-daily dosing.
How It Works
Brimonidine activates alpha-2 receptors at the ciliary epithelium, decreasing cAMP and aqueous secretion, while also increasing uveoscleral outflow. Timolol blocks beta-1/beta-2 receptors at the same epithelium, further reducing aqueous production. The combination is more potent than either monotherapy.
Dosing
One drop in affected eye(s) twice daily, ideally 12 hours apart. Wait 5 minutes if using other eye drops. Practise punctal occlusion for 1–2 minutes after each drop. Remove contact lenses; reinsert after 15 minutes.
Side Effects
Local: conjunctival hyperaemia, allergic conjunctivitis (late-onset, brimonidine signature), stinging, blurred vision, ocular pruritus.
Systemic: dry mouth, fatigue, somnolence, hypotension, bradycardia, bronchospasm in reactive airways.
Warnings & Contraindications
- Asthma, severe COPD — absolute (timolol)
- Sinus bradycardia, AV block, decompensated heart failure
- Children < 2 years — absolute (brimonidine apnoea)
- MAO inhibitors — relative
- Concurrent oral beta-blockers, calcium-channel blockers, digoxin
- Pregnancy Category C — avoid
- Severe cardiovascular disease, orthostatic hypotension
Storage
Store at 15–25°C. Discard 28 days after first opening.
Frequently Asked Questions
When should I take Combigan Eye Drop?
Twice daily, ideally 12 hours apart.
Why combine these two drugs?
Brimonidine and timolol both reduce aqueous production but through different mechanisms. The combination is moderately additive (more than either alone) and replaces two separate bottles.
Can I use Combigan Eye Drop if I have asthma?
No — the timolol component is contraindicated. Switch to a non-beta-blocker option.
What is punctal occlusion?
Press the inner corner of your eye for 1–2 minutes after instillation. This blocks tear drainage and reduces systemic absorption of both ingredients by ~70%.
Why is brimonidine unsafe in young children?
Brimonidine readily crosses the blood-brain barrier and can cause life-threatening apnoea, bradycardia, and hypotension in children < 2 years. Use is contraindicated in this age group.
Can I expect a late allergic reaction?
Yes — brimonidine has a characteristic late-onset allergic conjunctivitis (6–18 months in). Eye redness and itching after months of smooth use is a typical pattern.
Will I feel tired?
Brimonidine can cause systemic somnolence, dry mouth, and mild hypotension. Punctal occlusion reduces this.
Can I combine Combigan Eye Drop with other glaucoma drops?
Yes — additive with prostaglandins and CAIs. Wait 5 minutes between bottles.
What if I take an MAO inhibitor?
Avoid — additive sedation and hypotension are possible. Disclose to your prescriber.
What if I miss a dose?
Take it as soon as you remember unless the next dose is close.
Other Eye-Care Medications
Customers viewing this product also consider these alternatives in our Eye Care range:
- Xalatan Eye Drop (latanoprost)
- Azopt Eye Drops (brinzolamide)
- Alphagan P Drop (brimonidine)
- Iotim Eye Drops (timolol)
- Careprost (bimatoprost)
Medical Disclaimer
The information on this page is for educational purposes only and is not a substitute for medical advice from a qualified ophthalmologist or optometrist. Eye conditions can rapidly threaten sight — sudden vision loss, severe pain, or trauma is an ophthalmology emergency. Always consult an eye-care professional before starting, stopping, or changing any treatment.
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| Strength | 2mg+5mg |
|---|---|
| Quantity | 1 Bottle/s, 3 Bottle/s, 6 Bottle/s |
| Pharma Form | Eye Drop/s |
| Manufacturer | Allergan |
| Treatment | Ocular hypertension, Glaucoma |
| Generic Brand | Brimonidine + Timolol |
Combigan Eye Drop
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