Azarga

The active ingredients in Azarga are timolol maleate, a beta-adrenergic blocking agent, and brinzolamide hydrochloride, a carbonic anhydrase inhibitor. Beta-blockers work by relaxing blood vessels and reducing eye pressure. Carbonic anhydrase inhibitors work by reducing the amount of fluid in the cornea of the eye.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Azarga. However, the following is a synopsis of the general guidelines for the use of Azarga:

1. Wash your hands before and after each use.

2. Shake the bottle well, then twist open.

3. Do not allow the dropper tip to touch your eye, fingers, or any other surface to avoid contamination.

4. To apply the drops, tilt your head up and pull down on your lower eyelid of the affected eye while looking up. Squeeze the bottle to release one drop of the solution into your eye.

5. Following administration, close your eyes gently and hold pressure on your tear duct (inner corner of your eye, by your nose) for two minutes. Then repeat for the other eye if needed.

6. If you use more than one eye drop, wait at least 5 minutes between administrations.

7. It is recommended to apply the drops in the evening due to side effects (blurred vision) and increased contact time during sleep.

8. Those with diabetes should monitor their blood sugar levels more regularly, as this medication can mask the signs of low blood sugar (hypoglycemia).

9. If you wear contact lenses, remove them before administering these eye drops. You can put them back in 15 minutes after administration. The preservative benzalkonium chloride can discolor soft contact lenses.

Some mild and common side effects of Azarga include:

• Temporary blurred vision.
• Dry mouth.
• Bitter or unusual taste.
• Dry eyes, eye irritation, or eye pain.
• Throat irritation.
• Eye discharge or crusting.

Some individuals may experience serious side effects while using Azarga. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Cardiovascular (heart) problems, including irregular heartbeat or low blood pressure.
• Worsening heart failure symptoms include shortness of breath, chest pain (angina), rapid weight gain, fatigue, and fluid retention (swelling in the legs).
• Acute bronchospasm, which would feel like chest pain, shortness of breath, cough, lightheadedness, and extreme fatigue.
• Serious life-threatening allergic or hypersensitivity reactions, which may present as skin rash, hives, swelling of the face, mouth, or tongue, and/ or trouble breathing (anaphylaxis).

These are not all of the possible side effects of Azarga eye drops. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Azarga, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

• Diabetes.
• An upcoming major surgery or eye surgery.
• Overactive thyroid (hyperthyroidism).
• Kidney or liver impairment.
• History of stroke.
• Muscle weakness disorder, such as myasthenia gravis.

• Angle-closure glaucoma or problems with your cornea.
• Hyperchloraemic acidosis.
• Breathing problems such as allergic rhinitis, bronchospasm, or severe chronic obstructive pulmonary disease (COPD).
• Heart disease, including congestive heart failure (cardiac failure), heart block, cardiogenic shock, or slow heartbeat (sinus bradycardia).
• Hypersensitivity or allergy to timolol, brinzolamide, or any inactive ingredients: Benzalkonium chloride, Carbomer 974P, disodium edetate, hydrochloric acid, mannitol, purified water, sodium chloride, sodium hydroxide, or tyloxapol.
• Allergy to sulphonamides (sulfa allergy).

It will take several weeks before the full effect is seen.

When Azarga is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions.

• Oral beta-adrenergic inhibitors, when combined with these eye drops, may increase the effects of both medications.
• Oral carbonic anhydrase inhibitors such as acetazolamide may have an additive effect when combined with these eye drops.
• Calcium channel blockers or parasympathomimetics may increase the rate of severe side effects when combined with Arzaga.
• Certain antidepressants (fluoxetine, paroxetine), antifungals, cimetidine, and the drug quinidine may increase the effect of timolol on blood pressure.
• Arzaga may reduce the efficacy of salicylates such as acetylsalicylic acid (aspirin) and increase the side effects of Arzaga.
• Withdrawal from clonidine may be worsened by the use of timolol.
• Epinephrine may not be as effective in treating allergic reactions when you are taking timolol.

Brand-name Azarga is supplied as bottles containing 1.0% w/v of brinzolamide and 0.5% w/v of timolol.

It should be stored at room temperature away from the reach of children or pets.

It is manufactured by Novartis Pharmaceuticals.

Yes, and a similar product is available from Cosopt, containing timolol maleate and dorzolamide.

Barring any serious side effects as listed above, or as directed by a physician, you should not discontinue this medication suddenly. It needs to be tapered off gradually to avoid symptoms of withdrawal.

Timolol eye drops can cause a low heart rate in a growing fetus, and the minimum effective dose should be used if treating glaucoma during pregnancy. The effect of brinzolamide on a growing fetus is not well known, and other agents to treat glaucoma during pregnancy are recommended.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Studies show that exposure to beta-blockers during pregnancy may increase the risk of adverse events in a newborn. If the use of timolol is indicated, newborns should be monitored for bradycardia, hypoglycemia, and respiratory depression. It is not known whether brinzolamide is found in breast milk, and use of this agent during breastfeeding requires careful risk vs benefit consideration.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.