A fixed-dose combination (FDC) ophthalmic solution for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to beta-blockers or prostaglandin analogues alone. Timolol is a non-selective beta-adrenergic receptor antagonist, and Travoprost is a synthetic prostaglandin F2α analogue. This combination provides additive IOP-lowering effects through complementary mechanisms, offering enhanced efficacy and improved patient compliance.
Adult: One drop in the affected eye(s) once daily in the evening. Do not exceed one drop per eye per day.
Note: 1. Wash hands. 2. Tilt head back. 3. Gently pull lower eyelid to form a pouch. 4. Instill one drop. 5. Close eye gently and apply pressure to the nasolacrimal duct (inner corner of eye) for 1-2 minutes to minimize systemic absorption. 6. Do not let dropper tip touch eye or any surface. 7. Wait at least 5 minutes before instilling any other eye drops.
The combination works via two distinct pathways to reduce IOP. Timolol reduces aqueous humor production by blocking beta-2 adrenergic receptors in the ciliary epithelium. Travoprost increases uveoscleral outflow (and to a lesser extent, trabecular outflow) by relaxing ciliary muscle and remodeling the extracellular matrix via interaction with the prostaglandin FP receptor.
Pregnancy: Category C (US FDA). Travoprost: May have abortifacient potential. Timolol: Crosses placenta. Use only if the potential benefit justifies the potential risk to the fetus. Avoid especially during first trimester.
Driving: May cause transient blurred vision, dizziness, or fatigue after instillation. Patients should not drive or use machines until vision is clear.
| Oral Beta-Blockers (e.g., Propranolol, Atenolol) | Additive systemic beta-blockade; increased risk of bradycardia, AV block, heart failure. | Major |
| Calcium Channel Blockers (e.g., Verapamil, Diltiazem) | Potentiates negative inotropic and chronotropic effects; risk of severe bradycardia and heart failure. | Major |
| Digoxin | Additive effects on AV conduction; increased risk of bradycardia. | Moderate |
| Insulin, Oral Hypoglycemics | Timolol may mask tachycardia as a sign of hypoglycemia and may impair glucose recovery. | Moderate |
| Catecholamine-depleting drugs (e.g., Reserpine) | Additive hypotensive and bradycardic effects. | Moderate |
| NSAIDs (Topical Ocular, e.g., Diclofenac) | May attenuate the IOP-lowering effect of prostaglandin analogues. | Moderate |
| Cholinergic Agonists (e.g., Pilocarpine) | Additive IOP-lowering effect; may cause miosis. | Minor |
Same composition (Timolol (5mg) + Travoprost (40mcg)), different brands: