britivin eye drop - Timolol (0.5% w/v) + Brimonidine (0.15% w/v) medicine

Britivin Eye Drop: Comprehensive Guide to Uses, Side Effects, and Safety

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🏭 Zivira Labs Pvt Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 21, 2026
📋 Prescription Required 💊 Generic Available
Medically Reviewed
12 min read
Evidence: Well-established for the combination in lowering intraocular pressure.
Reviewed by
SaathiMed Expert Panel | Sep 21, 2026

When to Call Your Doctor IMMEDIATELY

  • Sudden decrease in vision or eye pain
  • Severe eye redness, swelling, or discharge
  • Chest pain, shortness of breath, or wheezing
  • Irregular or very slow heartbeat
  • Fainting or severe dizziness
  • Swelling of face, lips, tongue, or throat
  • Signs of an allergic reaction such as rash or itching

If experiencing severe symptoms, call emergency services immediately.

What is britivin eye drop used for?

This medicine is a combination eye drop containing timolol and brimonidine, used to lower high pressure inside the eye in conditions like open-angle glaucoma and ocular hypertension. It works by reducing fluid production and increasing fluid drainage from the eye.

  • Generic Name: Timolol (0.5% w/v) + Brimonidine (0.15% w/v)
  • Manufacturer: Zivira Labs Pvt Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 britivin eye drop के बारे में (Hindi Summary)

उपयोग: यह दवा आंखों की एक विशेष ड्रॉप है जिसमें टिमोलॉल और ब्रिमोनिडीन दो सक्रिय तत्व होते हैं। यह आंखों के अंदर के दबाव को कम करने के लिए इस्तेमाल की जाती है, जो ग्लूकोमा और ऑक्यूलर हाइपरटेंशन जैसी स्थितियों में आवश्यक होता है। यह दवा आंखों में तरल पदार्थ के उत्पादन को कम करती है और उसके निकास को बढ़ाती है, जिससे ऑप्टिक नर्व को नुकसान से बचाया जा सके। यह दवा केवल डॉक्टर के पर्चे पर ही मिलती है और इसे नियमित रूप से उपयोग करना चाहिए।

साइड इफेक्ट्स: इस दवा के कुछ सामान्य दुष्प्रभाव हो सकते हैं जैसे आंखों में जलन या चुभन, आंखें लाल होना, धुंधला दिखना, सिरदर्द, नींद आना और मुंह सूखना। ये आमतौर पर हल्के होते हैं और कुछ समय में ठीक हो जाते हैं। कभी-कभी गंभीर दुष्प्रभाव भी हो सकते हैं जैसे दिल की धड़कन धीमी होना, सांस लेने में कठिनाई, या एलर्जी की प्रतिक्रिया। अगर आपको ऐसा कुछ महसूस हो तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा का उपयोग करने से पहले अपने डॉक्टर को अपनी पूरी मेडिकल हिस्ट्री बताएं, खासकर अगर आपको दिल, फेफड़े, या मधुमेह की समस्या है। अगर आप सॉफ्ट कॉन्टैक्ट लेंस पहनते हैं तो दवा डालने से पहले उन्हें निकाल लें और 15 मिनट बाद ही वापस लगाएं। दवा डालने के बाद आंख के भीतरी कोने को 1-2 मिनट तक दबाए रखें ताकि दवा शरीर में कम जाए। ड्रॉपर की टिप को आंख या किसी सतह से न छुएं। दवा को डॉक्टर की सलाह के बिना अचानक बंद न करें।

💡 Did You Know? The Indian pharmaceutical market is expected to reach $130 billion by 2030.

💊 britivin eye drop Uses & Benefits

[{"condition":"Open-angle glaucoma","description":"This medicine is used to lower intraocular pressure in patients with open-angle glaucoma when a combination of timolol and brimonidine is needed to achieve target pressure.","evidence":"Well-established"},{"condition":"Ocular hypertension","description":"It is indicated for the reduction of elevated intraocular pressure in patients with ocular hypertension who require dual-agent therapy.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Angle-closure glaucoma","description":"Sometimes used after laser iridotomy or in combination with other treatments to further lower intraocular pressure, but this is not a standard first-line use.","evidence":"Limited"},{"condition":"Pediatric glaucoma","description":"May be used in children with glaucoma under close specialist supervision, but safety and efficacy are not fully established.","evidence":"Limited"}]

Primary treatment for: Open-angle glaucoma

Also treats: Ocular hypertension

📋 Drug Information

Generic Name(s)Timolol (0.5% w/v) + Brimonidine (0.15% w/v)
Brand Namebritivin eye drop
ManufacturerZivira Labs Pvt Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassOPHTHAL
Action Class
Route of AdministrationOphthalmic
StorageStore at room temperature (15-30°C). Protect from light and excessive heat. Keep the bottle tightly closed when not in use. Do not freeze.
Shelf Life24 months from the date of manufacture, or as printed on the packaging.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Instruct patients to perform punctal occlusion after instilling the drop to minimize systemic absorption.
2
Monitor heart rate and blood pressure regularly, especially in elderly patients or those with cardiovascular disease.
3
Ask about respiratory conditions such as asthma or COPD before prescribing, as timolol can cause bronchospasm.
4
Advise patients not to stop the medicine abruptly, as this can lead to a rebound increase in intraocular pressure.
5
Remind patients to wait at least 5-10 minutes between different eye drops to avoid washout.
6
Educate patients about the importance of regular follow-up to monitor intraocular pressure and optic nerve health.
7
Caution patients about drowsiness and the need to avoid driving until they know how the medicine affects them.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Elevated intraocular pressure
This medicine is commonly prescribed for this.
Likely Use
Eye pain
This medicine is not a primary pain reliever; eye pain may indicate a serious condition and should be evaluated.
Not Primary
Blurred vision
This medicine may cause temporary blurred vision, but persistent blurred vision requires medical attention.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionTimolol and brimonidine are absorbed systemically after topical ocular administration. Timolol is rapidly absorbed through the cornea and conjunctiva, and a significant fraction reaches the systemic circulation, avoiding first-pass metabolism. Brimonidine also undergoes systemic absorption, with peak plasma levels occurring within 1 to 4 hours after ocular instillation.
DistributionBoth timolol and brimonidine distribute into ocular tissues and systemically. Timolol is widely distributed in body tissues, and brimonidine has a large volume of distribution. Protein binding is low for both agents.
Protein BindingTimolol is approximately 60% bound to plasma proteins. Brimonidine binding to plasma proteins is about 29%.
MetabolismTimolol is extensively metabolized in the liver, primarily by the cytochrome P450 enzyme CYP2D6, with a small contribution from CYP2C19. Brimonidine is also metabolized in the liver, mainly by CYP2D6 and CYP1A2, to inactive metabolites.
Half-LifeThe elimination half-life of timolol is approximately 2.5 to 5 hours. The elimination half-life of brimonidine is approximately 2 to 3 hours.
ExcretionTimolol and its metabolites are excreted primarily in the urine. Brimonidine and its metabolites are also excreted mainly in the urine.
BioavailabilitySystemic bioavailability after ocular administration is approximately 50% for timolol and about 30% for brimonidine, although these values can vary.
Onset of ActionThe reduction in intraocular pressure begins within 1 hour after instillation, with a noticeable effect within 2 hours.
Peak Plasma TimePeak plasma concentrations of timolol occur about 1 to 2 hours after ocular administration. For brimonidine, peak plasma levels are reached within 1 to 4 hours.
Duration of ActionThe intraocular pressure-lowering effect lasts for approximately 12 hours, which supports twice-daily dosing.

How It Works

This medicine combines two agents with complementary mechanisms. Timolol is a non-selective beta-adrenergic receptor blocker that reduces aqueous humor production by the ciliary epithelium. Brimonidine is a selective alpha-2 adrenergic receptor agonist that both reduces aqueous humor production and increases uveoscleral outflow. The combined effect is a greater reduction in intraocular pressure than either agent alone.

Mechanism Steps

1
Timolol blocks beta-adrenergic receptors: Timolol binds to beta-1 and beta-2 receptors on the ciliary epithelium, reducing cyclic AMP production and thereby decreasing the secretion of aqueous humor into the eye.
2
Brimonidine stimulates alpha-2 receptors: Brimonidine selectively activates alpha-2 adrenergic receptors in the ciliary body, which reduces aqueous humor synthesis and also increases the outflow of fluid through the uveoscleral route.
3
Combined reduction in intraocular pressure: The two mechanisms work together to lower the pressure inside the eye more effectively than either agent alone, helping to protect the optic nerve from glaucoma damage.

💡 How to Take britivin eye drop

Strength: Ophthalmic solution containing timolol 0.5% w/v and brimonidine 0.15% w/v.

1Wash your hands thoroughly with soap and water.
2If you wear soft contact lenses, remove them before instilling the drops.
3Shake the bottle gently before use.
4Tilt your head back and pull down your lower eyelid to form a small pocket.
5Look up and squeeze one drop into the pocket. Avoid touching the dropper tip to your eye or eyelid.
6Close your eye gently and press the inner corner of your eye near the nose for 1-2 minutes to reduce systemic absorption.
7Repeat in the other eye if prescribed.
8Replace the cap tightly. Wash your hands again if needed.
9Wait at least 5-10 minutes before using any other eye drops.
10If you wear soft contact lenses, wait at least 15 minutes before reinserting them.

Dosage Information

Adult DosageThe usual adult dose is one drop in the affected eye(s) twice daily, approximately 12 hours apart. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Do not exceed the prescribed frequency. If you are using other eye drops, wait at least 5-10 minutes between administrations.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageNo specific dose adjustment is required for elderly patients, but they may be more susceptible to systemic effects such as bradycardia and hypotension. Monitor closely.
Renal ImpairmentNo specific dose adjustment is provided in the labeling. Use with caution in patients with renal impairment and monitor for systemic effects.
Hepatic ImpairmentNo specific dose adjustment is provided in the labeling. Use with caution in patients with hepatic impairment and monitor for systemic effects.
Maximum Daily DoseThe maximum recommended dose is one drop in each affected eye twice daily. Do not exceed this frequency.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

⏰ What to Do If You Miss a Dose

📌 Less than 6 hours have passed since the missed dose
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than 6 hours have passed since the missed dose
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of britivin eye drop

✅ Common Side Effects

Eye stinging or burning (Common (10-20%))
This usually resolves within a few minutes. If it persists or becomes severe, consult your eye doctor.
Eye redness (Common (5-15%))
Redness often decreases with continued use. If it worsens or is accompanied by pain, seek medical advice.
Blurred vision (Common (5-10%))
Wait until vision clears before driving or operating machinery. If blurred vision persists, contact your doctor.
Headache (Common (5-10%))
Rest and stay hydrated. If headaches are severe or frequent, consult your doctor.
Drowsiness (Common (5-10%))
Avoid driving or operating heavy machinery until you know how this medicine affects you.
Dry mouth (Common (5-10%))
Sip water regularly. If dryness is bothersome, discuss with your doctor.

🚨 Serious Side Effects

Severe bradycardia or heart block (Rare (<0.1%))
Seek immediate medical attention if you experience a very slow heartbeat, dizziness, or fainting.
Bronchospasm or difficulty breathing (Rare (<0.1%))
Stop using the medicine and get emergency help if you have wheezing, chest tightness, or shortness of breath.
Severe allergic reaction (Rare (<0.1%))
Call emergency services if you notice swelling of the face, lips, tongue, or throat, or a severe skin rash.
Hypotension (Rare (<0.1%))
If you feel faint or dizzy when standing up, lie down and contact your doctor promptly.

⚠️ Rare Side Effects

Iris pigmentation
This is usually reversible after stopping the medicine. Inform your eye doctor if you notice a change in eye color.
Eyelid pigmentation
Cosmetic change that may reverse after discontinuation. Discuss with your doctor if concerned.
Depression
Consult your doctor if you experience persistent low mood or changes in sleep.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Oral beta-blockers Major
Calcium channel blockers Major
MAOIs Major
Tricyclic antidepressants Moderate
Digoxin Moderate
CYP2D6 inhibitors Moderate
Other eye drops Minor
Antihypertensives Minor

🚨 Major Interactions

  • Oral beta-blockers
  • Calcium channel blockers (verapamil, diltiazem)
  • Monoamine oxidase inhibitors (MAOIs)

⚡ Moderate Interactions

  • Tricyclic antidepressants
  • Digoxin
  • CYP2D6 inhibitors (e.g., quinidine, fluoxetine)

🍷 Alcohol Interaction

Alcohol may enhance the drowsiness and dizziness caused by brimonidine. It is advisable to limit or avoid alcohol while using this medicine, especially when driving or operating machinery.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Hypersensitivity to timolol, brimonidine, or any component of the formulation","Severe bradycardia","Second- or third-degree atrioventricular block","Cardiogenic shock","Uncontrolled heart failure","Severe asthma or chronic obstructive pulmonary disease","Neonates and infants (due to risk of apnea)"]

⚠️ Warnings & Precautions

["Systemic absorption of timolol can cause bronchospasm, bradycardia, and hypotension. Use with caution in patients with respiratory or cardiac disease.","Brimonidine may cause drowsiness and fatigue; caution when driving or operating machinery.","Patients with a history of contact lens wear should remove lenses before instillation and wait 15 minutes before reinsertion.","Do not touch the dropper tip to any surface to avoid contamination.","If you develop an eye infection, consult your doctor; do not continue using the same bottle.","Do not stop this medicine abruptly without consulting your doctor, as this may cause a rebound increase in intraocular pressure.","Use with caution in patients with diabetes, as beta-blockers may mask symptoms of hypoglycemia.","Use with caution in patients with thyroid disease, as beta-blockers may mask symptoms of hyperthyroidism."]

🤱 Lactation Safety

It is not known whether timolol or brimonidine is excreted in human breast milk. Because many drugs are excreted in human milk and due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the medicine, taking into account the importance of the medicine to the mother.

💊 Overdose Management

Overdose with this eye drop is unlikely due to the small volume. If accidental ingestion occurs, seek immediate medical attention. Symptoms of overdose may include bradycardia, hypotension, bronchospasm, and drowsiness. Treatment is supportive and symptomatic. Contact a poison control center or emergency department if you suspect an overdose.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

Additional Safety Advice

General Safety

Before using this medicine, tell your doctor if you have a history of heart disease, asthma, chronic obstructive pulmonary disease, diabetes, thyroid problems, or any eye infection. Do not use this medicine if you have a known allergy to timolol, brimonidine, or any other ingredient. If you wear soft contact lenses, remove them before applying the drops and wait at least 15 minutes before reinserting them, as the preservative may be absorbed by the lenses. To reduce systemic absorption, gently press the inner corner of your eye near the nose for one to two minutes after putting in the drops. This technique, called punctal occlusion, helps keep the medicine in the eye and reduces side effects elsewhere in the body. Do not touch the dropper tip to your eye or any surface, as this can contaminate the solution. If you are using other eye drops, wait at least 5 to 10 minutes between different products. Do not stop using this medicine suddenly without consulting your doctor, as this can cause a rebound increase in eye pressure. Keep the bottle tightly closed when not in use and store it as directed. Inform any healthcare professional you see that you are using this medicine, especially before surgery or if you are prescribed new medicines.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more susceptible to systemic effects such as bradycardia, hypotension, and drowsiness. Monitor heart rate and blood pressure regularly. Use with caution in patients with age-related conditions.

🤰 Pregnancy Planning (TTC)

If you are planning to become pregnant, consult your doctor before using this medicine. There are no adequate studies in pregnant women. Your doctor will weigh the benefits and risks.

🏥 Post-Surgery Considerations

Inform your surgeon that you are using this medicine before any surgery, including eye surgery. It may need to be temporarily discontinued or adjusted. Follow your surgeon's instructions.

🦷 Dental Procedures

Inform your dentist that you are using this medicine, as it may interact with certain medications used during dental procedures. No specific precautions are typically required, but it is important for your dentist to know your full medication list.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to reduce overall health risks.
🥗
Engage in regular low-impact exercise such as walking or swimming.
😴
Avoid activities that increase eye pressure, such as heavy lifting or inverted yoga poses.
💧
Eat a balanced diet rich in fruits and vegetables.
🧘
Get adequate sleep and manage stress through relaxation techniques.
🌞
Avoid smoking, as it can worsen eye health.
🚭
Limit caffeine intake if you are sensitive to its effects on eye pressure.

🏋️ Exercise Considerations

Avoid strenuous activities that increase intraocular pressure, such as heavy weightlifting or inverted positions. Consult your doctor before starting any new exercise regimen.

🥗 Diet Recommendations

Include foods rich in omega-3 fatty acids, such as fish and flaxseed.
Eat plenty of leafy green vegetables and colorful fruits.
Reduce intake of processed foods and excess salt.
Stay well hydrated by drinking plenty of water.
Limit caffeine and alcohol consumption.

💼 Impact on Daily Work & Life

This medicine may cause drowsiness, dizziness, or blurred vision in some people. Avoid driving or operating heavy machinery until you know how it affects you. It is important to use the drops consistently at the same times each day to maintain effectiveness.

🛑 When to Stop This Medicine

Do not stop using this medicine without consulting your doctor. If you experience serious side effects such as severe breathing difficulty, slow heartbeat, or allergic reactions, seek immediate medical attention and follow your doctor's advice regarding discontinuation.

📅 Long-Term Use Effects

Long-term use of this medicine may lead to increased pigmentation of the iris, eyelid, or eyelashes, which is usually reversible after discontinuation. Regular monitoring of intraocular pressure, optic nerve health, and systemic effects such as heart rate and blood pressure is recommended. Patients should continue regular follow-up with their ophthalmologist.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Laser trabeculoplasty

A laser procedure that can improve fluid drainage from the eye and lower intraocular pressure.

Evidence: Well-established
Surgical trabeculectomy

A surgical procedure to create a new drainage pathway for aqueous humor.

Evidence: Well-established
Other eye drop combinations

Different classes of eye drops such as prostaglandin analogs, carbonic anhydrase inhibitors, or rho kinase inhibitors may be used.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No specific interactions between this medicine and vaccines have been reported. Continue routine vaccinations as recommended by your healthcare provider.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✅ DO

Keep the bottle tightly closed when not in use

❌ DON'T

Do not touch the dropper tip to any surface

✈️ Traveling with This Medicine

When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid extreme temperatures. If you are crossing time zones, continue with your regular dosing schedule as closely as possible; consult your doctor for specific advice. Store the bottle at room temperature and protect it from light. Check customs regulations for carrying prescription medicines to your destination.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 62-year-old man with open-angle glaucoma
He was prescribed this medicine after his eye pressure remained high on a single agent. Within a few weeks, his intraocular pressure dropped to the target range. He experienced mild eye stinging initially, which lessened over time. He learned to press the inner corner of his eye after instilling the drop, which reduced his drowsiness.
💡 Lesson: Combination therapy can be effective when monotherapy fails, and proper instillation technique reduces systemic side effects.
👤 A 55-year-old woman with ocular hypertension and a history of asthma
She was started on this medicine but developed wheezing and shortness of breath after a few days. Her doctor discontinued it and switched to a different class of eye drop. Her respiratory symptoms resolved.
💡 Lesson: Timolol can cause bronchospasm, so it is important to inform your doctor about respiratory conditions before using this medicine.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts lowering intraocular pressure within 1 hour, with a noticeable effect within 2 hours. However, it may take a few weeks to achieve the full therapeutic benefit.

Q: Can I use this medicine if I wear contact lenses?

A: Remove soft contact lenses before instilling the drops and wait at least 15 minutes before reinserting them, as the preservative may be absorbed by the lenses.

Q: What should I do if I miss a dose?

A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Q: Can I stop using this medicine if my eye pressure is normal?

A: No, do not stop using this medicine without consulting your doctor. Glaucoma often has no symptoms, and stopping treatment can lead to increased eye pressure and vision loss.

Q: Is this medicine safe during pregnancy?

A: There are no adequate studies in pregnant women. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult your doctor.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my heart rate?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?
  • Is it safe to use with contact lenses?
  • Can I use it if I have asthma?

🔄 Substitutes for britivin eye drop

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can cure glaucoma.
    Fact: This medicine does not cure glaucoma; it helps control intraocular pressure to prevent further vision loss. You must continue using it as prescribed.
  • Myth: If I feel fine, I can stop using the drops.
    Fact: Glaucoma often has no symptoms until vision loss occurs. Stopping the medicine can lead to increased eye pressure and irreversible damage.
  • Myth: This medicine is safe for everyone.
    Fact: It is not safe for people with certain heart or lung conditions. Always inform your doctor about your medical history.
  • Myth: Using more drops will work better.
    Fact: Using more than prescribed can increase side effects without added benefit. Follow your doctor's instructions exactly.

🔄 Alternative Options

Generic Alternatives

  • Timolol and brimonidine ophthalmic solution

Brand Alternatives

  • Combigan

📊 Comparison with Similar Medicines

[{"medicine":"This medicine (timolol + brimonidine)","active_ingredients":"Timolol 0.5% + brimonidine 0.15%","frequency":"Twice daily","common_side_effects":"Eye stinging, redness, drowsiness, dry mouth"},{"medicine":"Dorzolamide + timolol","active_ingredients":"Dorzolamide 2% + timolol 0.5%","frequency":"Twice daily","common_side_effects":"Eye stinging, bitter taste, blurred vision"},{"medicine":"Latanoprost + timolol","active_ingredients":"Latanoprost 0.005% + timolol 0.5%","frequency":"Once daily","common_side_effects":"Eye redness, eyelash growth, blurred vision"}]

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