Duoprost eye drops 2.5ml bottle

Description
Transparent colorless solution, without visible particles

Pharmacotherapeutic group

Antiglaucoma drugs and miotics. Beta-blockers.

Pharmacological properties

Pharmacokinetics

The maximum concentration of latanoprost (approximately 15-30ng / ml) in aqueous humor is reached 2 hours after topical administration. After the application of eye drops, latanoprost is distributed, first of all, in the anterior segment, in the conjunctiva and in the eyelids, and only a small amount of the drug reaches the posterior segment. The metabolism of latanoprost practically does not occur in the tissues of the eye. The main metabolism occurs in the liver. The plasma half-life is 17 min. The major metabolites, 1,2-dinor- and 1,2,3,4, -tetranor-metabolites, do not have or have weak biological activity and are mainly excreted in the urine.

With topical application of Timolol maleate, it quickly penetrates the cornea. After instillation of eye drops, the maximum concentration of timolol in the aqueous humor of the eye is reached after 1 h. The half-life in plasma is about 6 h. The removal of metabolites of timolol is carried out mainly by the kidneys.

Pharmacodynamics

Combined antiglaucoma drug lowers intraocular pressure by reducing the secretion of aqueous humor.

Latanoprost - an analogue of prostaglandin F2a and the selective FP receptor agonist. Latanoprost reduces intraocular pressure by increasing the outflow of aqueous humor and has an antiglaucoma effect. The underlying mechanism of action of latanoprost is associated with an increase in uveoscleral outflow. It has no significant effect on the production of aqueous humor and does not affect the hemato-ophthalmic barrier.

Timolol is a non-selective beta-adrenoreceptor blocker with a minor internal SMA. When applied topically reduces intraocular pressure by reducing the formation of aqueous humor and a slight increase in its outflow.

Indications for use

- increased intraocular pressure in patients with open angle glaucoma and ocular hypertension

Dosage and administration

1 drop in the conjunctival sac of the eye once a day. Daily dose should not exceed 1 drop per day.

In the case of joint use of Duoprost with another ophthalmologic preparation, an interval of at least 5 minutes is observed between use. You should remove the hard contact lenses before instillation of the drug and put them on again only after 15 minutes.

Contraindications

hypersensitivity to latanoprost, timolol or another component of the drug

bronchial asthma or other chronic obstructive pulmonary disease

sinus bradycardia, AV blockade II and III, heart failure, cardiogenic shock

child age (efficacy and safety unspecified)

Side effects

Very often (≥1 / 10):

- enhancement of iris pigmentation

Often (≥1 / 100, <1/10):

- eye irritation (including tingling, burning and itching), eye pain

Not often (≥1 / 1000, <1/100):

- eye hyperemia, conjunctivitis, blurred vision, increased sleep, blepharitis, corneal damage

- headache

- skin rash, skin itch

Side effects when using latanoprost:

- dizziness

- Changes in the hair of the eyelashes (increase in length, thickness, pigmentation and quantity). Dot epithelial erosion, periorbital edema, inflammation of the iris / uveitis, macular edema (in aphaktic, pseudofaki patients in patients with posterior lens capsule damage or in patients with known risk factors for macular edema). Dry eyes, keratitis, edema and erosions; incorrect eyelashes sometimes irritate the eyes

- heartbeat, exacerbation of stenocardia in patients with already existing diseases

- asthma, exacerbation of asthma, dyspnea

- darkening of the skin around the eyes

- joint pain, muscle pain

- chest pain

Side effects when using timolol:

- signs and symptoms of systemic allergic reactions, including angioedema, urticaria, localized and generalized rash

- depression, memory loss, decreased libido, insomnia, nightmares

- dizziness, paresthesia, cerebral ischemia, cerebral circulatory disorders, increased signs and symptoms of myasthenia, syncope

- signs and symptoms of irritation, including ocular keratitis, decreased sensitivity of the cornea and dry eyes, visual disturbances, including changes in refraction (due to the withdrawal of meiotic treatment), diplopia, ptosis, choroid (after filtration surgery)

- ringing in the ears

- fluttering, arrhythmia, bradycardia, cardiac arrest, heart block, congestive heart failure

- hypotension, Raynaud's phenomenon, cold hands and feet

- bronchospasm (mainly in patients with already existing bronchospasm), shortness of breath, cough

- nausea, diarrhea, dyspepsia, dry mouth

- hair loss, psoriasis rash or exacerbation of psoriasis

- asthenic fatigue, chest pain, swelling

Drug interactions

With simultaneous use with Calcium channel blockers, drugs that reduce the activity of catecholamines, beta-blockers, antiarrhythmics (including Amiodarone iichinidine), cardiovascular glycosides from the group of digitalis, cholinomimetics, narcotic analgesics, monoamine oxidase, it is possible to enhance your body patterns.

With simultaneous use of timolol maleate with adrenaline, mydriasis sometimes developed.

With simultaneous use of the drug sbet-blockers may increase blood sugar, which can disguise the symptoms of hyperglycemia.

Special notes

Heart failure must be properly regulated before initiating therapy with timolol. Patients with severe vanamnese heart disease should be under the close supervision of a physician. After the administration of timomololamelate, respiratory reactions and cardiac reactions are possible, including death due to bronchospasm in patients with bronchial asthma and, rarely, death due to heart failure. Beta-blockers should be used with caution in patients with spontaneous hypo- or glycemia, since beta-blockers may mask the symptoms of acute hypoglycemia. Beta blockers can mask signs of hyperthyroidism and cause worsening of angina pectoris, severe diseases of the peripheral and central circulation, and hypotension.

The use of two local beta-blockers or two local prostaglandins is not recommended.

The drug may cause a gradual change in eye color due to an increase in the amount of brown pigment in the iris. When using latanoprostoobrazno the increase in pigmentation diaphragm, this effect is mainly of patients with mixed colors of the irises. Usually, the brown pigmentation around the pupil extends concentrically to the periphery of the affected eye, but all or some of the iris may become more brown.

Before treatment, patients should be informed of the possibility of changes in eye color. Unilateral treatment can lead to permanent heterochromia.

During treatment with latanoprost, macular edema, including cystoid macular edema, may occur. Macular edema develops predominantly in aphakic patients, pseudo-fakichnyh patients with lesions of the posterior lens capsule. Duoprost should be used with caution in these patients.

Duoprost contains benzalkonium chloride, which is usually used as a preservative in ophthalmic preparations. Benzalkonium chloride is known to cause dotted keratopathy and / or toxic ulcerative keratopathy, can cause eye irritation, and is known to discolor soft contact lenses. Therefore, contact lenses should be removed, and then they can be inserted again 15 minutes after instillation.

If one dose is missed, treatment should be continued as usual, with the next dose (i.e., the dose is not doubled). Caution is recommended in patients with neovascular and congenital glaucoma, due to the lack of sufficient safety data.

Pregnancy and lactation period

Duoprost is not recommended for use in pregnant women, unless it is clearly necessary (with clear indications and analysis of the benefit / risk ratio for the mother and fetus).

The drug is excreted in milk, so when using the drug, mothers should stop breastfeeding.

Features of the effect of the drug on the ability to steer the vehicle or potentially dangerous machinery

Given the adverse effects of the drug, it is not necessary to drive motor vehicles and other potentially dangerous machinery.

Overdose

Symptoms: eye irritation, conjunctival or episodic hyperemia, dizziness, headache, arrhythmia, bradycardia, bronchospasm, nausea, vomiting, fatigue, flushes and sweating.

Treatment: symptomatic therapy.

Release form and packaging

At 2.5 ml of solution in a transparent polymer bottle-dropper with a capacity of 5 ml closed with a polymer cap with a safety ring. Single-bottle dropper along with instructions for use in the Russian state in a cardboard box.

Storage conditions

In the dark place at a temperature of from 2 ° C to 8 ° C.

After opening the bottle, the drug should be stored at a temperature not higher than 25 ° C and used within 4 weeks.

Keep out of the reach of children!