Dorzolamide-TimololDorzolamide/Timolol

About Dorzolamide-Timolol

Both ingredients lower eye pressure by reducing how much fluid the eye makes: dorzolamide blocks the enzyme carbonic anhydrase, and timolol cuts fluid production by another route. The combination is used when a beta-blocker drop alone has not lowered pressure enough. It lowers pressure more than either drug alone, from one bottle.

A bitter or unusual taste and burning or stinging in the eye are the most common complaints. Timolol reaches the bloodstream and can act like a beta blocker tablet, so the drop is not used by people with asthma or a history of it, severe COPD, a slow heart rhythm or heart block, or overt heart failure; deaths from bronchospasm have been reported in asthma. It can also hide the warning signs of low blood sugar. Dorzolamide is a sulfonamide, so sulfa-type reactions are possible, and the drop is not recommended in severe kidney disease. There is no boxed warning.

The bottle contains the preservative benzalkonium chloride, which soft contact lenses can absorb; the preservative-free vials avoid it.

Taking Dorzolamide-Timolol

How to take it

One drop in the affected eye or eyes twice a day. Remove contact lenses first and wait 15 minutes before putting them back. Space other eye drops at least 5 minutes apart, and keep the tip from touching the eye, since a contaminated bottle can cause a serious infection. Open a single-use vial just before use, for one or both eyes, and throw it away afterward even if some is left.

If you miss a dose

Use it when you remember, unless the next dose is almost due; then skip it and carry on as usual. Do not use extra drops to make up.

Storage

At room temperature, with bottles protected from light. Keep preservative-free vials in the foil pouch, do not freeze them, and throw away any left 15 days after the pouch is opened.

Interactions to know about

Beta blocker tablets add to its effect on heart rate and blood pressure; calcium channel blockers, digoxin and reserpine can slow the heart further; quinidine and SSRI antidepressants can strengthen the timolol effect. Oral carbonic anhydrase inhibitors such as acetazolamide are not recommended with it, and high-dose aspirin needs care.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Dorzolamide-Timolol differs from pharmacy to pharmacy

The preserved bottle is an established generic with many makers, so pharmacies pay little for it and the cash price mostly reflects mark-up and the dispensing fee. Preservative-free vials have fewer makers and package every dose separately, so they cost pharmacies far more. A prescription for Cosopt PF or preservative-free drops cannot be filled with the bottle, and a brand prescription marked dispense as written commits the pharmacy to Cosopt.

Ways to pay less for Dorzolamide-Timolol without insurance

• Ask for the generic bottle rather than brand Cosopt; it has the same ingredients at the same strengths.
• If preservative-free vials are prescribed, ask whether you need them, and if so, ask for a generic version rather than Cosopt PF.
• Ask for a prescription that covers several bottles per fill, so one dispensing fee covers a longer supply.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Dorzolamide-Timolol

1. 1.Is this the preserved bottle or the preservative-free vials, and which did my prescriber write?
2. 2.How long should I wait between this and my other eye drops?
3. 3.Is it safe with my asthma, COPD, heart condition or blood pressure tablets?
4. 4.How long will one bottle or pouch last at my dose?

Related medications