Several fixed combination products are now available in glaucoma management. Considerations when selecting combination therapy include safety, finding the best combination of mechanisms of action. Combigan® is one such product that has been shown to be more effective than either of its constituent agents, brimonidine or timolol, used alone. It has at least a similar intraocular pressure (IOP)-lowering effect as the concomitant use of its two constituents, and it produces a significant additional lowering of IOP in patients who switch from other therapies, including Cosopt®. Combigan has high patient satisfaction ratings.
Van der ValkR., WebersC.A., SchoutenJ.S., ZeegersM.P., HendrikseF., PrinsM.H.Intraocular pressure-lowering effects of all commonly used glaucoma drugs: A metaanalysis of randomised clinical trials.Ophthalmology2005; 112: 1177–85.
2.
KassM.A., HeuerD.K., HigginbothamE.J.The Ocular Hypertension Treatment Study: A randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open angle glaucoma.Arch Ophthalmol2002; 120: 701–13.
3.
Collaborative Normal-Tension Glaucoma (CNTG) Study Group.Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures.Am J Ophthalmol1998; 126: 487–97.
4.
ChoudhriS., WandM., ShieldsM.B.A comparison of dorzolamide-timolol combination versus the concomitant drugs.Am J Ophthalmol2000; 130: 832–3.
5.
BossowskaI.Combination products today: An update on a new fixed combination.Eur J Ophthalmol2007; 17(Suppl 5): S9–14.
6.
ManniG., CentofantiM., SacchettiM.Demographic and clinical factors associated with development of brimonidine tartrate 0.2%-induced ocular allergy.J Glaucoma2004; 13: 163–7.
7.
GouwsP.Combination products in clinical practice: Canadian experience.Eur J Ophthalmol2007; 17(Suppl 5): S15–7.
VenturaM.P., SahebN.E., SolariH.P., SaraivaV.S., ViannaR.N., BurnierM.N.Jr.Cost consideration of the new fixed combinations for glaucoma medical therapy.J Clin Pharm Ther2005; 30: 251–4.
