The response of these patients should be closely observed. The effect on intra-ocular pressure or the known effects of systemic beta blockade may be potentiated when timolol is given to patients already receiving a systemic beta-blocking medicinal product. timolol, acetazolamide) after filtration procedures. Patients with corneal diseases should be treated with caution.Ĭhoroidal detachment has been reported with administration of aqueous suppressant therapy (e.g. Ophthalmic beta blockers may induce dryness of eyes. diplopia, ptosis and generalised weakness). Respiratory reactions, including death due to bronchospasm in patients with asthma, have been reported following administration of some ophthalmic beta blockers.ĭuoTrav should be used with caution in patients with mild/moderate chronic obstructive pulmonary disease (COPD) and only if the potential benefit outweighs the potential risk.īeta blockers should be administered with caution in patients subject to spontaneous hypoglycaemia or in patients with labile diabetes, as beta blockers may mask the signs and symptoms of acute hypoglycaemia.īeta-adrenergic blocking medicinal products have been reported to potentiate muscle weakness consistent with certain myasthenic symptoms (e.g. severe forms of Raynaud's disease or Raynaud's syndrome) should be treated with caution. Patients with severe peripheral circulatory disturbance/disorders (i.e.

Patients with cardiovascular diseases should be watched for signs of deterioration of these diseases and of adverse reactions.ĭue to their negative effect on conduction time, beta blockers should only be given with caution to patients with first-degree heart block. coronary heart disease, Prinzmetal's angina and cardiac failure) and hypotension, therapy with beta blockers should be critically assessed and therapy with other active substances should be considered.

In patients with cardiovascular diseases (e.g. Like other topically applied ophthalmic agents, travoprost and timolol are absorbed systemically. Patients must be instructed to remove soft contact lenses prior to application of DuoTrav and wait 15 minutes after instillation of the dose before reinsertion. When substituting another ophthalmic antiglaucoma medicinal product with DuoTrav, the other medicinal product should be discontinued and DuoTrav should be started the following day. If more than one topical ophthalmic medicinal product is being used, the medicinal products must be administered at least 5 minutes apart. This may result in a decrease in systemic side effects and an increase in local activity. When nasolacrimal occlusion is used or the eyelids are closed for 2 minutes, systemic absorption is reduced. To prevent contamination of the dropper tip and solution, care must be taken not to touch the eyelids, surrounding areas or other surfaces with the dropper tip of the bottle. The patient should remove the protective overwrap immediately prior to initial use. The safety and efficacy of DuoTrav in children and adolescents below the age of 18 years have not been established. Patients with hepatic or renal impairment are unlikely to require dose adjustment with DuoTrav.

No dose adjustment was necessary in these patients. Travoprost has been studied in patients with mild to severe hepatic impairment and in patients with mild to severe renal impairment (creatinine clearance as low as 14 mL/min). No studies have been conducted with DuoTrav or with timolol 5 mg/mL eye drops in patients with hepatic or renal impairment. The dose should not exceed one drop in the affected eye(s) daily. If a dose is missed, treatment should be continued with the next dose as planned. It should be administered at the same time each day. The dose is one drop of DuoTrav in the conjunctival sac of the affected eye(s) once daily, in the morning or evening.

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