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Dorzolamide and timolol: Drug information

Dorzolamide and timolol: Drug information
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For additional information see "Dorzolamide and timolol: Patient drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Cosopt;
  • Cosopt PF
Brand Names: Canada
  • ACT Dorzotimolol;
  • APO-Dorzo-Timop;
  • Cosopt Preservative Free;
  • Cosopt With Preservative;
  • JAMP Dorzolamide-Timolol;
  • M-Dorzolamide-Timolol;
  • MED-Dorzolamide-Timolol;
  • RIVA-Dorzolamide/Timolol
Pharmacologic Category
  • Beta-Blocker, Nonselective;
  • Carbonic Anhydrase Inhibitor (Ophthalmic);
  • Ophthalmic Agent, Antiglaucoma
Dosing: Adult
Elevated intraocular pressure

Elevated intraocular pressure: Ophthalmic: Instill 1 drop in affected eye(s) twice daily.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: Use is not recommended (has not been studied).

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use with caution.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric
Elevated intraocular pressure

Elevated intraocular pressure: Children ≥2 years and Adolescents: Ophthalmic: Refer to adult dosing.

Dosing: Kidney Impairment: Pediatric

Children ≥2 years and Adolescents:

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: Use is not recommended (has not been studied).

Dosing: Liver Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use with caution.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Also see individual agents.

>10%:

Gastrointestinal: Dysgeusia (≤30%)

Ophthalmic: Blurred vision (5% to 15%), burning sensation of eyes (≤30%), conjunctival hyperemia (5% to 15%), eye pruritus (5% to 15%), stinging of eyes (≤30%), superficial punctate keratitis (5% to 15%)

1% to 10%:

Cardiovascular: Hypertension (1% to 5%)

Gastrointestinal: Abdominal pain (1% to 5%), dyspepsia (1% to 5%), nausea (1% to 5%)

Genitourinary: Urinary tract infection (1% to 5%)

Infection: Influenza (1% to 5%)

Nervous system: Dizziness (1% to 5%), headache (1% to 5%)

Neuromuscular & skeletal: Back pain (1% to 5%)

Ophthalmic: Blepharitis (1% to 5%), cataract (including subcapsular posterior cataract) (1% to 5%), cloudy vision (1% to 5%), conjunctival discharge (1% to 5%), conjunctival edema (1% to 5%), conjunctivitis (1% to 5%), corneal erosion (1% to 5%), corneal staining (1% to 5%), dry eye syndrome (1% to 5%), erythema of eyelid (1% to 5%), eye discharge (1% to 5%), eye disease (debris in eye) (1% to 5%), eye pain (includes eyelid) (1% to 5%), eyelid edema (1% to 5%), follicular conjunctivitis (1% to 5%), foreign body sensation of eye (1% to 5%), glaucomatous optic disc cupping (1% to 5%), lacrimation (1% to 5%), ocular discoloration (lens nucleus) (1% to 5%), ocular exudate (eyelid) (1% to 5%), scaling of eyelid (1% to 5%), visual field defect (1% to 5%), vitreous detachment (1% to 5%)

Respiratory: Bronchitis (1% to 5%), cough (1% to 5%), pharyngitis (1% to 5%), sinusitis (1% to 5%), upper respiratory tract infection (1% to 5%)

Postmarketing:

Cardiovascular: Acute myocardial infarction, bradycardia, chest pain, heart block, heart failure, hypotension

Dermatologic: Skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis

Gastrointestinal: Diarrhea, vomiting, xerostomia

Genitourinary: Urolithiasis

Nervous system: Cerebrovascular accident, depression, paresthesia

Ophthalmic: Choroidal detachment (following filtration procedures), iridocyclitis, photophobia

Respiratory: Dyspnea, nasal congestion, respiratory failure

Contraindications

Hypersensitivity to dorzolamide, timolol, or any component of the formulation; bronchial asthma or a history of bronchial asthma; severe chronic obstructive pulmonary disease; sinus bradycardia; second- or third-degree atrioventricular block; overt cardiac failure; cardiogenic shock.

Canadian labeling: Additional contraindications (not in US labeling): Severe renal impairment; sino-atrial block; concomitant use with oral carbonic anhydrase inhibitors.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Warnings/Precautions

Concerns related to adverse effects:

• Anaphylactic reactions: Use caution with history of severe anaphylaxis to allergens; patients taking beta-blockers may become more sensitive to repeated challenges. Treatment of anaphylaxis (eg, epinephrine) in patients taking beta-blockers may be ineffective or promote undesirable effects.

• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions has caused bacterial keratitis.

• Ocular effects: Local ocular adverse effects (conjunctivitis and lid reactions) were reported with chronic administration; many resolved upon discontinuation of drug therapy. Choroidal detachment has been reported after filtration procedures. Patients with low endothelial cell counts may have increased risk for corneal edema; use caution.

• Sulfonamide (“sulfa”) allergy: Dorzolamide is a sulfonamide; although administered ocularly, systemic absorption may occur and could result in hypersensitivity. Discontinue use if signs of hypersensitivity or a serious reaction occur.

• Systemic effects: Systemic absorption and adverse effects (similar to sulfonamides) including blood dyscrasias, Stevens-Johnson syndrome, toxic epidermal necrolysis, and fulminant hepatic necrosis may occur with ophthalmic use.

Disease-related concerns:

• Diabetes: Use with caution in patients with diabetes mellitus; may potentiate hypoglycemia and/or mask signs and symptoms.

• Heart failure (HF): Use with caution in patients with compensated heart failure and monitor for a worsening of the condition; control heart failure prior to initiation of therapy.

• Hepatic impairment: Use with caution in patients with hepatic impairment; not evaluated.

• Myasthenia gravis: Use with caution in patients with myasthenia gravis; may worsen disease or other myasthenic symptoms (diplopia, ptosis, and generalized weakness).

• Narrow-angle glaucoma: Use is not recommended in narrow-angle glaucoma (has not been studied).

• Peripheral vascular disease (PVD) and Raynaud's disease: Can precipitate or aggravate symptoms of arterial insufficiency in patients with PVD and Raynaud's disease. Use with caution and monitor for progression of arterial obstruction.

• Psychiatric disease: Use with caution in patients with a history of psychiatric illness; may cause or exacerbate CNS depression.

• Renal impairment: Use with caution in patients with renal impairment; not recommended with severe impairment (CrCl <30 mL/minute).

• Respiratory disease: In general, patients with mild-to-moderate COPD or bronchospastic disease should not receive beta-blockers; if used at all, should be used cautiously with close monitoring. Use is contraindicated in patients with asthma or severe COPD.

• Thyroid disease: May mask signs of hyperthyroidism (eg, tachycardia). If thyrotoxicosis is suspected, carefully manage and monitor; abrupt withdrawal may exacerbate symptoms of hyperthyroidism or precipitate thyroid storm.

Special populations:

• Contact lens wearers: Some products may contain benzalkonium chloride which may be absorbed by soft contact lenses; remove lens prior to administration and wait 15 minutes before reinserting.

Other warnings/precautions:

• Surgery: May block systemic effects of beta agonists (eg, epinephrine, norepinephrine); notify anesthesiologist if patient is receiving ophthalmic beta blocker therapy. Patients undergoing planned major surgery should be gradually tapered off therapy (if possible) prior to procedure. If necessary during surgery, effects of beta blocker therapy may be reversed by adrenergic agonists.

Dosage Forms Considerations

Ophthalmic solution contains dorzolamide hydrochloride 2.23% [22.3 mg/mL] and timolol maleate 0.68% [6.8 mg/mL]

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic:

Cosopt: Dorzolamide 2% and timolol 0.5% (10 mL) [contains benzalkonium chloride]

Generic: Dorzolamide 2% and timolol 0.5% (10 mL)

Solution, Ophthalmic [preservative free]:

Cosopt PF: Dorzolamide 2% and timolol 0.5% (15 ea, 60 ea)

Generic: Dorzolamide 2% and timolol 0.5% (5 ea, 15 ea, 60 ea)

Generic Equivalent Available: US

Yes

Pricing: US

Solution (Cosopt Ophthalmic)

2-0.5% (per mL): $25.15

Solution (Cosopt PF Ophthalmic)

2-0.5% (per each): $4.13

Solution (Dorzolamide HCl-Timolol Mal Ophthalmic)

2-0.5% (per mL): $2.50 - $12.26

Solution (Dorzolamide HCl-Timolol Mal PF Ophthalmic)

2-0.5% (per each): $2.80 - $2.83

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic:

Cosopt Preservative Free: Dorzolamide 2% and timolol 0.5% (0.2 mL)

Cosopt With Preservative: Dorzolamide 2% and timolol 0.5% (10 mL) [contains benzalkonium chloride]

Generic: Dorzolamide 2% and timolol 0.5% (5 mL, 10 mL)

Administration: Adult

Ophthalmic:

Cosopt: If using additional topical ophthalmic preparations, separate administration by at least 5 minutes. Remove contact lens prior to administration and wait 15 minutes before reinserting. Instruct patients to avoid allowing the tip of the dispensing container to contact the eye or surrounding structures. Ocular solutions can become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may occur from using contaminated solutions.

Cosopt PF: Discard single-use container after initial use. If using additional topical ophthalmic preparations, separate administration by at least 5 minutes.

Administration: Pediatric

Ophthalmic: Wash hands before use. Pull lower eyelid down slightly to form a pocket for the eye drop and tilt head back; administer 1 drop. Apply gentle pressure to lacrimal sac immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration to decrease systemic absorption of ophthalmic drops (Ref). Avoid contact of bottle tip with skin or eye; ocular solutions can become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may occur from using contaminated solutions. Some solutions contain benzalkonium chloride; remove contact lenses prior to administration and wait at least 15 minutes after instillation before reinserting soft contact lenses. Remove contact lens prior to administration (solution contains benzalkonium chloride) and wait 15 minutes before reinserting soft contact lenses. If using additional topical ophthalmic preparations, separate administration by at least 5 minutes.

Cosopt PF: Administer immediately after opening container; may be used to treat one or both eyes. Discard single-use container immediately after use.

Use: Labeled Indications

Elevated intraocular pressure: Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to beta-blockers

Metabolism/Transport Effects

Refer to individual components.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Acetylcholinesterase Inhibitors: May increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Ajmaline: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor

Alpha2-Agonists: Beta-Blockers may increase rebound hypertensive effects of Alpha2-Agonists. This effect can occur when the Alpha2-Agonist is abruptly withdrawn. Alpha2-Agonists may increase AV-blocking effects of Beta-Blockers. Sinus node dysfunction may also be enhanced. Management: Closely monitor heart rate during treatment with a beta blocker and clonidine. Withdraw beta blockers several days before clonidine withdrawal when possible, and monitor blood pressure closely. Recommendations for other alpha2-agonists are unavailable. Risk D: Consider Therapy Modification

Amantadine: Carbonic Anhydrase Inhibitors may increase serum concentration of Amantadine. Risk C: Monitor

Amiodarone: May increase bradycardic effects of Beta-Blockers. Possibly to the point of cardiac arrest. Amiodarone may increase serum concentration of Beta-Blockers. Risk C: Monitor

Antidiabetic Agents: Beta-Blockers (Nonselective) may increase hypoglycemic effects of Antidiabetic Agents. Beta-Blockers (Nonselective) may increase adverse/toxic effects of Antidiabetic Agents. Specifically, beta-blockers may mask the hypoglycemic symptoms of antidiabetic agents. Risk C: Monitor

Antipsychotic Agents (Phenothiazines): May increase hypotensive effects of Beta-Blockers. Beta-Blockers may decrease metabolism of Antipsychotic Agents (Phenothiazines). Antipsychotic Agents (Phenothiazines) may decrease metabolism of Beta-Blockers. Risk C: Monitor

Artemether and Lumefantrine: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor

Beta2-Agonists: Beta-Blockers (Nonselective) may decrease bronchodilatory effects of Beta2-Agonists. Risk X: Avoid

Bradycardia-Causing Agents: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Cafedrine: May increase bradycardic effects of Beta-Blockers. Beta-Blockers may decrease therapeutic effects of Cafedrine. Risk C: Monitor

Cannabis: Beta-Blockers may increase adverse/toxic effects of Cannabis. Specifically, the risk of hypoglycemia may be increased. Risk C: Monitor

Carbonic Anhydrase Inhibitors: May increase adverse/toxic effects of Carbonic Anhydrase Inhibitors. The development of acid-base disorders with concurrent use of ophthalmic and oral carbonic anhydrase inhibitors has been reported. Management: Avoid concurrent use of different carbonic anhydrase inhibitors if possible. Monitor patients closely for the occurrence of kidney stones and with regards to severity of metabolic acidosis. Risk X: Avoid

Ceritinib: Bradycardia-Causing Agents may increase bradycardic effects of Ceritinib. Management: If this combination cannot be avoided, monitor patients for evidence of symptomatic bradycardia, and closely monitor blood pressure and heart rate during therapy. Risk D: Consider Therapy Modification

Cholinergic Agonists: Beta-Blockers may increase adverse/toxic effects of Cholinergic Agonists. Of particular concern are the potential for cardiac conduction abnormalities and bronchoconstriction. Risk C: Monitor

CYP2D6 Inhibitors (Strong): May increase serum concentration of Timolol (Ophthalmic). Risk C: Monitor

Dipyridamole: May increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Disopyramide: May increase bradycardic effects of Beta-Blockers. Beta-Blockers may increase negative inotropic effects of Disopyramide. Risk C: Monitor

DOBUTamine: Beta-Blockers may decrease therapeutic effects of DOBUTamine. Risk C: Monitor

Dronedarone: May increase bradycardic effects of Beta-Blockers. Dronedarone may increase serum concentration of Beta-Blockers. This likely applies only to those agents that are metabolized by CYP2D6. Management: Use lower initial beta-blocker doses; adequate tolerance of the combination, based on ECG findings, should be confirmed prior to any increase in beta-blocker dose. Increase monitoring for clinical response and adverse effects. Risk D: Consider Therapy Modification

EPHEDrine (Systemic): Beta-Blockers may decrease therapeutic effects of EPHEDrine (Systemic). Risk C: Monitor

EPINEPHrine (Nasal): Beta-Blockers (Nonselective) may increase hypertensive effects of EPINEPHrine (Nasal). Risk C: Monitor

EPINEPHrine (Oral Inhalation): Beta-Blockers (Nonselective) may increase hypertensive effects of EPINEPHrine (Oral Inhalation). Risk C: Monitor

EPINEPHrine (Systemic): Beta-Blockers (Nonselective) may increase hypertensive effects of EPINEPHrine (Systemic). Risk C: Monitor

Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates): Beta-Blockers may increase vasoconstricting effects of Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates). Risk C: Monitor

Etilefrine: Beta-Blockers may decrease therapeutic effects of Etilefrine. Etilefrine may increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Etofylline: Beta-Blockers may decrease therapeutic effects of Etofylline. Risk X: Avoid

Etrasimod: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Fexinidazole: Bradycardia-Causing Agents may increase arrhythmogenic effects of Fexinidazole. Risk X: Avoid

Fingolimod: Bradycardia-Causing Agents may increase bradycardic effects of Fingolimod. Management: Consult with the prescriber of any bradycardia-causing agent to see if the agent could be switched to an agent that does not cause bradycardia prior to initiating fingolimod. If combined, perform continuous ECG monitoring after the first fingolimod dose. Risk D: Consider Therapy Modification

Grass Pollen Allergen Extract (5 Grass Extract): Beta-Blockers may increase adverse/toxic effects of Grass Pollen Allergen Extract (5 Grass Extract). More specifically, Beta-Blockers may inhibit the ability to effectively treat severe allergic reactions to Grass Pollen Allergen Extract (5 Grass Extract) with epinephrine. Some other effects of epinephrine may be unaffected or even enhanced (e.g., vasoconstriction) during treatment with Beta-Blockers. Management: Consider alternatives to either grass pollen allergen extract (5 grass extract) or beta-blockers in patients with indications for both agents. Canadian product labeling specifically lists this combination as contraindicated. Risk D: Consider Therapy Modification

Insulin: Beta-Blockers (Nonselective) may increase hypoglycemic effects of Insulin. Beta-Blockers (Nonselective) may decrease therapeutic effects of Insulin. Risk C: Monitor

Isoproterenol: Beta-Blockers may decrease therapeutic effects of Isoproterenol. Risk C: Monitor

Ivabradine: Bradycardia-Causing Agents may increase bradycardic effects of Ivabradine. Risk C: Monitor

Lacosamide: Bradycardia-Causing Agents may increase AV-blocking effects of Lacosamide. Risk C: Monitor

Landiolol: Bradycardia-Causing Agents may increase bradycardic effects of Landiolol. Risk X: Avoid

Mavacamten: Beta-Blockers may increase adverse/toxic effects of Mavacamten. Specifically, negative inotropic effects may be increased. Risk C: Monitor

Mavorixafor: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk X: Avoid

Methacholine: Beta-Blockers may increase adverse/toxic effects of Methacholine. Risk C: Monitor

Midodrine: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Mivacurium: Beta-Blockers may increase therapeutic effects of Mivacurium. Risk C: Monitor

NIFEdipine (Topical): May increase adverse/toxic effects of Beta-Blockers. Risk C: Monitor

NIFEdipine: May increase hypotensive effects of Beta-Blockers. NIFEdipine may increase negative inotropic effects of Beta-Blockers. Risk C: Monitor

Nitrendipine: May increase therapeutic effects of Beta-Blockers. Risk C: Monitor

Nonsteroidal Anti-Inflammatory Agents (Topical): May decrease therapeutic effects of Beta-Blockers. Risk C: Monitor

Nonsteroidal Anti-Inflammatory Agents: May decrease antihypertensive effects of Beta-Blockers. Risk C: Monitor

Opipramol: Beta-Blockers may increase serum concentration of Opipramol. Opipramol may increase serum concentration of Beta-Blockers. Risk C: Monitor

Ozanimod: May increase bradycardic effects of Bradycardia-Causing Agents. Risk C: Monitor

Peginterferon Alfa-2b: May decrease serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Peginterferon Alfa-2b may increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor

Ponesimod: Bradycardia-Causing Agents may increase bradycardic effects of Ponesimod. Management: Avoid coadministration of ponesimod with drugs that may cause bradycardia when possible. If combined, monitor heart rate closely and consider obtaining a cardiology consult. Do not initiate ponesimod in patients on beta-blockers if HR is less than 55 bpm. Risk D: Consider Therapy Modification

Reserpine: May increase hypotensive effects of Beta-Blockers. Reserpine may increase bradycardic effects of Beta-Blockers. Risk C: Monitor

Rivastigmine: May increase bradycardic effects of Beta-Blockers. Risk X: Avoid

Siponimod: Bradycardia-Causing Agents may increase bradycardic effects of Siponimod. Management: Avoid coadministration of siponimod with drugs that may cause bradycardia. If combined, consider obtaining a cardiology consult regarding patient monitoring. Risk D: Consider Therapy Modification

Succinylcholine: Beta-Blockers may increase neuromuscular-blocking effects of Succinylcholine. Risk C: Monitor

Sulfonylureas: Beta-Blockers (Nonselective) may increase hypoglycemic effects of Sulfonylureas. Beta-Blockers (Nonselective) may decrease therapeutic effects of Sulfonylureas. Risk C: Monitor

Tasimelteon: Beta-Blockers may decrease therapeutic effects of Tasimelteon. Management: Consider avoiding nighttime administration of beta-blockers during tasimelteon therapy due to the potential for reduced tasimelteon efficacy. Risk D: Consider Therapy Modification

Theodrenaline: May increase bradycardic effects of Beta-Blockers. Beta-Blockers may decrease therapeutic effects of Theodrenaline. Risk C: Monitor

Theophylline Derivatives: Beta-Blockers (Nonselective) may decrease bronchodilatory effects of Theophylline Derivatives. Risk C: Monitor

White Birch Allergen Extract: Beta-Blockers may increase adverse/toxic effects of White Birch Allergen Extract. Specifically, beta-blockers may reduce the effectiveness of beta-agonists that may be required to treat systemic reactions to white birch allergen extract. Risk X: Avoid

Pregnancy Considerations

Reproductive studies have not been conducted with this combination. Refer to individual agents.

Breastfeeding Considerations

Timolol is excreted in breast milk following oral and ophthalmic administration; however, it is unknown whether dorzolamide is also excreted. Due to the potential for serious adverse reactions in the nursing infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of treatment to the mother. Refer to individual agents.

Monitoring Parameters

Ophthalmic exams and IOP periodically

Mechanism of Action

Dorzolamide: Inhibits carbonic anhydrase in the ciliary processes of the eye resulting decreased bicarbonate ion formation which decreases sodium and fluid transport, thus decreasing aqueous humor secretion and reduces intraocular pressure.

Timolol: Blocks both beta1- and beta2-adrenergic receptors, reduces intraocular pressure by reducing aqueous humor production or possibly increases the outflow of aqueous humor

Pharmacokinetics (Adult Data Unless Noted)

See individual agents.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Apisopt plus | Cosopt | Dualkopt | Xolamol;
  • (AR) Argentina: Aliviapres | Cosopt | Dor Timolol | Dorlamida t | Dorzoflax | Dorzolamida t dorf | Eliptic ofteno | Eliptic ofteno pf | Glaucotensil td | Glaucotensil td lc | Press Out T | Timed d | Zopirol DM;
  • (AT) Austria: Arutidor | Cosopt | Cosopt sine | Dorzastad | Dorzocomp vision | Dorzolamid comp | Dorzolamid+timolol 1a pharma | Dorzolamid+timolol arcana | Dorzolamid+timolol sandoz | Dorzoratio comp | Duokopt;
  • (AU) Australia: Apo dorzolamide/timolol | Cosdor | Cosopt | Dorzolamide/timolol an | Dorzolamide/Timolol Sandoz | Vizo pf dorzolatim;
  • (BD) Bangladesh: Cozopt | Orzolol;
  • (BE) Belgium: Cosopt | Dorzolamide/timolol eg | Dorzolamide/timolol teva | Dualkopt | Tensocmylan | Timoglaucon;
  • (BF) Burkina Faso: Cosopt | Twinzol;
  • (BG) Bulgaria: Amiptifree | Cosopt imulti | Dorsolol | Dorzasopt | Dorzoptol | Duokopt | Oftidorix | Oftidorix pf;
  • (BR) Brazil: Cloridrato de dorzolamida + maleato de timolol | Cloridrato de dorzolamida+maleato de timolol | Cosopt | Dorzal mt | Drusolol | Glalfital | Pert mt | Pressaliv | Timosopt;
  • (CH) Switzerland: Co dorzolamid teva | Cosopt | Cosopt s | Dorzocomp vision | Dorzolamid plus spirig hc | Dorzolamid/Timolol Sandoz | Duokopt;
  • (CI) Côte d'Ivoire: Cosopt | Twinzol | Xolamol;
  • (CL) Chile: Ailicec | Cosopt | Dorsof T | Dorzox t | Eliptic ofteno | Glaucotensil T | Glausolets Plus | Tiof plus;
  • (CO) Colombia: Cosopt | Dorlamida t | Dormol | Dorpretim | Dortim | Dorzolamida + timolol | Dorzolol | Dorzolol MK | Dorzolol ud | Dorzopres T | Dorzopt | Dorzovision t | Eliptic ofteno | Glaucotensil T | Glautim | Low press | Op quar | Opti qua;
  • (CZ) Czech Republic: Amiptic | Batidor | Cosopt | Cosopt free | Dorzogen Combi | Dorzolamid/timolol | Dorzolamid/timolol olikla | Dozotima | Dualkopt | Vizidor duo;
  • (DE) Germany: Cosduo | Cosopt | Cosopt s | Dorzo plus t stada | Dorzocomp stulln sine | Dorzocomp vision | Dorzolamid + timolol trb | Dorzolamid al comp | Dorzolamid comp | Dorzolamid plus timolol dr mann | Dorzolamid ratiopharm comp | Dorzolamid/timolol heumann | Dorzolamid/timolol micro labs | Dorzolamid/timolol pharma stulln | Dorzolamide/Timolol Micro Labs | Dorzotim | Duokopt;
  • (DK) Denmark: Arzotilol | Codotim;
  • (DO) Dominican Republic: Cosomidol | Cosopt | Duolol | Eliptic ofteno | Glaucotensil T | Iripress mol | Oculgla-d | Oculpres D | Timox D | Tiof plus;
  • (EC) Ecuador: Cosomidol | Cosopt | Dorlamida t | Dorzopt | Dorzotim | Duocitol | Eliptic ofteno | Eliptic ofteno pf | Episopt | Glaucotensil | Glaucotensil T | Lemulol d | Tiof plus;
  • (EE) Estonia: Cosopt | Dorzolamid/timolol | Dotizolil | Vizidor duo;
  • (EG) Egypt: Cosopt | Episopt | Epitimozal | Glaucosopt | Queenzolamide Plus | Ramedazolamide | Timosopt | Twinzol | Xolamol | Zolatilol;
  • (ES) Spain: Cosduo | Cosopt | Cosopt pf | Dorzolamida/timolol actavis | Dorzolamida/timolol aurovitas | Dorzolamida/timolol cinfa | Dorzolamida/Timolol FDC pharma | Dorzolamida/timolol kern pharma | Dorzolamida/timolol mabo | Dorzolamida/timolol normon | Dorzolamida/timolol stada | Dorzolamida/timolol tarbis | Dorzolamida/timolol vir | Dorzolamide/timolol | Dorzolamide/Timolol Mylan | Duokopt | Tidimaz | Visucopt;
  • (ET) Ethiopia: Apisopt plus | Dorzolamide + Timolol | Dorzolamide Hcl + Timolol Maleate | Lowiop | Misopt | Optodrop co | Twinzol | Xolamol;
  • (FI) Finland: Cosopt | Cosopt sine | Dortiva | Dorzolamid/Timolol Sandoz | Duokopt | Glaukostad;
  • (FR) France: Cosidime | Cosopt | Costec | Dorzolamide/timolol actavis | Dorzolamide/Timolol Biogaran | Dorzolamide/timolol cristers | Dorzolamide/timolol eg | Dorzolamide/Timolol Mylan | Dorzolamide/Timolol Sandoz | Dorzolamide/timolol teva | Dorzolamide/Timolol Zentiva | Dualkopt;
  • (GB) United Kingdom: Cosopt | Cosopt imulti | Dorzolamid/timolol | Dorzolamide and timolol | Dorzolamide hydrochloride/timolol maleate | Dorzolamide Timolol | Dorzolamide/timolol | Eylamdo | Glaucopt | Tidomat | Vizidor duo;
  • (GR) Greece: Cosopt | Cosopt imulti | Cosopt pf | Dorzoptic plus | Dorzotim | Dorzylea | Dotiz | Ophtha biotic | Optodrop co | Phardinol | Vizidor duo;
  • (HK) Hong Kong: Cosopt | Cosopt s | Dorzoptic t | Mardozia;
  • (HR) Croatia: Cosopt | Dorvis plus | Glaumax | Oftidorix pf;
  • (HU) Hungary: Cosopt multi | Cosopt ocumet.plus | Cosopt uno | Dorsocomb | Dorzolep Komb | Dozopres combi | Dozopticum duo | Glamzolid | Kiranol | Venturax;
  • (IE) Ireland: Cosopt | Dorzolamide/timolol | Tidimaz;
  • (IL) Israel: Cosopt | Dorzatol Avenir;
  • (IN) India: Arodor t | Ciaz duo | Cosopt | Dorbet pf | Dorfort t | Dormide t | Dortas-t | Dortim | Dorzone t | Dorzox t | Endor plus | Gludorz | Glustop | Glutim d | Misopt | Ocudor T;
  • (IQ) Iraq: Dorzilol;
  • (IT) Italy: Arutidor | Betaclar | Cosopt | Dorlede | Dorzamox | Dorzolamide e timolol zentiva | Dorzolamide e Timololo EG | Dorzolamide e timololo pensa | Dorzolamide timolol tubilux pharma | Dorzolamide Timololo Sandoz | Dorzolamide/timolol actavis | Dorzolamide/timololo teva | Eyroobi | Tidocomb | Zitodor;
  • (JO) Jordan: Apisopt plus | Cosopt | Daromed T | Optodrop co | Twinzol;
  • (JP) Japan: Cosopt | Dormolol | Dormolol nitto | Dormolol senju | Dormolol ts | Dormolol wakamoto;
  • (KE) Kenya: Augdor | Glantrim | Timodol | Xolamol | Zolichek t;
  • (KR) Korea, Republic of: Codor S | Combisopt | Cosopt | Cosopt s | Dortisop | Dortisop s | Dotimol | Dualkopt | Glazols | Jetisopt | Lowiop | Luce dt | Opticos | S Sopt | Tearsop free | Tearsopt free | Timomide | Tisop | Tisopt | Vatidor;
  • (KW) Kuwait: Cosopt | Dualkopt | Xolamol;
  • (LB) Lebanon: Combisopt | Cosopt | Dorzolamide/timolol bgr | Dorzoptic plus | Twinzol | Xolamol | Zolol;
  • (LT) Lithuania: Amiptic | Amiptifree | Cosopt | Cosopt sine | Dorzolamide/timolol | Dorzolamide/timolol actavis | Dorzolamide/timolol elvim | Oftidorix;
  • (LU) Luxembourg: Cosopt | Dualkopt;
  • (LV) Latvia: Amiptic | Amiptinon | Cosopt | Cosopt pf | Dorzolamid/timolol actavis | Dorzolamid/timolol portfarma | Dorzolamid/timolol teva | Dotizolil | Oftidorix | Vizidorix;
  • (MA) Morocco: Cosopt | Olamid | Xolamol;
  • (MX) Mexico: Ailicec | Anhigot | Anhigot pf | Besser | Cosopt | Dorzolamida timolol | Dorzolamida/Timolol kendrick | Eliptic ofteno | Ipka | Loftemide | Nonvesho | Oftilam | Sotoldor | Trovost | Zotilox;
  • (MY) Malaysia: Cosopt | Cosopt s;
  • (NG) Nigeria: Dorzoptol | Finarid | Iotim d | Midozol | Vitasopt;
  • (NL) Netherlands: Cosopt | Dorzolamide + timolol stulln | Dorzolamide/timolol | Dorzolamide/timolol actavis | Dorzolamide/timolol b&l | Dorzolamide/Timolol CF | Dorzolamide/Timolol Mylan | Dorzolamide/timolol pch | Dorzolamide/Timolol Sandoz | Dualkopt;
  • (NO) Norway: Cosopt | Cosopt sine | Dorzolamid/Timolol Sandoz | Duokopt;
  • (NZ) New Zealand: Arrow dortim | Cosopt | Dortimopt;
  • (PE) Peru: Cosomidol | Cosopt | Dorlip T | Dorsof T | Dortim | Duostop | Duozopt | Eliptic ofteno | Glamax | Glaucotensil T | Glaucox duo | Piodor T SP | Sefson T | Tidorzak | Tidorzak free | Tiof plus | Unidorzo T;
  • (PH) Philippines: Cosopt;
  • (PK) Pakistan: Co Dorzal | Cosopt | Dorlol | Dortex t | Dorz t | Dorzica | Dorzitol | Dorzolol | Dozypress T | Drimolol | Droptim | Glantrim | Glazol T | Medisopt | Neodore eye drops | Ocu lol | Tilomide | Timodor | Timorex D | Timotek d | Zolamed;
  • (PL) Poland: Cosopt | Dolopt plus | Dorzolamide + Timolol Genoptim | Dotiteva | Dropzol tim | Duokopt | Nodofree combi | Nodom combi | Oftidorix | Rozacom | Tymolamid | Vizidor duo;
  • (PR) Puerto Rico: Cosopt | Cosopt pf | Dorzolamide HCl and timolol maleate | Dorzolamide hcl Timolol maleate | Dorzolamide HCl-Timolol Maleate | Dorzolamide hcl/timolol maleate | Dorzolamide hydrochloride and timolol maleate | Dorzolamide hydrochloride-timolol maleate | Dorzolamide hydrochloride/timolol maleate;
  • (PT) Portugal: Cosopt | Cosopt multi | Duokopt | Protizol | Timolol + Dorzolamida Actavis | Timolol + Dorzolamida Generis | Timolol + dorzolamida germed | Timolol + dorzolamida mylan | Timolol + Dorzolamida Sandoz | Timolol + dorzolamida teva | Zycopt;
  • (PY) Paraguay: Citol dorzotim | Dorlamida t | Dorzoflax | Dorzolamida timolol | Glaucotensil td | Ileton dorzo | Simulten | Tiof plus;
  • (QA) Qatar: Apisopt Plus | Cosopt | Xolamol | Xolatim;
  • (RO) Romania: Cosopt | COSOPT fara conservant | SifiOpt;
  • (RU) Russian Federation: Cosopt | Dortimol antiglau eco | Dorzolan extra | Dorzopt plus | Dorzotimol;
  • (SA) Saudi Arabia: Cosopt | Dorzalol | Twinzol | Xolamol;
  • (SE) Sweden: Amelocare | Cosopt | Cosopt sine | Costad | Dorlatim | Dorzolamid/timolol abacus medicine | Dorzolamid/timolol actavis | Dorzolamid/Timolol ebb | Dorzolamid/timolol medical valley | Dorzolamid/Timolol Sandoz | Dorzolamid/timolol teva | Dorzolamide/timolol teva | Duokopt | Torzkom;
  • (SG) Singapore: Cosopt;
  • (SI) Slovenia: Cosopt | Duokopt;
  • (SK) Slovakia: Amiptic | Cosopt | Cosopt free | Dorzolamide / Timolol Indoco | Dualkopt | Vizidor duo;
  • (SR) Suriname: Dorzolamide/Timolol Mylan | Dorzox t | Glaucotensil td;
  • (TH) Thailand: Cosopt;
  • (TN) Tunisia: Dualkopt | Optodrop co | Zolol;
  • (TR) Turkey: Cosopt | Dorzasopt | Dorzotim | Duosopt | Oftomix | Tidomix | Tomec | Xolatim;
  • (TW) Taiwan: Ansee | Co dorzomide | Cosopt;
  • (UA) Ukraine: Cosopt | Cosopt bk | Dorzitim | Dorzopt plus | Dorzoptic combi | Dorzotimol | Mardozia | Rozacom;
  • (UG) Uganda: Apisopt plus | Ocudort t | Xolamol;
  • (UY) Uruguay: Cosopt | Dorzotim | Eliptic ofteno | Glaucotensil T | Tidorzak | Timed d | Tiof plus;
  • (VE) Venezuela, Bolivarian Republic of: Azopt | Cofador t | Cosomidol | Cosopt | Dobet | Dortimol | Dorzolamida timolol | Dotilol | Glaucotensil T | Opti qua | Tidor | Xolatim;
  • (ZA) South Africa: Cosopt | Glaumide co | Glauopt co | Ocudor co;
  • (ZM) Zambia: Phardinol
  1. Cosopt (dorzolamide hydrochloride/timolol maleate) [prescribing information]. Waltham, MA: Thea Pharma Inc; May 2023.
  2. Cosopt and Cosopt Preservative-Free (dorzolamide hydrochloride/timolol maleate) [product monograph]. Toronto, Ontario, Canada: Elvium Life Sciences; November 2023.
  3. Cosopt PF (dorzolamide hydrochloride/timolol maleate) [prescribing information]. Lake Forest, IL: Akorn; June 2018.
  4. Urtti A, Salminen L. Minimizing systemic absorption of topically administered ophthalmic drugs. Surv Ophthalmol. 1993;37(6):435-456. [PubMed 8100087]
  5. Zimmerman TJ, Kooner KS, Kandarakis AS, Ziegler LP. Improving the therapeutic index of topically applied ocular drugs. Arch Ophthalmol. 1984;102(4):551-553. [PubMed 6704011]
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