Index of drugs

Treatment of all types of glaucoma in which the intraocular pressure can not be reduced by the use of pilocarpine or the beta blocker separately (glaucoma with an open or closed angle of perception).

1 ml of solution contains 20 mg of pilocarpine hydrochloride and 1,118 mg of metipranolol hydrochloride (equivalent to 1 mg of metypranolol).

The product contains two active substances that reduce intraocular pressure due to different mechanisms of action. Pilocarpine is a nonselective parasympathomimetic. It causes contraction of the ciliary muscle in the eye, thanks to which it facilitates the outflow of aqueous humor. The biological activity time of pilocarpine is 5-8 h. Metipranolol is a non-selective beta-blocker. It lowers intraocular pressure by reducing the production of aqueous humor. The resistance during secretion is not disturbed. Up to 5% of the metipranolol dose is absorbed through the cornea. The drug has affinity for the structures of the cornea and the inner eye. T_0,5 is 18 h. The primary metabolite of metipranolol is deacetylmetypranolol with the same biological activity.

Hypersensitivity to any of the ingredients. acute iritis or other condition where miosis is not desirable. Diseases associated with airway obstruction, bronchial asthma, diseases related to lung failure, cardiac failure (III and IV on the NYHA circulatory failure scale), sick sinus syndrome, atrio-ventricular block IIst. and III., sinoatrial block, bradycardia (less than 50 beats per min), hypotension, shock, metabolic acidosis, late stages of peripheral circulatory disorders, as well as dystrophic processes of the cornea (inadequate diet). Patients with hyperthyroidism, gastric or duodenal ulcers, gastrointestinal obstruction (intestinal obstruction), urinary obstruction caused by urinary tract obstruction or with reduced secretion should also be closely monitored during treatment with the preparation.

Caution should be exercised in patients with diabetes who have fluctuations in blood Glucose levels and during an intense fasting because the preparation may mask the symptoms of hypoglycaemia. Do not use this medicine in children.

The preparation should not be used during pregnancy and breastfeeding.

Due to the pilocarpine content at the beginning of treatment, spinal cord contractions may occur. There may be occasional cases of decreased visual acuity in cataract patients, difficulties in eye accommodation with transient myopia, miosis associated with impaired vision at dusk and at night, increased level of tear secretion, occurrence of iris cyst, short-lasting conjunctival congestion, conjunctival irritation and short-term sensation baking. After prolonged use of the preparation may occur iritis and allergic skin reactions, cysts on the edge of the pupils, shallowing of the anterior chamber of the eye, which in very rare cases may cause acute glaucoma with a closed angle of perception. In extremely rare cases, patients with a predisposition may be at risk of retinal detachment. The metipranolol contained in the preparation may reduce the secretion of tears and short-term reduction of corneal sensitivity; in rare cases, uveitis of the anterior segment of the eye. General side effects: pain and dizziness, fatigue, a feeling of emptiness in the head. Occasionally, you may also experience symptoms of paralysis and a feeling of cold in the extremities, a feeling of deafness. In rare cases, breathing difficulties (impaired patency of the airways), digestive tract disorders, allergic skin reactions, sleep disturbances, severe heart failure, atrioventricular block, bradycardia, hypotension, worsening of peripheral circulation disorders, dry mouth, hypoglycemia, laxity or muscle cramps, impaired potency and changes in the number of blood cells.In very rare cases, it is possible: nausea, vomiting, constipation, muscle spasms, excessive sweating, increased activity of the large intestine and urinary tract, pneumothorax, depression, hallucinations and intense angina attacks. In very rare cases, pilocarpine may cause excessive salivation and hypertension. Hypoglycaemia may be masked during treatment. The preservative contained in the preparation - benzalkonium chloride - may cause eye irritation and other side effects such as taste disorder.

Adults: 1 drop into the conjunctival sac of the affected eye (eyes) 2-4 times a day. If the preparation is used with other eye medicines (drops, ointments), wait about 5 minutes between the Next medication; the preparation should always be given last.