dorzolamide / timolol
Cosopt is a combination ophthalmic drop (eye drop) medication that contains dorzolamide (a carbonic anhydrase inhibitor) and timolol (a beta blocker). It's used to lower eye pressure for certain people with glaucoma or high eye pressure. Typically, one drop of Cosopt (dorzolamide / timolol) is placed into the affected eye(s) twice a day. Common side effects of this medication include changes in taste, blurry vision, and itchy eyes. Cosopt (dorzolamide / timolol) is available as both brand name and generic medications. It comes in a multi-dose bottle, as well as single-use, preservative-free vials.
What is Cosopt (dorzolamide / timolol)?
What is Cosopt (dorzolamide / timolol) used for?
- To lower eye pressure in people with open-angle glaucoma or high eye pressure
How Cosopt (dorzolamide / timolol) works
Cosopt (dorzolamide / timolol) is a combination of two medications that work together to lower eye pressure:
- Dorzolamide is a carbonic anhydrase inhibitor, meaning it blocks a protein called carbonic anhydrase. In doing so, dorzolamide lowers the amount of fluid in the eye.
- Timolol is a non-selective beta blocker. It works by blocking both beta-1 and beta-2 receptors in the eye, which lowers the amount of fluid in the eye.
Drug facts
Side effects of Cosopt (dorzolamide / timolol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Changes in taste (up to 30%)
- Eye burning or stinging (up to 30%)
- Blurry vision (5-15%)
- Itchy eye (5-15%)
- Corneal inflammation (5-15%)
- Eye redness (5-15%)
Less Common Side Effects
- Belly pain
- Bronchitis
- Cloudy vision
- Eye discharge or swelling
- Eyelid swelling
- Dizziness
- Dry eyes
- Eye tearing
- Headache
- Sinus infection
- Upper respiratory infection
Cosopt (dorzolamide / timolol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Worsening heart failure: shortness of breath, unusual swelling, tiredness, sudden weight gain
- Bronchospasm: tightness in the chest, trouble catching your breath, difficulty breathing, wheezing, cough, dizziness, extreme tiredness
- Serious allergic and skin reactions: hives, rash, blisters, swelling of the lips or tongue, difficulty breathing, skin reddening
The following Cosopt (dorzolamide / timolol) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blurred vision
burning or stinging of the eye (when medicine is applied)
feeling of something in the eye
itching of the eye
redness of the eye and lining of the eyelid
sensitivity of the eyes to light
Less common
Back, abdominal, or stomach pain
change in vision
coughing, shortness of breath, troubled breathing, tightness in the chest, or wheezing
discharge from the eye
dizziness
eye or eyelid pain, swelling, discomfort, or irritation
increased blood pressure
increased frequency of urination or painful urination
itching of the eyelid
seeing flashes or sparks of light
seeing floating spots before the eyes
swelling of lining of the eyelid
tiny bumps on lining of the eyelid
Rare
Blistering, peeling, or loosening of the skin
blood in the urine
blue lips, fingernails, or skin
chest pain or discomfort
chills
difficult or troubled breathing
fainting
headache or weakness, severe and sudden
irregular, fast or slow, or shallow breathing
joint or muscle pain
lightheadedness
mental depression
nausea or vomiting
pain, numbness, tingling, or burning feeling in the hands or feet
red, irritated eyes
red skin lesions, often with a purple center
shortness of breath
skin rash
slow or irregular heartbeat
sores, ulcers, or white spots in the mouth or on the lips
sweating
unusual tiredness or weakness
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Bitter, sour, or unusual taste
Less common
crusting or scales on eyelid
dryness of the eyes
indigestion or upset stomach
stuffy or runny nose
tearing of the eye
Rare
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Cosopt (dorzolamide / timolol)
Pros
- Available in a preservative-free form if you're sensitive to the preservative, benzalkonium chloride
- Available as a lower-cost generic medication
- Combines two medications into one eye drop for convenience
Cons
- Might not be safe if you're allergic to sulfa medications
- Not safe for use in uncontrolled asthma or chronic obstructive pulmonary disease (COPD)
- Needs to be used twice a day
Pharmacist tips for Cosopt (dorzolamide / timolol)
- If you wear contact lenses, make sure to take them out before using Cosopt (dorzolamide / timolol). Wearing contact lenses while using Cosopt (dorzolamide / timolol) can cause the medication to work less well. If you use a multidose bottle, your contact lenses can absorb the preservative, which can further irritate your eyes. Make sure to wait at least 15 minutes after using the medication to put them back in.
- To use Cosopt (dorzolamide / timolol), pull down your lower eyelid with one hand and hold the bottle upside down with the other. Make sure the tip of the bottle is above your eye, but don't let the tip touch your eye. Squeeze 1 drop of medication into your eye. Then, close your eye, and press your finger on the corner of your eye closest to your nose for a minute. Doing this helps the medication stay in your eye and prevents it from leaking into your nose.
- If you need to use another eye drop medication in the same eye, wait at least 5 minutes after using Cosopt (dorzolamide / timolol) so the second eye drop doesn't rinse off the first one.
- Cosopt (dorzolamide / timolol) contains dorzolamide, a sulfa medication. Be sure to tell your eye specialist if you've an allergy to sulfa-containing medications. You might need to use different eye drops.
- Let your eye specialist know if you're pregnant before using Cosopt (dorzolamide / timolol). If you're pregnant or thinking of getting pregnant during treatment, contact your eye specialist.
- If you have diabetes, be careful using Cosopt (dorzolamide / timolol), since this medication can hide symptoms of low blood sugar, except for sweating and dizziness.
- Let your eye specialist know about your medical history before starting this medication. Timolol in Cosopt (dorzolamide / timolol) can cause your muscle weakness to worsen if you've a history of myasthenia gravis or muscle disorders. Dorzolamide in Cosopt (dorzolamide / timolol) also hasn't been studied in people with severe kidney or liver problems.
- It's not easy to tell if your eye pressure has improved at home. Make sure to use Cosopt (dorzolamide / timolol) regularly as prescribed by your eye specialist, even if you don't notice any difference in your vision right away. More tips on using preservative-free Cosopt (dorzolamide / timolol)
- For preservative-free vials, write down the date you open the foil pouch on the outside of the pouch. Remember to throw away any unused Cosopt (dorzolamide / timolol) vials inside the foil pouch 15 days after opening it.
- Keep preservative-free vials in the original foil pouch at room temperature. Protect the medication from light.
- Don't open a preservative-free vial until you're ready to use Cosopt (dorzolamide / timolol). After you've placed a drop in the affected eye(s), throw the vial away. Don't save any leftover medication. These single-use vials don't have any preservatives in them to prevent germs from growing in the medication. So, opening the vial before you're ready to use it and using any leftover medication can raise your risk of an eye infection.
Common questions about Cosopt (dorzolamide / timolol)
Your eye specialist will let you know how long you need to use Cosopt (dorzolamide / timolol). Typically, this depends on how well Cosopt (dorzolamide / timolol) works to lower your eye pressure and whether you're experiencing any serious side effects. In most eye conditions, such as glaucoma), your eye specialist might ask you to use this medication every day to keep your eye pressure under control. But let your care team know right away if you experience side effects, such as eye pain or swelling. Depending on your symptoms, they might ask you to stop Cosopt (dorzolamide / timolol).
When you start Cosopt (dorzolamide / timolol), your eye specialist will check your eye pressure regularly to see whether this medication is working for you. One study showed that people who used the eye drops consistently had lower eye pressure at the 6-week check point. Keep in mind that Cosopt (dorzolamide / timolol) works best when it's used regularly in the affected eye(s) two times daily. Missing a dose or using this medication not as directed can cause Cosopt (dorzolamide / timolol) to not work as well. Your eye specialist will let you know how often you should come in for eye exams.
Though rare, few people have reported lower blood pressure after starting Cosopt (dorzolamide / timolol). But it's unclear whether the low blood pressure was caused by Cosopt (dorzolamide / timolol) or by other factors. Cosopt contains timolol, a beta blocker. Typically, beta blockers can lower blood pressure. But because Cosopt (dorzolamide / timolol) drops are placed in the eyes, it might not have as noticeable of an effect on blood pressure compared to timolol that's taken by mouth. Talk with your eye specialist if you're concerned about how Cosopt (dorzolamide / timolol) might affect blood pressure.
No, Cosopt (dorzolamide / timolol) doesn't need to be refrigerated. You can store this medication at room temperature in the original container or pouch. Make sure to protect Cosopt (dorzolamide / timolol) from light, since long exposure to heat and light can cause it to not work as well.
An opened multi-dose bottle of Cosopt (dorzolamide / timolol) can be used until the expiration date on the bottle. Each Cosopt (dorzolamide / timolol) preservative-free vial should only be used once and thrown away. This is because the vials don't have preservatives, which have a higher risk of contamination. Once a pouch of preservative-free vials is opened, store the remaining vials in the foil pouch and throw them away after 15 days.
Cosopt (dorzolamide / timolol) is available in both preservative-free and multi-dose formulations. Preservative ingredients in eye drop medications can sometimes cause serious eye irritation, especially if you use them for a long time. If you're sensitive to preservatives, such as benzalkonium chloride, the preservative-free formulation might be less likely to cause eye discomfort. Speak to your eye specialist if preservative-free formulation best fits your needs.
Cosopt (dorzolamide / timolol) and Combigan (brimonidine / timolol) are both eye drop medications to treat high eye pressure in certain people with glaucoma, but they aren't the same. While both eye drops contain timolol, Cosopt also contains dorzolamide (a carbonic anhydrase inhibitor) and Combigan contains brimonidine (an alpha agonist). Cosopt is available in both preservative-free vials (each vial can be used once) and multi-dose bottles (each bottle can be used multiple times). Combigan is only available in multi-dose bottles. Both medications are available by prescription from your eye specialist and have lower-cost generics. Talk with your eye specialist if you've more questions about Cosopt and Combigan.
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Risks and warnings for Cosopt (dorzolamide / timolol)
Cosopt (dorzolamide / timolol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of difficulty breathing
- Risk factors: Chronic obstructive pulmonary disease (COPD) | Asthma
Cosopt (dorzolamide / timolol) contains timolol, which can rarely cause the vessels in your lung to tighten. This can make breathing difficult, especially in people with breathing problems, like asthma. This problem is very rare with Cosopt (dorzolamide / timolol) because it's used in your eyes and it's not absorbed into your blood in a large amount. To be safe, make sure your eye specialist knows about your full medical history before starting this medication. Your eye specialist will start you on the lowest dose possible that works well for you.
Heart failure
- Risk factors: Heart failure | Sudden heart attack
Taking beta blockers might lead to heart failure or worsen heart failure in people who already have it. This is because beta blockers can slow down your heart, which leads to your heart muscle not pumping as often.
Cosopt contains timolol, a beta blocker. It's unclear whether using a beta blocker eye drop carries the same risk of heart failure as taking an oral beta blocker. But there's a chance that people with heart failure might not be able to use Cosopt (dorzolamide / timolol) if their symptoms aren’t well-managed. Discuss with your eye specialist before starting Cosopt (dorzolamide / timolol) if you've a history of heart failure. Let your eye specialist know right away if you experience symptoms such as trouble breathing, tiredness, swelling in your body, or sudden weight gain. They might ask you to stop this medication
Severe allergic and skin reactions
- Risk factor: Allergy to sulfa medications
Severe allergic reactions to Cosopt (dorzolamide / timolol) are possible, including life-threatening reactions, like facial swelling and anaphylaxis. Let your eye specialist know if you have a sulfa allergy. If you notice hives, rash, swelling of the lips or tongue, or difficulty breathing after using Cosopt (dorzolamide / timolol), get medical attention right away.
Although rare, Cosopt (dorzolamide / timolol) can also cause serious skin reactions, such as Stevens-Johnson syndrome (SJS) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS syndrome). If you notice changes in your skin, such as rash, blisters, skin reddening, or skin peeling, stop using Cosopt (dorzolamide / timolol) and get medical attention right away.
Hiding symptoms of low blood sugar
- Risk factors: Diabetes | History of high blood sugar
Taking oral beta blockers can make it difficult for you to identify some symptoms of low blood sugar, such as fast heartbeat or tremors. This means you might not be able to rely on all the typical symptoms of low blood sugar to warn you of a dangerous drop in your sugar levels. Sweating might be the only symptom not affected by taking Cosopt (dorzolamide / timolol).
Cosopt contains timolol, a beta blocker. But it's unclear whether timolol in eye drops will mask low blood sugar symptoms to the same degree as an oral beta blocker. If you've diabetes, speak with your endocrinologist about how often to monitor your blood sugar once you start Cosopt (dorzolamide / timolol).
Hiding symptoms of overactive thyroid
- Risk factor: Hyperthyroidism
If you have hyperthyroidism (overactive thyroid), don't suddenly stop taking Cosopt (dorzolamide / timolol) without first talking to your eye specialist. Doing so might lead to a condition called a "thyroid storm,” which include symptoms such as a high temperature, rapid heartbeat, and fainting. Get medical attention right away if you've these symptoms.
Greater risk during surgery
- Risk factor: Major surgery requiring anesthesia
If you're planning to undergo a major surgery requiring anesthesia, tell your surgeon that you're using Cosopt (dorzolamide / timolol). Beta-blockers, such as timolol in Cosopt (dorzolamide / timolol), might raise the risk of side effects, such as changes in heartbeat or low blood pressure, from anesthesia. If you've been using it for a while, your surgeon might not ask you to stop it, but they'll need to monitor your heart closely during your procedure.
Cornea swelling
- Risk factor: Low number of cells on the cornea
Cosopt (dorzolamide / timolol) contains dorzolamide, which raises the risk of cornea (the protective covering on the front of the eye) swelling. If you've ever been told that your cornea is thin or has a low number of cells, you might be at risk for this side effect. Talk to your eye specialist before starting Cosopt (dorzolamide / timolol).
Eye inflammation and infection
- Risk factors: Eye inflammation | Using a multiple-dose bottle | Eye infection
Cosopt (dorzolamide / timolol) might cause or worsen inflammation of the eyes. Your risk of eye inflammation and infection is higher if you're using multiple-dose eye drops or have had an eye infection during treatment with this medication. Let your eye specialist know if you have symptoms of red, itchy, or painful eyes. Ask them if you should continue to use Cosopt (dorzolamide / timolol) while your eyes are inflamed. Consider using the preservative-free version of Cosopt (dorzolamide / timolol) if you've frequent eye infection.
Risk of muscle weakness
Though extremely rare, some people using Cosopt (dorzolamide / timolol) have reported muscle weakness in or around the eyes that have led to droopy eyelids or double vision. Let your eye specialist know right away if you experience these symptoms.
Cosopt (dorzolamide / timolol) dosage
Eye dropper| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10ml of 2%/0.5% | 1 eye dropper | $15.31 | $15.31 |
Typical dosage for Cosopt (dorzolamide / timolol)
Interactions between Cosopt (dorzolamide / timolol) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Albuterol
- Ceritinib
- Clonidine
- Crizotinib
- Diltiazem
- Dronedarone
- Epinephrine
- Fenoldopam
- Fingolimod
- Formoterol
- Indacaterol
- Iobenguane I 131
- Iohexol
- Lacosamide
- Levalbuterol
- Memantine
- Olodaterol
- Oxymetazoline
- Paroxetine
- Ponesimod
- Rivastigmine
- Salmeterol
- Terbutaline
- Verapamil
- Vilanterol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aceclofenac
- Acemetacin
- Acetyldigoxin
- Albiglutide
- Alfuzosin
- Alogliptin
- Amtolmetin Guacil
- Arbutamine
- Aspirin
- Bromfenac
- Bufexamac
- Bunazosin
- Canagliflozin
- Celecoxib
- Chlorpropamide
- Choline Salicylate
- Cimetidine
- Clonixin
- Dapagliflozin
- Deslanoside
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Digitoxin
- Digoxin
- Dipyrone
- Doxazosin
- Droxicam
- Dulaglutide
- Empagliflozin
- Ertugliflozin
- Etodolac
- Etofenamate
- Etoricoxib
- Exenatide
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Glimepiride
- Glipizide
- Glyburide
- Ibuprofen
- Indomethacin
- Insulin Aspart, Recombinant
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Human Inhaled
- Insulin Human Isophane (NPH)
- Insulin Human Regular
- Insulin Lispro, Recombinant
- Ketoprofen
- Ketorolac
- Linagliptin
- Liraglutide
- Lixisenatide
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Metformin
- Methyldopa
- Metildigoxin
- Mibefradil
- Miglitol
- Morniflumate
- Moxisylyte
- Nabumetone
- Naproxen
- Nateglinide
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenoxybenzamine
- Phentolamine
- Phenylbutazone
- Piketoprofen
- Pioglitazone
- Piroxicam
- Pramlintide
- Pranoprofen
- Prazosin
- Proglumetacin
- Propyphenazone
- Proquazone
- Repaglinide
- Rofecoxib
- Rosiglitazone
- Salicylic Acid
- Salsalate
- Saxagliptin
- Sitagliptin
- Sodium Salicylate
- St John's Wort
- Sulindac
- Tamsulosin
- Tenoxicam
- Terazosin
- Tiaprofenic Acid
- Tolazamide
- Tolbutamide
- Tolfenamic Acid
- Tolmetin
- Trimazosin
- Urapidil
- Valdecoxib
- Vildagliptin
How much does Cosopt (dorzolamide / timolol) cost?
Cosopt (dorzolamide / timolol) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Cosopt (dorzolamide / timolol) will not be safe for you to take.
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Symptomatic heart failure
- Second or third degree heart block
- Slow heartbeat
- Heart not pumping enough blood
What are alternatives to Cosopt (dorzolamide / timolol)?
Treatment of high pressure in the eye in people ages 2 years and older with:
News about Cosopt (dorzolamide / timolol)
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