Dorzolamide Hydrochloride And Timolol Maleate

1 INDICATIONS AND USAGE Dorzolamide hydrochloride-timolol maleate ophthalmic solution (preservative-free) is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to beta-blockers (failed to achieve target IOP determined after multiple measurements over time). The IOP-lowering of dorzolamide hydrochloride-timolol maleate ophthalmic solution administered twice a day was slightly less than that seen with the concomitant administration of 0.5% timolol administered twice a day and 2% dorzolamide administered three times a day [see Clinical Studies (14.1) ] .

6 ADVERSE REACTIONS The most frequently reported adverse reactions were taste perversion (bitter, sour, or unusual taste) or ocular burning and/or stinging in up to 30% of patients. Conjunctival hyperemia, blurred vision, superficial punctate keratitis or eye itching were reported between 5-15% of patients. (6) To report SUSPECTED ADVERSE REACTIONS, contact Hi-Tech Pharmacal Co., Inc. at 1-800-262-9010 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Studies Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

8.1 Pregnancy Teratogenic Effects. Pregnancy Category C. Developmental toxicity studies with dorzolamide hydrochloride in rabbits at oral doses of ≥ 2.5 mg/kg/day (31 times the recommended human ophthalmic dose) revealed malformations of the vertebral bodies. These malformations occurred at doses that caused metabolic acidosis with decreased body weight gain in dams and decreased fetal weights. No treatment-related malformations were seen at 1 mg/kg/day (13 times the recommended human ophthalmic dose).

5 WARNINGS AND PRECAUTIONS • Potentiation of Respiratory Reactions Including Asthma (5.1) • Cardiac Failure (5.2) • Sulfonamide Hypersensitivity (5.3) • Obstructive Pulmonary Disease (5.4) • Increased Reactivity to Allergens (5.5) • Potentiation of Muscle Weakness (5.6) • Masking of Hypoglycemic Symptoms in Patients with Diabetes Mellitus (5.7) • Masking of Thyrotoxicosis (5.8) • Renal and Hepatic Impairment (5.9) • Impairment of Beta-Adrenergically Mediated Reflexes During Surgery (5.10) 5.1 Potentiation of Respiratory Reactions Including Asthma Dorzolamide hydrochloride-timolol maleate ophthalmic solution (preservative-free) contains timolol maleate, a beta-adrenergic blocking agent; and although administered topically, is absorbed systemically. 4 CONTRAINDICATIONS Dorzolamide hydrochloride-timolol maleate ophthalmic solution (preservative-free) is contraindicated in patients with: • Bronchial asthma or a history of bronchial asthma, severe chronic obstructive pulmonary disease. (4.1) • Sinus bradycardia, second or third degree atrioventricular block, overt cardiac failure, cardiogenic shock.