Buy Gunfort eye drops 0.3 mg + 5 mg/ml, 3 ml

Ganfort

Brand Allergan

In stock 1927 Items

Available since: 2019-09-19

All payments are SSL encrypted
Full Refund if you haven't received your order
International shipping to the USA, UK and Europe

Clinical Pharmacology

Ganfort is a combination drug, its composition bimatoprost and timolol reduce intraocular pressure (IOP) due to the combined interaction, leading to a much more pronounced hypotensive affect compared with the effect of each of the components separately.

Bimatoprost

Refers to synthetic prostamides, the chemical structure is similar to prostaglandin F2α (PGF2α). Bimatoprost does not affect any of the known types of prostaglandin receptors. The hypotensive effect of bimatoprost is carried out by increasing the outflow of intraocular fluid through the trabecula and along the pathway of the eye.

Non-selective beta adrenoblocker, does not possess internal sympathomimetic and membrane stabilizing activity.

Timolol reduces IOP by reducing the formation of intraocular fluid. The exact mechanism of action has not been established, it may be associated with inhibition of the synthesis of cyclic adenosine monophosphate (c-AMP) and is caused by endogenous stimulation of beta-adrenergic receptors.

Pharmacokinetics

Systemic absorption of the drug is minimal, not different as with the combined treatment, and with the instillation of each of the components of the drug separately.

In two studies with a duration of 12 months, no systemic accumulation of any of the active substances was observed.

Bimatoprost

In vitro studies have shown that bimatoprost penetrates the iris and sclera. With instillation of a 0.03% solution of bimatoprost, 1 drop in both eyes once a day for 2 weeks, the maximum concentration (C _max a) bimatoprost in the blood plasma is reached within 10 minutes after application, and within 1.5 hours its concentration in the blood plasma decreases to the lower limit of detection (0.025 ng / ml). Average C _max and areas under the concentration-time curve (AUC _0-24 h) bimatopros were close on days 7 and 14, and were 0.08 ng / ml and 0.09 ng * h / ml, respectively, indicating that the equilibrium concentration of bimatoprost is reached during the first week of use.

Bimatoprost is moderately distributed in the tissues, and the systemic volume of distribution when the equilibrium concentration of the drug is reached is 0.67 l / kg. Bimatoprost is mainly in the blood plasma. The connection of bimatoprost with plasma proteins is approximately 88%. Bimatoprost undergoes oxidation, N-deethylation and glucuronidation with the formation of various metabolites.

Bimatoprost is excreted primarily by the kidneys. About 67% of the drug, administered intravenously to healthy volunteers, excreted in the urine, and 25% through the gastrointestinal tract. The half-life (T _1/2a) bimatoprost, determined after intravenous administration, was approximately 45 minutes; and the total clearance of -1.5 l / h / kg.

Pharmacokinetics in special clinical situations

In elderly patients

When using bimatoprost 2 times a day, the average value of AUC _0-24 h in elderly patients is 0.0634 ng * h / ml, which significantly exceeds the value of this indicator in healthy young individuals - 0.0218 ng * h / ml.

However, this difference has no clinical significance, since the systemic exposure of bimatoprost, when applied locally in elderly patients and healthy young individuals, remains very low. Bimatoprost does not show cumulation in the systemic circulation, the safety profile does not differ in elderly patients and young people.

In patients who underwent cataract surgery, after instillation of eye drops in the form of a 0.5% solution, C _max timolol intraocular fluid after 1 h amounted to 898 ng / ml. A certain amount of the drug enters the systemic circulation, and is metabolized in the liver. T _1/2 timolol is about 4-6 hours. A part of timolol that has been metabolized in the liver is excreted through the gastrointestinal tract, and the other part and metabolites are excreted by the kidneys.

Timolol is slightly bound to plasma proteins.

Indications

Reduction of intraocular pressure (IOP) in patients with open-angle glaucoma and intraocular hypertension with a lack of efficacy of topical administration of drugs of the beta-blockers group and prostaglandin analogues.

Composition

1 ml of eye drops solution contains:

Active substance

Bimatoprost 0.3 mg.
Timolol maleate 6.8 mg.
- In terms of timolol 5.0 mg.

Excipients

Benzalkonium chloride, citric acid monohydrate, sodium hydrogen phosphate heptahydrate, sodium chloride, hydrochloric acid, sodium hydroxide, water.

No customer reviews for the moment.

Write your review

Dosage and Administration

Recommended doses in adults (including elderly patients): 1 drop in the conjunctival sac of the affected eye 1 time per day in the morning.

If a drug is missed once, the drug is injected the next day. It is not recommended to exceed the dose of 1 injection 1 time per day. If you use more than 2 drugs, you need to take a 5-minute break between each instillation.

Adverse reactions

The frequency of side effects identified during the studies was assessed as follows:

Very often (> 1/10).
Often (> 1/100,
Infrequently (> 1/1000,

The following side effects have been identified in clinical studies of the drug Ganfort:

From the side of the central nervous system

Infrequently - a headache.

On the part of the organ of vision

Very often - conjunctival hyperemia, eyelash growth.
Often - superficial keratitis, corneal erosion, burning sensation, itching, burning pain in the eyes, foreign body sensation, dryness of the mucous membrane of the eyes, redness of the eyelids, eye pain, photophobia, discharge from the eyes, blurred vision, eyelid itching.
Infrequently - iridocyclitis, irritation of the mucous membrane of the eyes, conjunctival edema, blepharitis, epiphora, eyelid edema, eyelid soreness, reduced visual acuity, asthenopia, trichiasis.
Frequency unknown - cystoid macular edema.

On the part of the respiratory system

Infrequently - rhinitis.

From the skin and subcutaneous fat

Often - eyelid skin pigmentation.
Infrequently - hirsutism.

Other side effects that were observed with the use of one of the components of the drug and potentially possible during the period of treatment with the drug Ganfort:

Bimatoprost

Infectious and parasitic diseases
Infectious disease (catarrhal symptoms and symptoms of lesions of the upper respiratory tract).

The nervous system
Dizziness .

On the part of the organ of vision
Allergic conjunctivitis, cataracts, darkening of the eyelashes, increased pigmentation of the iris, blepharospasm, eyelid retraction, retinal hemorrhage, uveitis.

Since the cardiovascular system
Increased blood pressure.

General violations and changes at the site of administration
Asthenization neuropsychiatric, peripheral edema.

Laboratory values
Changes in the activity of liver enzymes.

Mental disorders
Insomnia, nightmares, decreased libido.
From the side of the central nervous system
Myasthenia gravis, Paresthesia, cerebral ischemia.

On the part of the organ of vision
Reduced corneal sensitivity, diplopia, ptosis, retinal detachment (after surgical treatment), changes in refraction (due to withdrawal of therapy with miotic agents in some cases), keratitis.
From the organ of hearing and vestibular apparatus
Noise in ears.
Since the cardiovascular system
Heart block, cardiac arrest, cardiac arrhythmias, loss of consciousness, bradycardia, heart failure, congestive heart failure; lowering blood pressure, chest pain, cerebrovascular accident, intermittent claudication, Raynaud's syndrome, cold extremities, palpitations.
On the part of the respiratory system
Bronchospasm (mainly in individuals with a history of bronchospasm), shortness of breath, cough.
From the gastrointestinal tract
Nausea, diarrhea, dyspepsia, dryness of the oral mucosa.
From the skin and subcutaneous fat
Alopecia, psoriasis-like rashes, exacerbation of psoriasis.

From the musculoskeletal system and connective tissue
Systemic lupus erythematosus.

On the part of the urinary system
Peyronie's Disease.

Other

Swelling, chest pain, fatigue.

Contraindications

Carefully:

Impaired liver and kidney function (the drug is not well studied in this category of patients).
In patients with risk factors for macular edema (for example, with aphakia, pseudophakia, lens rupture).
In patients with diabetes mellitus (unstable course) and impaired glucose tolerance, as part of the drug Ganfort beta-blocker timolol may mask signs of hypoglycemia.
In patients with inflammatory changes in the eyes, neovascular, inflammatory, angle-closure glaucoma, congenital glaucoma or narrow-angle glaucoma (there is no data on the study of efficacy and safety).

Pregnancy and Lactation

Contraindicated.

Special instructions

Just like other ophthalmologic drugs, Ganfort can penetrate the systemic circulation.

Symptoms of heart failure should be compensated before the start of the use of the drug Ganfort. Requires regular monitoring of patients with severe heart failure, determination of heart rate.. When using timolol, there were reports of side effects from the cardiovascular system and respiratory organs, including deaths due to bronchospasm in patients with bronchial asthma, and less often from heart failure.

Beta-blockers may mask the symptoms of hypoglycemia, hyperthyroidism and cause deterioration of Prinzmetal angina, severe peripheral and central vascular disorders, as well as arterial hypotension.

In patients with atopic manifestations in history and severe anaphylactic reactions to various allergens, doses of epinephrine (adrenaline), which are commonly used to relieve anaphylactic reactions, may be ineffective against the use of beta-blockers.

In patients with pulmonary liver disease or initially elevated liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (ACT) and / or total bilirubin, bimatoprost did not affect liver function for a study period of more than 24 months.

Prior to the treatment of patients, it is necessary to inform about the possible growth of eyelashes, intensify eyelid skin pigmentation and iris pigmentation, since these side effects were established during the study of bimatoprost and Ganfort. Some changes may be permanent, and may be accompanied by the appearance of a difference between the eyes, if the instillations of the drug were carried out only in one eye. After withdrawal of the drug Ganfort, pigmentation of the iris may remain constant. After 12 months of treatment with Ganfort, the frequency of pigmentation of the iris was observed in 0.2% of patients. And after 12 months of treatment, only bimatoprost in the form of 1.5% eye drops, a further increase in the frequency of this effect was not observed during the course of therapy for a period of 3 years. The increased pigmentation of the iris is due to increased production of melanocytes, and not just an increase in their number.

The excipient benzalkonium chloride, which is part of the drug Ganfort, can cause irritation of the mucous membrane of the eyes and change the color of soft contact lenses. Contact lenses must be removed before the introduction of the drug, you can wear them 15 minutes after instillation.

Benzalkoniya chloride can cause acute keratitis and / or toxic corneal ulcer. In this regard, it is necessary to monitor the patient's condition with frequent or long-term treatment with Gunfort in patients with dry eye syndrome and changes in the cornea.

Once the bottle is opened, the possibility of microbial contamination of its contents cannot be ruled out, which can lead to inflammatory lesions of the eyes. The shelf life of the drug after the first opening of the bottle is 28 days. After the specified time has elapsed, the bottle should be discarded even if the solution is not fully used. It is recommended that the date of opening of the vial be recorded on the carton of the drug.

Impact on the ability to drive vehicles and mechanisms

Perhaps a transient visual impairment after the introduction of the drug, so the patient must wait until full recovery of vision before proceeding to drive a car or control mechanisms.

Overdosage

No cases of drug overdose were reported to Gunfort; when administered as an eye drop, overdose is unlikely.

Bimatoprost

When inadvertently taking Ganfort orally, the following information may be helpful - no toxic effects of bimatoprost were noted at doses up to 100 mg / kg / day during a 2-week oral administration in an experiment on rats and mice. The dose used in the study, expressed in mg / m ² , 70 times the possible dose of bimatoprost in case of accidental ingestion of the contents of the vial of the drug Hanfort by a child weighing 10 kg.

Timolol

Symptoms in an overdose of timolol can be observed as follows: bradycardia, lowering blood pressure, bronchospasm, headache, dizziness, shortness of breath, cardiac arrest

Treatment: symptomatic therapy. Studies have shown that timolol is not completely eliminated during hemodialysis.