Fotil
Fotil: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Fotil
ATX code: S01EB51
Active ingredient: pilocarpine (pilocarpine), timolol (timolol)
Manufacturer: SANTEN, JSC (SANTEN, OY) (Finland)
Description and photo update: 2018-21-11
Prices in pharmacies: from 121 rubles.
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Fotil - combined antiglaucoma drug; beta-blocker in combination with m-cholinomimetic.
Release form and composition
Fotil is available in the form of eye drops: a transparent liquid without color (5 ml in polyethylene dropper bottles, in a cardboard box 1 bottle).
1 ml drops contain:
- active ingredients: timolol maleate - 6.84 mg (equivalent to 5 mg of timolol); pilocarpine hydrochloride - 20 mg;
- auxiliary components: hypromellose, citric acid, benzalkonium chloride, sodium citrate, water for injection.
Pharmacological properties
Pharmacodynamics
Fotila's antiglaucoma action is due to the properties of its active components. Timolol - being a beta-adrenergic receptor blocker, reduces the production of intraocular fluid, and pilocarpine is an m-cholinomimetic, stimulates m-cholinergic receptors and improves the outflow of intraocular fluid.
Pilocarpine lowers intraocular pressure, causing miosis and spasm of accommodation when it enters the eye. As a result of contraction of the ciliary muscle and the muscle of the iris, the angle of the anterior chamber of the eye expands and the physical structure of the trabecular network changes, facilitates the outflow of fluid. The effect lasts from 4 to 14 hours.
The action of timolol is aimed at preventing the binding in the ciliary body of sympathomimetic neurotransmitters with beta 1 - and beta 2 -adrenergic receptors. Reduced production of aqueous humor leads to a decrease in intraocular pressure, which begins to emerge through the 1 / 3 hours after instillation. The maximum hypotensive effect occurs after 2 hours and lasts up to 24 hours.
Timolol crosses the blood-brain barrier and acts on the central nervous system.
Pharmacokinetics
Both active components of Fotila quickly penetrate through the cornea into the aqueous humor of the anterior chamber of the eye.
The maximum concentration of pilocarpine in the aqueous humor is reached in 1 / 2 hour, and is associated with many ocular tissues.
Timolol enters the systemic circulation up to 80% of the local dose, its Cmax (maximum concentration) in blood plasma is reached approximately 1 hour after instillation into the eye.
T 1/2 (half-life) of pilocarpine eye media - 1 1 / 2 -2 1 / 2 hour excretion rate slows its presence timolol, reducing the formation of aqueous humor. It is excreted unchanged in the intraocular fluid. In the blood plasma and liver is rapidly hydrolyzed to inactive forms, T 1/2 of the body - to 1 / 2 hour.
Timolol metabolism occurs mainly in the liver, its T 1/2 is from 2 to 5 hours. Timolol is excreted mainly through the kidneys.
Indications for use
According to the instructions, Fotil is indicated for the treatment of glaucoma or increased intraocular pressure when it is necessary to use a combination of timolol with pilocarpine:
- angle-closure glaucoma;
- secondary glaucoma;
- open-angle glaucoma;
- increased intraocular pressure after ophthalmic surgery.
Contraindications
- anterior uveitis;
- cardiogenic shock;
- AV (atrioventricular) block II – III degree;
- sinus bradycardia;
- decompensated heart failure;
- bronchial asthma;
- chronic obstructive pulmonary disease (COPD);
- a condition in which constriction of the pupil is undesirable, including the period immediately after ophthalmic surgery, eye disease;
- age up to 18 years;
- hypersensitivity to the components of the drug.
Fotil eye drops should be prescribed with caution to patients with diabetes mellitus, hypoglycemia, heart failure, cerebrovascular disorders, myopia, retinal detachment, thyrotoxicosis, before surgical operations using general anesthesia, during pregnancy and during breastfeeding (lactation).
Instructions for use Fotila: method and dosage
Fotil eye drops are used by instillation into the conjunctival sac of the affected eye.
Recommended dosage: 1 drop 2 times a day.
Since a steady decrease in intraocular pressure is not achieved immediately, when assessing the therapeutic effect, the measurement of intraocular pressure should be carried out after 28 days of treatment. If the expected decrease in intraocular pressure is not observed, it is recommended to continue treatment with Fotil forte, 1 drop 2 times a day.
Side effects
- local reactions: transient burning sensation and pain in the eye, blurred vision, increased lacrimation, eye irritation, dry eye syndrome, redness of the conjunctiva, dermatitis of the eyelids, spasm of the ciliary muscle, induced myopia, decreased visual acuity at dusk, decreased sensitivity of the cornea, allergic blepharoconjunctiva, punctate keratitis; very rarely - ptosis, diplopia; possibly - retinal detachment, iris rigidity, cyst formation in the iris of the eye, on the background of prolonged therapy - reversible lens opacity;
- systemic reactions: skin rash, increased sweating, nausea, diarrhea, lowering blood pressure (BP), increased salivation, exacerbation of bronchial asthma, bradycardia, arrhythmia, heart failure, headache in the supraorbital and temporal region; very rarely - nasal congestion; in patients with heart failure - headache, development of asthenic syndrome, dizziness, hallucinations, anxiety, depression.
Overdose
Symptoms: bronchospasm, lowering blood pressure, bradycardia, acute heart failure.
Treatment: pilocarpine antidote - atropine. Appointment of symptomatic therapy. To relieve bronchospasm and severe bradycardia, intravenous administration of isoprenaline is indicated, arterial hypotension - dobutamine.
special instructions
Do not use Fotil in combination with other eye drops, which include beta-blockers.
Treatment with the drug should be started only after the abolition of other ophthalmic agents, its instillation can be started the next day after the termination of the use of the previous antiglaucoma drug.
Treatment should be accompanied by regular monitoring of intraocular pressure.
Contact lenses should be removed before instillation Fotila again install them only through the 1 / 4 hours after the procedure.
Patients with diabetes should take into account that against the background of the use of eye drops (due to the presence of timolol in their composition), symptoms of hypoglycemia or thyroid hyperfunction may be masked.
For elective surgery under general anesthesia, Fotil should be discontinued 48 hours before the start of the operation.
Influence on the ability to drive vehicles and complex mechanisms
The use of Fotil drops can cause temporary visual impairment in the form of a feeling of myopia, therefore, patients need to be careful when driving and working with complex mechanisms.
Application during pregnancy and lactation
During pregnancy and breastfeeding, the use of Fotila is possible if, in the opinion of the doctor, the expected effect of therapy for the mother significantly exceeds the potential threat to the fetus or child.
Pediatric use
The appointment of Fotila in childhood and adolescence is contraindicated, since the safety and efficacy of using drops in patients under 18 years of age has not been established.
Drug interactions
With the simultaneous use of Fotila:
- reserpine and other drugs that promote the release of catecholamines: can contribute to the appearance of dizziness, the development of arterial hypotension (including orthostatic hypotension), bradycardia;
- beta-blockers, blockers of slow calcium channels of systemic action: enhance their pharmacological action and increase the risk of developing cardiac conduction disorders, arterial hypotension;
- quinidine, cimetidine and other inhibitors of the isoenzyme CYP2D6: may cause an increase in the level of timolol in blood plasma.
Analogs
Fotil's analogues are: Fotil Forte, Saladzhen, Pilocarpine, Pilocarpine with methylcellulose, Pilocarpine Bufus, Pilocarpine-DIA, Oftan Pilocarpine, Pilocarpine-Ferein, Pilocarpine Prolong, Pilocarpine-long.
Terms and conditions of storage
Keep out of the reach of children. Store at 2-8 ° C.
The shelf life is 3 years.
After breaking the tightness of the bottle, the drops are suitable for use for 30 days at a storage temperature not exceeding 25 ° C.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Fotila
The few reviews about Fotila are mostly positive, but they do not allow an objective assessment of the therapeutic efficacy of the drug. Most often, in reviews, patients report side effects that occur immediately after instillation. In almost all, the drug causes severe dizziness, therefore, it is recommended to carry out the procedure in the supine position and not get up until the condition is normalized. In some patients, against the background of the use of drops, a strong diuretic effect is observed. The antihypertensive effect of the drug in some cases normalizes blood pressure and allows you to abandon the systematic intake of antihypertensive drugs.
Price for Fotil in pharmacies
The price of Fotil eye drops for 1 bottle (5 ml) can range from 250 to 320 rubles.
Fotil: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Fotil forte 40 mg + 5 mg / ml eye drops 5 ml 1 pc. 121 RUB Buy |
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Fotil 20 mg + 5 mg / ml eye drops 5 ml 1 pc. 205 RUB Buy |
|
Fotil forte drops ch. 40mg + 5mg / ml 5ml n1 302 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
