Fotil forte
Fotil forte: 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 forte
ATX code: S01EB51
Active ingredient: pilocarpine (Pilocarpine) + timolol (Timolol)
Manufacturer: Santen, JSC (Santen, OY) (Finland); Santen Pharmaceuticals Co., Ltd. (Santen Pharmaceutical Co., Ltd.) (China)
Description and photo updated: 2020-19-03
Prices in pharmacies: from 121 rubles.
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Fotil forte is a combined antiglaucoma remedy.
Release form and composition
The drug is produced in the form of eye drops: a colorless, transparent solution (5 ml each in a polyethylene dropper bottle, closed with a plastic stopper with a screw cap; in a cardboard box 1 dropper bottle and instructions for use Fotil forte).
1 ml of eye drops contains:
- active ingredients: timolol maleate - 6.84 mg, which corresponds to timolol in an amount of 5 mg; pilocarpine hydrochloride - 40 mg;
- additional components: citric acid - 0.88 mg; benzalkonium chloride - 0.1 mg; hypromellose - 5 mg; sodium citrate - 6.13 mg; water for injection - up to 1 ml.
Pharmacological properties
Pharmacodynamics
Fotil forte is a combined antiglaucoma drug that contains an m-cholinomimetic and a β-blocker.
Pilocarpine is a parasympathomimetic that stimulates m-cholinergic receptors. When this active substance is instilled into the eye, miosis occurs, accommodation spasm and intraocular pressure (IOP) decreases. A decrease in IOP is caused by contraction of the ciliary (ciliary) muscle and the muscles of the iris, which provides an expansion of the angle of the anterior chamber of the eye, and a change in the physical structure of the trabecular network, which facilitates the outflow of aqueous humor. The resulting effect is observed from 4 to 14 hours.
Timolol is a β-blocker that prevents the binding in the ciliary body of sympathomimetic neurotransmitters with β1- and β2-adrenergic receptors. The active ingredient lowers IOP by decreasing the production of aqueous humor. A decrease in IOP is noted ⅓ h after instillation, the maximum hypotensive effect - after 2 hours, the action of Fotil forte lasts an average of 24 hours.
Pharmacokinetics
Pilocarpine passes well through the cornea. The maximum content of the active component in the aqueous humor is fixed after 0.5 hours. The agent is bound by many tissues of the eye, the half-life (T 1/2) from the eye is 1.5-2.5 hours. Pilocarpine is excreted unchanged with the intraocular fluid. Its combined use with timolol, which reduces the production of aqueous humor, reduces the rate of excretion of pilocarpine. In the liver and blood plasma, pilocarpine is intensively hydrolyzed into inactive forms, T 1/2 - less than 0.5 hours.
Timolol quickly passes through the cornea into the aqueous humor that fills the anterior chamber of the eye. Approximately 80% of the active ingredient used topically is found in the systemic circulation. The maximum concentration (C max) of timolol in blood plasma is observed approximately 1 hour after the injection of drops, T 1/2 - 2-5 hours. The drug is metabolized mainly in the liver, excreted mostly through the kidneys.
Indications for use
Fotil forte is recommended for the treatment of glaucoma or increased IOP, if the combined use of pilocarpine and timolol is necessary:
- angle-closure and open-angle glaucoma;
- secondary glaucoma;
- increased IOP after ophthalmic surgery.
Contraindications
Absolute:
- anterior uveitis;
- atrioventricular (AV) block II – III degree;
- sinus bradycardia;
- cardiogenic shock;
- decompensated heart failure;
- chronic obstructive pulmonary disease (COPD);
- bronchial asthma;
- conditions in which constriction of the pupil is undesirable, including the period immediately after the ophthalmic operation and other eye diseases;
- age up to 18 years;
- hypersensitivity to any component of Fotil forte eye drops.
Relative (use the product with caution):
- cerebrovascular disorders;
- heart failure;
- hypoglycemia;
- diabetes;
- thyrotoxicosis;
- retinal disinsertion;
- myopia;
- the period before surgery with the use of general anesthesia.
Fotil forte, instructions for use: method and dosage
Fotil forte antiglaucoma eye drops are injected into the conjunctival sac of the diseased eye by instillation.
The recommended dosage regimen is 1 drop 2 times a day.
Since a steady decrease in IOP caused by the action of the drug, in some cases, is noted only after a few weeks, to assess the therapeutic effect, IOP should be measured 28 days after the start of the course.
If when using the drug Fotil it is not possible to reduce the IOP to the desired level, it is recommended to transfer the patient to Fotil forte treatment as usual - 1 drop 2 times a day.
Side effects
- local reactions: dry eye syndrome, eye irritation, blurred vision, increased lacrimation, rapidly passing pain and burning sensation in the eye, redness of the conjunctiva, eyelid dermatitis, ciliary muscle spasm and induced myopia, reduced corneal sensitivity, decreased visual acuity in low light (due to miosis), allergic blepharoconjunctivitis, punctate keratitis; extremely rare - ptosis, diplopia; in some cases (as a result of the use of miotics) - the appearance of a cyst in the iris of the eye, iris rigidity, retinal detachment; against the background of long-term treatment with pilocarpine - reversible clouding of the lens;
- systemic reactions: skin rashes, sweating, increased salivation, nausea, diarrhea, decreased blood pressure (BP), supraorbital and temporal headaches, exacerbation of bronchial asthma, arrhythmia, bradycardia, heart failure; extremely rare - diplopia, ptosis, nasal congestion; in the presence of heart failure - the development of asthenic syndrome, dizziness, headache, anxiety, depression, hallucinations; Timolol crosses the blood-brain barrier and acts on the central nervous system.
Overdose
The common symptoms of an overdose of β-blockers and parasympathomimetic agents may include a decrease in blood pressure, bradycardia, acute heart failure, bronchospasm.
Treatment is predominantly symptomatic; atropine can be used as an antidote to pilocarpine. If bronchospasm develops, severe bradycardia, isoprenaline is administered intravenously, with arterial hypotension, dobutamine.
special instructions
Fotil forte cannot be used in combination with other eye drops containing β-blockers.
You need to start treatment only after you stop using other eye drops. The previously used antiglaucoma agent must be canceled, and the introduction of Fotil forte should be started the next day.
Therapy with this antiglaucoma agent should be accompanied by regular IOP monitoring.
The drops contain benzalkonium chloride as a preservative; therefore, it is not recommended to use them when wearing contact lenses. Before instillation of the drug, contact lenses must be removed, and then reinstalled no earlier than 15 minutes after the procedure.
Due to the presence of timolol in the preparation, Fotil forte is able to mask the symptoms of hypoglycemia in patients with diabetes mellitus, or the symptoms of hyperthyroidism.
Since the drug potentiates the effect of muscle relaxants and general anesthetics, if surgery is necessary, Fotil forte must be canceled 48 hours before its start.
Influence on the ability to drive vehicles and complex mechanisms
The myotic effect caused by the drug Fotil forte can lead to a temporary deterioration in vision (a feeling of myopia), therefore, during treatment, care must be taken when operating complex moving mechanisms, including vehicles, and operating complex equipment.
Application during pregnancy and lactation
During pregnancy and during breastfeeding, the use of Fotil forte is possible only if, in the opinion of the doctor, the expected benefit from therapy to the mother significantly outweighs the possible threat to the fetus / child.
Pediatric use
Due to the fact that the safety and effectiveness of using drops in persons under 18 years of age has not been established, the appointment of Fotil forte is contraindicated in childhood and adolescence.
Drug interactions
- blockers of slow calcium channels of systemic action: the pharmacological effects of these drugs are enhanced and the risk of arterial hypotension and cardiac conduction disorders is aggravated when combined treatment with β-blockers;
- drugs that promote the release of catecholamines, including reserpine: dizziness, arterial hypotension (including orthostatic), bradycardia may occur;
- cimetidine, quinidine and other inhibitors of the isoenzyme CYP2D6: increase the plasma content of timolol in the blood.
Analogs
The analogues of Fotil forte are Azarga, Glaumax, Kombigan, Cosopt, Ksalatamax, Latanoprost-Optic, Proxofelin, Taflotan Multi, Fotil, Travatan, Pilotimol mini, Pilotimol, etc.
Terms and conditions of storage
Store out of the reach of children at 2–8 ° C.
The shelf life is 3 years.
After opening the bottle should be stored at a temperature not exceeding 25 ° C. The eye drops can be used within 1 month.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Fotil Fort
Rare reviews of Fotil Fort are mostly positive. Patients note that the drug helps to normalize IOP, improve vision and avoid surgery.
However, there are also complaints about the development of side effects observed immediately after the introduction of drops. Sometimes they indicate a significant visual impairment that occurs with a decrease in IOP.
Price for Fotil forte in pharmacies
The price for Fotil forte, in the form of eye drops (40 + 5 mg / ml), can be 260-300 rubles. for a dropper bottle with a volume of 5 ml.
Fotil forte: prices in online pharmacies
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Drug name Price Pharmacy |
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Fotil forte 40 mg + 5 mg / ml eye drops 5 ml 1 pc. 121 RUB Buy |
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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!
