Nodom Combi (Dorzolamide, Timolol)

Nodom Combi, a combination antiglaucoma eye drop, acts on aqueous humor dynamics to lower intra‑ocular pressure.

• Open‑angle glaucoma: reduces intra‑ocular pressure to help prevent optic nerve damage.
• Ocular hypertension: lowers eye pressure to decrease the risk of developing glaucoma.
• Glaucoma (any type) as adjunct therapy: provides additional pressure reduction when monotherapy is insufficient.

• Dorzolamide inhibits carbonic anhydrase in the ciliary body, decreasing aqueous humor production, while timolol blocks β‑adrenergic receptors on the same tissue, further reducing aqueous secretion. The dual action results in a synergistic decline in intra‑ocular pressure, improving fluid outflow balance. Both agents are delivered directly to the eye as a sterile ophthalmic solution, allowing rapid onset of action and minimizing systemic exposure.

The most frequently reported ocular and systemic reactions to Nodom Combi are listed below.

Common Side Effects

• Eye irritation or burning sensation.
• Stinging or transient discomfort after instillation.
• Blurred vision.
• Dry eye or foreign body sensation.
• Altered taste or bitter after drainage.
• Headache.

Serious or Rare Side Effects

• Severe allergic reaction (e.g., angio‑edema, anaphylaxis).
• Marked bradycardia or heart block.
• Bronchospasm or worsening asthma.
• Significant hypotension.
• Persistent eye pain or vision loss.
• Corneal edema.

Before prescribing Nodom Combi, clinicians should consider the following precautions.

• Cardiac assessment: avoid in patients with severe bradycardia, heart block, or uncontrolled heart failure.
• Respiratory evaluation: use with caution in asthma or chronic obstructive pulmonary disease.
• Systemic beta‑blocker use: monitor for additive bradycardic or hypotensive effects.
• Pregnancy and lactation: prescribe only if the potential benefit outweighs the risk.
• Concomitant carbonic anhydrase inhibitors: assess for excessive intra‑ocular pressure reduction.
• Store at room temperature: keep in the original container, protect from light and moisture.

Nodom Combi may interact with other systemic or ocular medications as follows.

Major Interactions (Avoid)

• Non‑selective oral beta‑blockers (e.g., propranolol): risk of severe bradycardia and hypotension.
• Systemic carbonic anhydrase inhibitors (e.g., acetazolamide): additive reduction of aqueous humor production.
• Other topical beta‑blocker eye drops: excessive ocular beta‑blockade.

Moderate Interactions (Monitor Closely)

• Topical sympathomimetic agents (e.g., phenylephrine): may diminish the intra‑ocular pressure‑lowering effect.
• Prostaglandin analogues (e.g., latanoprost): monitor intra‑ocular pressure for adequate control.
• Systemic antihypertensives (e.g., ACE inhibitors): observe blood pressure for additive lowering.
• Anticholinergic eye drops: assess for potential ocular surface irritation.