2 x FOTIL FORTE EYE DROPS 5ML — MADE IN FINLAND — FREE SHIPPING

Fotil and fotil forte are a combination of pilocarpine and timolol, drugs that reduce intraocular pressure.

Chemical name of pilocarpine: 3 - ethyl-4 - [(1-methylimidazol-5-yl) methyl] tetrahydrofuran-2-one. Used in the form of hydrochloride. Chemical name of timolol maleate: (S) -1- [1,1-dimethylethyl) amino] -3 [[4- (4-morpholinyl) -1,2,5-thiadiazol-3-yl] -oxy] -2- propanol. (Z) -butenedioate (1: 1) salt. The structure of the compound contains an asymmetric carbon atom, and the levorotatory isomer of the compound is included in the Fotil eye drops.

Pilocarpine is a parasympathomimetic, a stimulant of M-cholinergic receptors. When instilled in the eyes, it reduces intraocular pressure, causes miosis and spasm of accommodation. A decrease in intraocular pressure is achieved by contraction of the ciliary and circular muscles of the iris, which is accompanied by an increase in the angle of the anterior chamber of the eye and changes the organization of the trabecular tissue, thus facilitating the outflow of aqueous humor. When instilling a solution of pilocarpine into the eye, the drug penetrates well into the cornea. Its maximum concentration in aqueous humor is reached after 30 minutes. It spreads in the tissues of the eye, the half-life of them is 1.5–2.5 hours. The spasm of accommodation and constriction of the pupil are observed 10 minutes after instillation and persist for 1–2 hours. The decrease in intraocular pressure persists for several hours. Pilocarpine is not metabolized in aqueous humor, but is eliminated with its outflow. The simultaneous use of timolol, which reduces the production of aqueous humor, reduces the rate of elimination of pilocarpine. Resorbed pilocarpine in the blood and liver tissue is hydrolyzed to inactive metabolites. The half-life of blood plasma is 30 minutes.

Timolol is a β-adrenergic receptor blocker that effectively inhibits the interaction of sympathomimetic neurotransmitters with β1- and β2-adrenergic receptors. Reduces intraocular pressure by reducing the production of aqueous humor. Acts on β2-adrenergic receptors of the ciliary body.

It does not possess ICA, local anesthetic (membrane stabilizing) effect, does not affect blood circulation in the retina. When the eyes are instilled, a certain amount of timolol is resorbed and enters the systemic circulation, through the nasolacrimal canal it enters the digestive tract, which can lead to the development of undesirable systemic effects, primarily from the cardiovascular and respiratory systems.

When administered orally, timolol is well absorbed; undergoes active first-pass metabolism. It is excreted mainly by the kidneys in the form of inactive metabolites, the half-life is about 4 hours. It penetrates well through the cornea. A decrease in intraocular pressure with topical application of the drug usually develops after 2 hours. The maximum effect is observed after 3-4 hours, the duration of action is 10-20 hours.

When pilocarpine and timolol are combined in one preparation, an additive effect is observed in relation to a decrease in intraocular pressure, since the mechanisms of action of timolol and pilocarpine are different. When applied topically, Fotil reduces both high and normal intraocular pressure. After Fotil's instillation, intraocular pressure usually begins to decrease after 30 minutes. The maximum effect is noted after 2 hours, and a significant decrease in intraocular pressure with a single administration can persist for 20 hours.

Open-angle and closed-angle glaucoma, glaucoma associated with aphakia; newly-onset secondary glaucoma; as an additional agent in the treatment of glaucoma with other drugs; with an increase in intraocular pressure, including in the postoperative period.

Usually 1 drop of Fotila is prescribed in the affected eye / s 2-3 times a day. Fotil forte is prescribed 1 drop 2 times a day. Since some patients need several weeks to stabilize the drug-induced decrease in intraocular pressure, the effectiveness of the action of Fotil should be evaluated approximately 4 weeks after the start of treatment. if the intraocular pressure is maintained at a satisfactory level, then the dose of the drug can be reduced to 1 drop once a day into the affected eye.

Increasing the dose of Fotila Forte (more than 1 drop 2 times a day) does not lead to a further decrease in intraocular pressure. If intraocular pressure is still high at such a dose, dipivephrine therapy and / or systemic use of carbonic anhydrase inhibitors (for example, acetazolamide) should be prescribed.

Cholinergic drugs (pilocarpine) are contraindicated in acute iritis, as well as in corneal lesions. blockers of β-adrenergic receptors (timolol) are contraindicated in patients with BA or with a history of it, as well as with hoblas, sinus bradycardia, av-blockade of II – III degrees, severe heart failure, cardiogenic shock and hypersensitivity to any of the components of the drug.