GANFORT EYE DROPS 3ML

Indications

Approved Uses

Reduction of intraocular pressure (IOP) in adult patients with open-angle glaucoma or ocular hypertension who are insufficiently responsive to topical beta-blockers or prostaglandin analogues.

Dosage & Administration

Dosing by Condition

Open-angle glaucoma or ocular hypertension: instill 1 drop in the affected eye(s) once daily, preferably in the evening; do not use more than once daily.

Initial Dose

One drop in the affected eye(s) once daily in the evening

Maintenance Dose

One drop in the affected eye(s) once daily in the evening

Maximum Dose

One drop in the affected eye(s) once daily (maximum: once daily); do not exceed once daily dosing.

Children's Dosage

Not approved for children under 18 years

Dose Adjustment Notes

No specific dose adjustment is recommended for renal or hepatic impairment; use caution in severe renal/hepatic impairment due to limited study data and potential systemic beta-blocker effects.

How to Take

Wash hands; remove contact lenses; instill 1 drop into the affected eye(s) once daily (preferably in the evening); close the eye and perform nasolacrimal occlusion (press inner canthus) for 1-2 minutes; if using other ophthalmic products, separate by at least 5 minutes; wait 15 minutes before reinserting contact lenses.

Side Effects

Common Side Effects

Common: conjunctival hyperemia (eye redness), ocular burning/stinging/irritation, pruritus, dry eye, foreign body sensation/eye pain, eyelid erythema, eyelash growth; prostaglandin-class effects may include periocular/iris pigmentation changes.

Side Effect Frequency

Very common (≥10%): conjunctival hyperaemia. Common (≥1% to <10%): eye irritation/burning/stinging, pruritus, eye pain, dry eye, eyelid erythema, eyelash growth, headache. Uncommon (≥0.1% to <1%): iritis/uveitis, cystoid macular oedema, iris pigmentation increase, periorbital skin hyperpigmentation, deepening of eyelid sulcus (sunken eyes), fatigue/asthenia; systemic beta‑blocker effects such as bradycardia, hypotension and bronchospasm are uncommon/rare but clinically important.

Safety & Warnings

Contraindications

Reactive airway disease including bronchial asthma or a history of bronchial asthma; severe chronic obstructive pulmonary disease (COPD); sinus bradycardia; sick sinus syndrome; sinoatrial block; second- or third-degree atrioventricular block (unless controlled with a pacemaker); overt cardiac failure; cardiogenic shock; hypersensitivity to timolol, bimatoprost, or any excipient.

Warnings & Precautions

Warn about permanent increased iris pigmentation, eyelid/periorbital skin darkening, and eyelash changes; minimize systemic absorption (e.g., nasolacrimal occlusion) due to timolol-related cardiopulmonary effects-use caution in cardiovascular disease, diabetes (mask hypoglycemia), hyperthyroidism, and mild/moderate COPD; monitor for macular edema/uveitis in at-risk patients (aphakia/pseudophakia, intraocular inflammation history); remove soft contact lenses before use and reinsert after ~15 minutes because benzalkonium chloride can be absorbed/discolor lenses; inform anesthesiologist before surgery due to beta-blocker effects.

Age Restriction

Not approved under 18 years.

Drug Interactions

Drug Interactions

Systemic beta-blockers (additive beta-blockade); calcium channel blockers (e.g., verapamil/diltiazem) and other antihypertensives (hypotension/AV block); antiarrhythmics (e.g., amiodarone) and digoxin (bradycardia/AV block); catecholamine-depleting drugs (e.g., reserpine/guanethidine) (marked bradycardia/hypotension); CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine) (increased timolol exposure); antidiabetics/insulin (mask hypoglycemia); clonidine (rebound hypertension if clonidine withdrawn while on beta-blocker); adrenaline/epinephrine (reported mydriasis and cardiovascular effects).

Interaction Severity

MAJOR: systemic beta-blockers; non-dihydropyridine calcium channel blockers (verapamil/diltiazem) and other agents that depress AV conduction (risk bradycardia/heart block/hypotension). MODERATE: antiarrhythmics (e.g., amiodarone), digoxin, CYP2D6 inhibitors (e.g., quinidine, fluoxetine/paroxetine) increasing timolol exposure, and antidiabetics (mask hypoglycemia). MINOR: epinephrine/adrenaline (rare mydriasis) and clonidine (rebound hypertension risk on withdrawal).

Food Interaction

No restriction

Special Populations

Pregnancy

Consult Doctor

Children

Not approved for children under 18 years

Elderly

Standard adult dosing; monitor more closely for systemic cardiovascular and respiratory effects of timolol

Kidney Impairment

No specific dose adjustment is recommended; use with caution in severe renal impairment because GANFORT has limited study data in this population.

Liver Impairment

No specific dose adjustment is recommended; use with caution in hepatic impairment because GANFORT has limited study data in this population.

Storage & Patient Advice

Storage Conditions

Store below 25°C; keep the bottle in the original outer carton/container; discard 4 weeks after first opening.

Missed Dose

If a dose is missed, instill the next dose at the usual time; do not use a double dose or more than 1 drop per eye per day.

Stopping the Medicine

Do not stop without prescriber advice; if discontinuation is needed, arrange follow-up IOP monitoring and consider gradual withdrawal in patients with ischemic heart disease or significant cardiovascular disease due to beta-blocker withdrawal risk.

Overdose

Topical ocular overdose: rinse/flush the eye with water or normal saline; systemic overdose (e.g., ingestion or excessive absorption) may cause bradycardia, hypotension, bronchospasm, and acute cardiac failure-manage with immediate medical evaluation and supportive/symptomatic treatment (e.g., atropine for bradycardia, bronchodilators for bronchospasm, IV fluids/vasopressors as needed).

Patient Counseling

Use 1 drop once daily (preferably evening) and do not exceed once daily; remove contact lenses and reinsert after 15 minutes; perform nasolacrimal occlusion for 1-2 minutes; separate other eye drops by ≥5 minutes; expect possible redness/irritation and eyelash growth, and possible permanent iris/eyelid skin darkening; report wheeze/shortness of breath, slow pulse, dizziness/syncope; store below 25°C.

Monitoring Requirements

Monitor intraocular pressure and glaucoma progression (optic nerve/visual fields) regularly; in at-risk patients monitor for systemic beta-blocker effects (heart rate, blood pressure, bronchospasm/respiratory symptoms).

Pharmacology

Mechanism of Action

Bimatoprost increases aqueous humor outflow (uveoscleral and trabecular pathways), while timolol (non-selective beta-blocker) decreases aqueous humor production; together they lower intraocular pressure via complementary mechanisms.

Onset of Action

IOP lowering begins within a few hours after instillation, with peak effect typically around 8-12 hours after dosing.

Duration of Effect

24 hours

Half-Life

Timolol systemic half-life is approximately 4-6 hours; bimatoprost has very low systemic levels after ocular dosing with rapid decline (plasma half-life roughly ~45 minutes when measurable).

Bioavailability

Systemic exposure is low after ocular dosing, but timolol can be systemically absorbed via nasolacrimal drainage; nasolacrimal occlusion reduces systemic absorption.

Metabolism

Bimatoprost: rapidly hydrolyzed in ocular tissues to bimatoprost acid (active), then further metabolized mainly by oxidation, N-de-ethylation and glucuronidation. Timolol: systemically absorbed fraction is extensively metabolized hepatically, primarily via CYP2D6 (with minor contribution from other CYPs), with renal excretion of metabolites.

Product Information

Available Dosage Forms

Eye drops, solution

Composition per Dose

Each 1 ml of solution: Bimatoprost 0.3 mg + Timolol maleate equivalent to Timolol 5 mg. Each drop (approximately 0.03 ml): Bimatoprost 0.009 mg + Timolol 0.15 mg

OTC Alternatives

No OTC alternative

Target Organ

Eye

Preservative Free

No

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