Eylamdo 20 mg/ml + 5 mg/ml, eye drops solution

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Eylamdo Eye Drops are contained within a novel multidose eye drop bottle, which allows for the solution not to contain any preservatives. Due to the design of the container, administration with these eye drops is not the same as standard eye drop bottles.

• Prior to first use, practice using the drops away from the eye. Slowly squeeze the bottle to deliver one drop in the air to get used to the pressure and time required to deliver one drop.
• Please note that there might be a few seconds delay between squeezing and the drop coming out. Do not squeeze too hard, or more than one drop may come out.
• After use and prior to recapping, the bottle should be shaken once in a downwards direction, without touching the dropper tip, in order to remove any residual liquid on the tip. This is necessary in order to ensure delivery of subsequent drops.
• If more than one type of eye drop is used, leave at least 10 minutes between administration of each eye drop solution.

Please read the full instructions on the correct use of this product in Section 3 of the leaflet (‘‘How to use Eylamdo’’), before using these eye drops.

1. What Eylamdo is and what it is used for
2. What you need to know before you use Eylamdo
3. How to use Eylamdo
4. Possible side effects
5. How to store Eylamdo
6. Contents of the pack and other information

• if you are allergic to dorzolamide, timolol or any of the other ingredients of this medicine (listed in section 6);
• if you have now or had in the past respiratory problems, such as asthma or severe chronic obstructive bronchitis (severe lung disease which may cause wheeziness, difficulty in breathing and/or long-standing cough);
• if you have a slow heartbeat, heart failure or disorders of heart rhythm (irregular heartbeats);
• if you have severe kidney disease or problems, or a prior history of kidney stones;
• if you have excess acidity of the blood caused by a buildup of chloride in the blood (hyperchloraemic acidosis).

If you are not sure whether you should use this medicine, contact your doctor or pharmacist.

Talk to your doctor or pharmacist before using Eylamdo.

Tell your doctor about any medical or eye problems you have now or have had in the past, such as:

• coronary heart disease (symptoms can include chest pain or tightness, breathlessness, or choking), heart failure, low blood pressure;
• disturbances of heart rate such as slow heartbeat;
• breathing problems, asthma or chronic obstructive pulmonary disease;
• poor blood circulation disease (such as Raynaud’s disease or Raynaud’s syndrome);
• diabetes, as timolol may mask signs and symptoms of low blood sugar;
• overactivity of the thyroid gland, as timolol may mask signs and symptoms.

If you have a history of contact hypersensitivity to silver, you should not use this product as dispensed drops may contain traces of silver from the container closure.

Tell your doctor before you have an operation that you are using Eylamdo, as timolol may change effects of some medicines used during anaesthesia.

Also tell your doctor about any allergies or anaphylactic reactions including hives, swelling of the face, lips, tongue, and/or throat which may cause difficulty in breathing or swallowing.

Tell your doctor if you have muscle weakness or have been diagnosed as having myasthenia gravis.

If you develop any eye irritation or any new eye problems such as redness of the eye or swelling of the eyelids, contact your doctor immediately.

If you suspect that Eylamdo is causing an allergic reaction or hypersensitivity (for example, skin rash, severe skin reaction, or redness and itching of the eye), stop using this medicine and contact your doctor immediately.

Tell your doctor if you develop an eye infection, receive an eye injury, have eye surgery, or develop a reaction including new or worsening symptoms.

When Eylamdo is instilled into the eye, it may affect the entire body.

Eylamdo has not been studied in patients wearing contact lenses.

If you wear soft contact lenses, you should consult your doctor before using this medicine.

There is limited experience with dorzolamide/timolol (preserved formulation) in infants and children.

Tell your doctor about any liver problems you have now or have suffered from in the past.

Eylamdo can affect or be affected by other medicines you are using, including other eye drops for the treatment of glaucoma. Tell your doctor if you are using or intend to use medicines to lower blood pressure, heart medicine or medicines to treat diabetes. Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines, particularly:

• medicine to lower blood pressure or to treat heart disease (such as calcium channel blockers, beta-blockers or digoxin);
• medicines to treat a disturbed or irregular heartbeat such as calcium channel blockers, beta-blockers or digoxin;
• another eye drop that contains a beta-blocker;
• another carbonic anhydrase inhibitor such as acetazolamide;
• monoamine oxidase inhibitors (MAOIs);
• a parasympathomimetic medicine which may have been prescribed to help you pass urine.
  Parasympathomimetics are also a particular type of medicine which is sometimes used to help restore normal movements through the bowel;
• narcotics such as morphine used to treat moderate to severe pain;
• medicines to treat diabetes;
• antidepressants known as fluoxetine and paroxetine;
• a sulfa medicine such as sulfamethoxazole (used to prevent the growth of bacteria);
• quinidine (used to treat heart conditions and some types of malaria).

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.

Use in pregnancy

You should not use Eylamdo if you are pregnant unless your doctor considers it necessary.

Use in breast-feeding

You should not use Eylamdo if you are breast-feeding. Timolol may get into your milk.

No studies on the effects on the ability to drive or use machines have been performed. There are side effects associated with Eylamdo, such as blurred vision, which may affect your ability to drive and/or operate machinery. Do not drive or operate machinery until you feel well or your vision is clear.

Before instillation of the eye drops:

• Wash your hands before opening the bottle.
• Do not use this medicine if you notice that the tamper-proof seal on the bottle neck is broken before you first use it.
• When using for the first time, before delivering a drop to the eye, you should first of all practise using the dropper bottle by squeezing it slowly to deliver one drop away from the eye.
• When you are confident that you can deliver one drop at a time, choose the position that you find most comfortable for the instillation of the drops (you can sit down, lie on your back, or stand in front of a mirror).

Instillation:

1. Hold the bottle directly below the cap and turn the cap to open the bottle. Do not touch anything with the tip of the bottle to avoid contamination of the solution.

2. Tilt your head backwards and hold the bottle above your eye.
3. Pull the lower eyelid down and look up. Squeeze the bottle gently in the middle and let a drop fall into your eye. Please note that there might be a few seconds delay between squeezing and the drop coming out. Do not squeeze too hard.

If you are not sure how to administer your medicine, ask your doctor, pharmacist or nurse.

4. Blink a few times so that the drop spreads over the eye.

5. After using Eylamdo, close your eye and press the inner corner of the eye with your finger for about two minutes. This helps to stop the medicine getting into the rest of the body.

6. Repeat the instructions 2. – 5. to deliver a drop into the other eye also, if your doctor has instructed you to do this. Sometimes only one eye needs to be treated and your doctor will advise if this applies to you and which eye needs treatment.
7. After each use and prior to recapping, the bottle should be shaken once in a downwards direction, without touching the dropper tip, in order to remove any residual liquid on the tip. This is necessary in order to ensure delivery of subsequent drops.

8. At the end of the 28-day in-use shelf life of the medicine, there will be some Eylamdo left in the bottle.
Do not attempt to use the excess medicine remaining in the bottle after you have completed the course of treatment. Do not use the eye drops for longer than 28 days after first opening the bottle.

If you put too many drops in your eye or swallow the contents of the container, among other effects, you may become light-headed, have difficulty breathing, or feel that your heart rate has slowed. Contact your doctor immediately.

It is important to use this medicine as prescribed by your doctor.

If you miss a dose, use it as soon as possible. However, if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule.

Do not use a double dose to make up for a forgotten dose.

If you want to stop using this medicine talk to your doctor first.

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme (website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store).

By reporting side effects you can help provide more information on the safety of this medicine.

• The active substances are dorzolamide and timolol. Each ml contains 20mg of dorzolamide (as dorzolamide hydrochloride) and 5mg of timolol (as timolol maleate).
• The other ingredients are hydroxyethyl cellulose, mannitol, sodium citrate, sodium hydroxide and water for injections.

Eylamdo eye drops solution is presented as a 5ml clear, colourless slightly viscous solution, in white opaque 11ml LDPE bottle and white Novelia nozzle (HDPE and silicone) with a white HDPE cap.

Pack sizes: 1, 2, 3, 4 or 6 bottles in a cardboard box.

Not all pack sizes may be marketed.

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