Consumer Medicine Information
What is in this leaflet?
This leaflet answers some common questions about TENOPT.
It does not contain all the available information.
It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you using TENOPT against the benefits they expect it will have for you.
If you have any concerns about using this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
What TENOPT is used for
TENOPT is used to lower raised pressure in the eye and to treat glaucoma. Glaucoma is a condition in which the pressure of fluid in the eye may be high. However, some people with glaucoma may have normal eye pressure. Also, some people with raised eye pressure may not have glaucoma.
Glaucoma is usually caused by a build up of the fluid which flows through the eye. This build up occurs because the fluid drains out of your eye more slowly than it is being pumped in.
Since new fluid continues to enter the eye, joining the fluid already there, the pressure continues to rise. This raised pressure may damage the back of the eye resulting in gradual loss of sight.
Damage can progress so slowly that the person is not aware of this gradual loss of sight. Sometimes even normal eye pressure is associated with damage to the back of the eye.
There are usually no symptoms of glaucoma. The only way of knowing that you have glaucoma is to have your eye pressure, optic nerve and visual field checked by an eye specialist or optometrist.
If glaucoma is not treated it can lead to serious problems. You may have no symptoms but eventually glaucoma can lead to total blindness. In fact, untreated glaucoma is one of the most common causes of blindness.
Although TENOPT helps control your glaucoma it does not cure it.
For more information about glaucoma, contact the Glaucoma Foundation of Australia (PO Box 420, Crows Nest 2065, telephone 02 9906 6640).
TENOPT is used, either alone or in combination with other eye drops or medicines, to lower raised pressure within your eye(s).
TENOPT lowers pressure in the eye by reducing the production of fluid.
TENOPT belongs to a family of medicines called beta-blockers.
TENOPT is not addictive.
Before you use TENOPT
When you must not use it
Do not use TENOPT if you have an allergy to TENOPT or any of the ingredients listed at the end of this leaflet.
Do not use TENOPT if:
you have asthma, or a history of asthma, chronic obstructive lung disease (emphysema), or other breathing problems
you have certain heart conditions, such as a very slow heart rate, an irregular heart beat, or heart failure.
Do not use TENOPT if you are breast-feeding or intend to breast-feed. Your baby may absorb this medicine from breast milk and therefore there is a possibility of harm to the baby.
Do not put the eye drops into your eye(s) while you are wearing soft contact lenses. The preservative in TENOPT (benzalkonium chloride) may be deposited in soft contact lenses. You can put your soft contact lenses back into your eyes at least 15 minutes after you have used TENOPT.
Do not use TENOPT if:
the seal around the cap is broken
the bottle shows signs of tampering
the expiry date on the pack has passed.
If you use this medicine after the expiry date has passed, it may not work.
If you are not sure whether you should start using TENOPT, talk to your doctor.
Do not use TENOPT in a child. The safety and effectiveness of TENOPT in children have not been established.
Before you start to use it
Tell your doctor if:
1. you are pregnant or intend to become pregnant
Your doctor will discuss the possible risks and benefits of using TENOPT during pregnancy and a decision can be made if you should or should not use it.
2. you have any medical conditions, especially the following:
3. you are already using another beta-blocker eye drop
It is not recommended to use two beta-blocker eye drops at the same time.
4. you have a history of allergic problems, including eczema, hives or hay fever
5. you have had an allergy to any other medicines or any other substances, such as foods, preservatives or dyes.
If you have not told your doctor about any of the above, tell them before you use TENOPT.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.
Some medicines and TENOPT may interfere with each other.
medicines for high blood pressure or heart conditions, including a group of medicines called beta-blockers
clonidine, a medicine used to treat high blood pressure
digoxin, a medicine used to treat heart failure
quinidine, a medicine used to treat irregular heart beats
These medicines may be affected by TENOPT, or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.
Your doctor or pharmacist has more information on medicines to be careful with or avoid while using TENOPT.
How to use TENOPT
How much to use
Your doctor will tell you how many drops you need to use each day.
Use TENOPT only when prescribed by your doctor.
The usual dose for adults is one drop of TENOPT twice a day, in either one or both eyes.
Follow all directions given to you by your doctor carefully. They may differ from the information contained in this leaflet.
Use TENOPT every day, at about the same time each day, unless your doctor tells you otherwise. Using your eye drops at the same time each day will have the best effect on your eye pressure. It will also help you remember when to use the eye drops.
After using TENOPT, wait at least 5 minutes before putting any other eye drops in your eye(s).
How to use it
You may find it easier to put drops in your eye while you are sitting or lying down.
If you are wearing contact lenses, remove them before putting the drops in your eye.
To open a new bottle of TENOPT, first twist off the protective cap (clear plastic) from the bottle. The seal will break and you can pull it off and then throw it away.
1. Wash your hands well with soap and water.
2. Remove the lid (mauve or pink colour).
3. Hold the bottle upside down in one hand between your thumb and index finger.
4. Using your other hand, gently pull down your lower eyelid to form a pouch.
5. Tilt your head back and look up.
6. Put the tip of the bottle close to your lower eyelid. Do not let it touch your eye.
7. Release one drop into the pou ch formed between your eye and eyelid by gently squeezing the bottle.
8. Close your eye and keep it closed. Do not blink or rub your eye.
9. While your eye is still closed, place your index finger against the inside corner of your eye and press against your nose for about two minutes. This will help to stop the medicine from draining through the tear duct to the nose and throat, from where it can be absorbed into other parts of your body. Ask your doctor for more specific instructions on this technique.
10. Replace the lid, sealing it tightly
11. Wash your hands again with soap and water to remove any residue.
Wait at least 15 minutes before replacing your contact lenses.
Be careful not to touch the dropper tip against your eye, eyelid or anything else to avoid contaminating the eye drops. Contaminated eye drops may give you an eye infection.
You may feel a slight burning sensation in the eye shortly after using the eye drops.
If this persists, or is very uncomfortable, contact your doctor or pharmacist.
How long to use it
TENOPT helps control your condition but does not cure it. Therefore TENOPT must be used every day.
Continue using TENOPT for as long as your doctor prescribes.
If you forget to use it
If it is almost time for your next dose, skip the dose you missed and use your next dose when you are meant to.
Otherwise, use the drops as soon as you remember, and then go back to using them as you would normally.
If you are not sure whether to skip the dose, talk to your doctor or pharmacist.
Do not use double the amount to make up for the dose that you missed.
If you have trouble remembering to use your eye drops, ask your pharmacist for some hints.
If you use too much (overdose)
If you think that you or anyone else may have swallowed any or all of the contents of a bottle of TENOPT, or used too many drops, immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26) for advice, or go to accident and emergency at your nearest hospital. Do this even if there are no signs of discomfort or poisoning.
If TENOPT is accidentally swallowed, or if you use too many drops, you may feel light-headed or dizzy, you may faint, have a very slow pulse rate, or have wheezing or difficulty breathing.
While you are using TENOPT
Things you must do
Have your eye pressure checked when your eye specialist says, to make sure TENOPT is working.
If you develop an eye infection, receive an eye injury, or have eye surgery tell your doctor. Your doctor may tell you to use a new container of TENOPT because of possible contamination of the old one, or may advise you to stop your treatment with TENOPT.
If you become pregnant while using TENOPT tell your doctor.
If you are about to be started on any new medicine tell your doctor and pharmacist that you are using TENOPT.
Things you must not do
Do not give TENOPT to anyone else, even if they have the same condition as you.
Do not stop using TENOPT without first talking to your doctor. If you stop using your eye drops, your eye pressures may rise again and damage to your eye may occur.
Things to be careful of
Be careful driving or operating machinery until you know how TENOPT affects you. TENOPT generally does not cause any problems with your ability to drive a car or operate machinery. However, TENOPT may cause blurred vision or dizziness in some people. Make sure you know how you react to TENOPT or that your vision is clear before driving a car or operating machinery.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using TENOPT. TENOPT helps most people with high eye pressure and glaucoma, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
Problems with your eye/s such as:
blurred vision, double vision or other visual problems
allergic reactions including redness, swelling and/or itching of the eye
burning and stinging of the eyes
irritation or feeling of having something in the eye, dry eyes
drooping of eyelid/s
Difficulty thinking or working because of:
ringing or buzzing in the ears
difficulty sleeping, nightmares
changes in mood such as depression, memory loss
Stomach or bowel problems
feeling sick (nausea), upset stomach
Changes in the way your hands and feet feel such as:
cold hands or feet
numbness, tingling and colour change (white, blue then red) in fingers when exposed to the cold (Raynaud's Phenomenon)
numbness or tingling in the fingers or toes
Hair loss or thinning
Less desire for sex
These are usually mild side effects of TENOPT.
Tell your doctor immediately if you notice any of the following:
fast or irregular heart beats, also called palpitations
dizziness and light-headedness, which may be due to low blood pressure
skin rash, itching
swelling of the hands, feet, ankles or legs
These may be serious side effects. You may need urgent medical attention.
Serious side effects are rare.
If any of the following happen, stop using TENOPT and tell your doctor immediately or go to to accident and emergency at your nearest hospital:
wheezing, difficulty in breathing, shortness of breath
very slow pulse, chest pain
swelling of the face, lips, mouth, tongue or throat which may cause difficulty in breathing or swallowing
severe and sudden onset of pinkish, itchy swellings on the skin, also called hives or nettlerash
These are serious side effects. You may need urgent medical attention. These side effects are rare.
Other side effects not listed above may also occur in some patients. Tell your doctor if you notice any other effects.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
After using TENOPT
Keep your eye drops in a cool place where the temperature stays below 30°C.
Do not store it or any other medicine in the bathroom or near a sink.
Do not leave it in the car or on window sills.
Do not carry the eye drops in pockets of your clothes.
Heat and dampness can destroy some medicines.
Keep the eye drops away from direct light.
Keep it where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Do not leave the lid off the bottle for any length of time to avoid contaminating the eye drops.
Write the date on the bottle when you open the eye drops and throw out any remaining solution after four weeks. Eye drops contain a preservative which helps prevent germs growing in the solution for the first four weeks after opening the bottle. After this time there is a greater risk that the drops may become contaminated and cause an eye infection. A new bottle should be opened.
If your doctor tells you to stop using the eye drops or they have passed their expiry date, ask your pharmacist what to do with any remaining solution.
How does it come?
TENOPT comes as eye drops in a 5 mL dropper pack. It is available in two strengths.
TENOPT 0.25% - timolol maleate, equivalent to timolol 0.25%
TENOPT 0.5% - timolol maleate, equivalent to timolol 0.5%
sodium acid phosphate
benzalkonium chloride as preservative
TENOPT is supplied in Australia by:
Sigma Pharmaceuticals Pty Ltd (A.C.N. 004 118 594)
1408 Centre Road Clayton
Phone: 03 - 9839 2800
This leaflet was prepared in October 1997 and updated in April 1998 and in June 2000.
Australian Register Numbers:
TENOPT 0.25% - AUST R 19794
TENOPT 0.5% - AUST R 19795