Combigan alternatives: What can I take instead of Combigan?

In this article:

• Combigan alternatives
• Cosopt
• Xalatan/Xelpros
• Azopt
• Rhopressa
• Simbrinza
• Natural alternatives
• How to switch

In this article

• Combigan alternatives
• Cosopt
• Xalatan/Xelpros
• Azopt
• Rhopressa
• Simbrinza
• Natural alternatives
• How to switch

Combigan (brimonidine tartrate–timolol maleate) is a brand-name prescription eye drop medication that combines two drugs that work in different ways to lower eye pressure. Eye doctors use Combigan in people diagnosed with high eye pressure or glaucoma, a condition in which elevated eye pressure damages the optic nerve. While eye doctors consider a variety of issues when prescribing eye pressure drugs, the initial choice may not be the right one. It may not be powerful enough, or side effects may be a problem. In those cases, they have a variety of alternative drug types to relieve ocular hypertension. 

What can I take instead of Combigan?

While an effective treatment for some people, Combigan may not be the best and safest option. First of all, not everyone with elevated eye pressure needs two medications. Most cases of elevated eye pressure due to the most common form of glaucoma–open-angle glaucoma–can be treated with just one drug. First-line agents are typically prostaglandin analogs, such as Xalatan (latanoprost) or Travatan Z (travoprost), which may be more effective at decreasing intraocular pressure (IOP) than the components of Combigan. If patients do not achieve a goal decrease in IOP, ophthalmologists may need to add a second or third drug for severe or more stubborn cases.

Some people can never take Combigan safely because of asthma, chronic obstructive pulmonary disease (COPD), or serious heart problems. They will need a different drug than one that contains timolol.

Ophthalmologists have a wide variety of drugs they can use. For fixed combination eye drops, they can use Combigan, generic Combigan, Cosopt, generic Cosopt, Rocklatan, or Simbrinza. 

There are also a variety of single-medication eye drops and oral medications available that may work better than Combigan, including carbonic anhydrase inhibitors like Azopt, prostaglandin analogs like Xalatan (latanoprost), and a new type of drug called a rho-kinase inhibitor like Rhopressa (netarsudil). 

Before switching, get medical advice from the eye doctor. While many glaucoma medications have common side effects, some alternatives have distinct adverse effects that should be considered before switching to a different medication.

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of 02/01/26. Click the link under “See our lowest price” to see the latest drug prices.

Top 5 Combigan alternatives

1. Cosopt (dorzolamide/timolol)

Cosopt is a combination eye drop that can be used to manage open-angle glaucoma and ocular hypertension. Cosopt contains a carbonic anhydrase inhibitor (dorzolamide) and a beta blocker (timolol). Like Combigan, Cosopt is dosed twice daily into the affected eyes. 

Cosopt also has a lower-priced generic option available called dorzolamide hydrochloride and timolol maleate. Cosopt is available in a preservative-free formulation (Cosopt PF) that can help reduce eye inflammation and be beneficial for those who experience dry eyes. 

Cosopt has side effects similar to those of Combigan, but there are also reports of a bitter, sour, or unusual taste. Like Combigan, Cosopt should not be used in people who have asthma, COPD, sinus bradycardia, second- or third-degree atrioventricular block, overt cardiac failure, or cardiogenic shock.

2. ​​Xalatan, Xelpros (latanoprost)

Latanoprost is a prostaglandin analogue, a highly potent treatment for high eye pressure and open-angle glaucoma. Unlike Combigan or Cosopt, latanoprost doses are administered once daily, usually in the evening. Brand-name versions include Xalatan and Xelpros, but the generic version is a more affordable option. 

Latanoprost has similar side effects as Combigan, but also has reports of foreign body sensation (gritty sensation in the eye), upper respiratory infection, increased pigmentation or darkening of the iris, and eyelash changes, including increased length and thickness.

RELATED: What are prostaglandins?

3. Azopt (brinzolamide)

Brinzolamide is a carbonic anhydrase inhibitor and a potent treatment for open-angle glaucoma and ocular hypertension. As a carbonic anhydrase inhibitor, it’s not as powerful as latanoprost, but it should be strong enough for many cases of high eye pressure. Unlike Combigan, brinzolamide is dosed three times daily. 

Azopt has similar side effects as Combigan, but also has reports of inflammation of the eyelids, foreign body sensation (gritty sensation in the eye), stuffy nose, and bitter, sour, or unusual taste. Unlike Combigan, Azopt can be prescribed to people with asthma, COPD, or serious heart problems.

RELATED: Carbonic anhydrase inhibitors: Uses, common brands, and safety information

4. Rhopressa (netarsudil ophthalmic solution)

Rhopressa is a new type of open-angle glaucoma and eye pressure drug called a rho-kinase inhibitor. It’s slightly less potent than latanoprost, but it may be the right medication for certain situations. Unfortunately, there is no generic version. Doses are administered once daily in the evening. 

Rhopressa has reports of side effects that Combigan does not have, including eye pain when administering, corneal verticillata (deposits in the cornea), and broken blood vessels in the eye.

5. Simbrinza (brinzolamide and brimonidine tartrate)

Simbrinza is a combination eye drop that can be used to manage open-angle glaucoma and ocular hypertension. There is no generic version. Simbrinza contains a carbonic anhydrase inhibitor (brinzolamide) and an alpha blocker (brimonidine tartrate). Unlike Combigan, Simbrinza is dosed three times daily. 

Simbrinza has reports of side effects that Combigan does not have, including a bad taste in the mouth and dry mouth. Unlike Combigan, Simbrinza can be prescribed to people with asthma, COPD, or serious heart problems.

Natural alternatives to Combigan 

Natural alternatives to Combigan can help eye health, but they are no substitute for medical attention and drugs that lower eye pressure. Relying solely on natural treatments may be risky. Elevated intraocular pressure steadily damages the optic nerve and can lead to permanent vision loss or blindness. If the pressure is high enough, optic nerve damage can happen quickly.

That being said, certain supplements, lifestyle changes, and diet modifications can help keep the eyes healthy. According to the American Optometric Association, proper nutrition for eye health includes a diet that has zinc, copper, essential fatty acids, lutein, vitamin C, vitamin E, and vitamin A. The supplement PreserVision includes many of these nutrients and is available over the counter.

Physical exercise and weight loss can have a positive impact on reducing some glaucoma risk factors, including high blood pressure and diabetes. Since caffeine can increase eye pressure, it may help to limit caffeine intake. 

How to switch to a Combigan alternative

1. Discuss all health conditions with a healthcare provider

Before switching from Combigan to an alternative, it’s important that the prescribing doctor has reviewed all health conditions and potential drug interactions. Get medical advice from an ophthalmologist prior to changing medication therapy.

2. Do not suddenly stop taking Combigan

Before stopping Combigan, make a glaucoma or ocular hypertension care plan with the prescribing doctor to avoid increases in intraocular pressure. Once a plan has been established, Combigan can be safely discontinued and replaced with the new treatment.

3. Continue proper eye drop administration

Using eye drops correctly ensures proper drug administration and absorption into the eye. It’s important to make sure contact lenses are removed from the eye before using eye drops, unless the eye doctor has instructed the patient to keep them in. Make sure hands are washed, tilt head backward while sitting, standing, or lying down, place the index finger below the lower lid to gently pull down and form a pocket, look up, and squeeze the drop into the pocket. It’s important to keep the eye closed after the drop has been administered. Try to keep your eye closed for 1 to 3 minutes without blinking.

If using more than one drop or more than one type of eye drop, wait five minutes before putting the next drop in. This will keep the first drop from being washed out by the second before it has had time to work.

4. Keep and maintain eye doctor appointments

People with glaucoma and ocular hypertension should be regularly checked by their eye doctor. At these appointments, intraocular pressure (IOP) can be measured to assess the effectiveness of their medication regimen. People managing their IOP need to be aware of the normal eye pressure range (12-21 mm Hg) and the high pressure range (greater than 21 mm Hg). Vision tests may also be performed to detect any loss of vision or optic nerve damage.