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The following safety information highlights crucial risks and precautions associated with the use of Cosopt (dorzolamide / timolol). Please review these details carefully and consult your healthcare provider with any questions or concerns.

• Breathing Difficulties: Cosopt contains timolol, which in rare cases can cause the blood vessels in the lungs to tighten, making breathing difficult. This is especially important for individuals with asthma or chronic obstructive pulmonary disease (COPD). Ensure your eye specialist is aware of your full medical history before beginning treatment.

• Heart Health Concerns: Beta blockers like those in Cosopt can potentially cause or worsen heart failure due to their effect of slowing the heart rate. If you have heart failure or a history of sudden heart attacks, discuss the risks with your healthcare provider.

• Severe Allergic Reactions: Individuals with a sulfa allergy should be cautious, as Cosopt can trigger severe allergic reactions, including facial swelling and anaphylaxis. Seek immediate medical attention if you experience hives, rash, swelling, or difficulty breathing.

• Masked Hypoglycemia Symptoms: Cosopt can obscure symptoms of low blood sugar, such as a rapid heartbeat or tremors, except for sweating. Those with diabetes should monitor their blood sugar levels closely.

• Thyroid Considerations: If you have hyperthyroidism, do not abruptly discontinue Cosopt without consulting your eye specialist, as this may lead to a "thyroid storm," characterized by high fever and rapid heartbeat, requiring prompt medical attention.

• Surgical Risks: Inform your surgeon if you are using Cosopt prior to major surgery requiring anesthesia, as beta blockers may increase the risk of heart-related side effects. Close monitoring of your heart may be necessary during the procedure.

• Corneal Swelling: Dorzolamide, a component of Cosopt, can increase the risk of corneal swelling, particularly in individuals with a low number of corneal cells. Consult your eye specialist if you have been informed of any corneal issues.

• Eye Inflammation and Infection: Cosopt can cause or worsen eye inflammation, especially if you use multiple-dose eye drops or have a history of eye infections. Discuss with your eye specialist whether to continue using Cosopt during inflammation.

• Muscle Weakness: Although extremely rare, some users have reported muscle weakness around the eyes, leading to droopy eyelids or double vision. Report these symptoms to your eye specialist immediately.

Contraindications: Do not use Cosopt if you have any of the following conditions without consulting your healthcare provider, as serious health risks may arise:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Symptomatic heart failure
• Second or third-degree heart block
• Slow heartbeat
• Insufficient heart pumping capacity

Common side effects:

• Changes in taste
• Temporary blurred vision
• Eye discomfort (burning, stinging, itching, redness)
• Watery or dry eyes
• Sensation of something in the eye
• Sensitivity to light
• Headaches

Less common but important to monitor:

• Dizziness
• Sinus or upper respiratory infections
• Cloudy vision
• Belly pain
• Eye or eyelid swelling
• Discharge or tearing

Serious side effects:

• Worsening heart failure (shortness of breath, unusual swelling, sudden weight gain)
• Bronchospasm (chest tightness, difficulty breathing, wheezing)
• Severe allergic reactions (hives, swelling of the lips or tongue, difficulty breathing)
• Severe skin reactions

Interactions with high risk of serious adverse effects and should be avoided:

• Albuterol
• Diltiazem
• Verapamil
• Clonidine
• Epinephrine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Digoxin
• Methyldopa
• SSRIs (e.g., Fluoxetine)

Interactions with low risk that usually do not require a change in therapy:

• Aspirin
• Ibuprofen
• Insulin
• Metformin