What Xalacom is used for and how to use it
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Xalacom - Consumer Medicine Information

Manufacture: Pfizer Inc.
Country: Canada
Condition: Glaucoma, Open Angle, Intraocular Hypertension
Class: Ophthalmic glaucoma agents
Form: Liquid solution, Eye drops (ophthalmic)
Ingredients: latanoprost, timolol as timolol maleate, benzalkonium chloride (preservative), sodium chloride, sodium dihydrogen phosphate monohydrate, disodium hydrogen phosphate anhydrous, water for injection, hydrochloric acid, sodium hydroxide

(latanoprost 50 µg/mL and timolol 5 mg/mL)

Ophthalmic solution

About This Medication

What Xalacom is Used For

XALACOM is used to reduce eye pressure in patients with open angle glaucoma ocular hypertension. Both these conditions are related to an increase in pressure within the eye and eventually they may affect your eyesight.

What Xalacom Does

XALACOM is a combination of an ophthalmic prostaglandin drug (latanoprost) and an ophthalmic beta-blocking drug (timolol), both of which lower the pressure within the eye in different ways. The prostaglandin drug works by increasing the natural outflow of fluid from inside the eye. The beta-blocking drug works by decreasing the fluid production in the eye.

When Xalacom Should not be Used

  • if you have a reactive airway disease including bronchial asthma, a history of bronchial asthma, or severe chronic obstructive pulmonary disease.
  • if you have heart problems such as a sinus bradycardia (low heart beat), sick sinus syndrome, sino-atrial block, second or third degree atrioventricular block not controlled with pace-maker, overt cardiac (heart) failure, or cardiogenic shock.
  • if you have known hypersensitivity to latanoprost, timolol, benzalkonium chloride or any other ingredient in the product. ( See What the medicinal ingredients are).

What the Medicinal Ingredient Is

Each millilitre (mL) contains 50 micrograms of latanoprost and 5 milligrams of timolol as timolol maleate

What the Important Nonmedicinal Ingredients Are

Benzalkonium chloride (preservative), sodium chloride, sodium dihydrogen phosphate monohydrate, disodium hydrogen phosphate anhydrous, water for injection, hydrochloric acid and sodium hydroxide.

What Dosage Forms it Comes In

XALACOM is supplied in a 5 mL plastic ophthalmic dispenser bottle with a dropper tip, screw cap and tamper proof overcap.

Warnings and Precautions

Before using XALACOM, talk to your doctor or pharmacist if

  • You are allergic to any of the ingredients in XALACOM.
  • You have a respiratory disease such as asthma, have a history of asthma, or have chronic obstructive pulmonary disease (severe lung disease which may cause wheeziness, difficulty in breathing and/or long-standing cough).
  • You have disturbances of heart rate such as slow heart beat (bradycardia).
  • You have certain heart diseases or conditions – symptoms can include chest pain or tightness, breathlessness or choking, heart failure, low blood pressure (hypotension).
  • You have problems with your blood pressure or thyroid function.
  • You have poor blood circulation disease (peripheral arterial disease such as Raynaud’s disease or Raynaud’s syndrome).
  • You have diabetes or have low blood sugar levels.
  • You have or have had muscle weakness or have been diagnosed as having myasthenia gravis.
  • You are using any other eye drops or taking any other medication.
  • You are pregnant, think you might be pregnant or you are planning a pregnancy.
  • You are breast feeding or planning to breastfeed.
  • You have or have had herpes simplex keratitis (inflammation of the cornea caused by the herpes simplex virus
  • Your eyes are sensitive to light
  • You are planning a surgery
  • You have kidney or liver disease

Tell your doctor before you have an operation that you are using XALACOM as Timolol Maleate may change effects of some medicines used during anaesthesia.

XALACOM contains a preservative (benzalkonium chloride) that may be absorbed by contact lenses. The preservative may form a precipitate with an ingredient (thimerosal) present in several contact lens soaking solutions. If you wear contact lenses, remove them before using XALACOM. Wait 15 minutes after applying the eye drops before putting your lenses back in. If you are using more than one type of eye drop medication, wait at least 5 minutes between each different eye drop

Interactions With This Medication

XALACOM 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 or other medicines including:

  • calcium channel blockers, beta-adrenergic blocking agent
  • antiarrhythmics ( e.g. amiodarone, quinidine),
  • monoamine oxidase inhibitors
  • narcotics
  • digitalis, fluoxetine, paroxetine

Proper Use of This Medication

Always use XALACOM exactly as your doctor has told you.

Usual Adult Dose

One drop of XALACOM should be dropped into the affected eye(s) once daily.

Do not allow the dropper tip of the bottle to touch the eye or other surrounding structures, because this could contaminate the tip with common bacteria known to cause eye infections. Serious damage to the eye with subsequent loss of vision may result if you use eye drop solutions that have become contaminated. If you experience any type of eye condition or have surgery, immediately seek your doctor's advice concerning the continued use of the bottle you are using.

If you forget to use your eye drops at the usual time, wait until it is time for your next dose. If you put too many drops in your eye(s), you may feel some slight irritation.

Follow These Steps to Help You Use Xalacom Properly

  1. Wash your hands and sit or stand comfortably. If you wear contact lenses, remove them before using your eye drops.

  2. Twist off the outer protective cap from the bottle.

  3. Unscrew the inner cap of the bottle.

  4. Once the bottle is opened, hold it in one hand and steady your thumb against your brow or the bridge of your nose.
  5. Use your index finger to gently pull down the lower eyelid of the affected eye(s) to create a pocket for the drop.
  6. Gently press, or lightly tap, the side of the bottle to allow only a single drop to fall into the pocket. Do not let the tip of the bottle touch your eye.
  7. Close your eye for 2 to 3 minutes.
  8. If your doctor has told you to use drops in both eyes, repeat the process for the other eye. XALACOM should be used until your doctor tells you to stop.

XALACOM is not recommended for use in children.


In case of drug overdose, contact a healthcare practitioner, hospital emergency department or regional poison control centre, even if there are no symptoms.

Missed Dose

If you forget one dose of XALACOM, continue with the next dose as normal. Do not double dose.

Side Effects and What to Do About Them

In some patients, XALACOM may cause a gradual change in eye color by increasing the amount of brown pigment in the iris (the colored part of the eye). This change may not be noticeable for several months to years. This effect may be more noticeable in patients with eye colors that are mixtures of green and brown, blue/gray and brown, or yellow and brown. The brown pigment may gradually spread outward toward the outside edge of the iris. However, the entire iris or parts of it may become more brownish in appearance. This change may be more noticeable if you are only treating one eye. Therefore, there is the potential for permanent difference in the colour between the treated and the untreated eyes. Your doctor will examine you regularly to make sure that your medication is working and look for changes in eye color. If you should experience any changes in eye color, your doctor can stop treatment. However, any color change that has already occurred may be permanent, even after the medication is stopped.

XALACOM may also cause your eye lashes to darken, appear thicker and longer than they usually do. A very small number of people may notice their eye lid skin looks darker after using XALACOM for some time. These changes may be more noticeable if you are only treating one eye.

When using XALACOM, you might feel as if there is something in your eye(s). Your eye(s) might water and become red. As with other eye drops, if your vision is blurred when you first put your drops in, wait until this wears off before you drive or operate machinery. A few people using XALACOM have developed a skin rash.

A few people may experience changes in their vision, sometimes in combination with a red and sore/painful eye. These changes do not always occur right after administering the drops, and if they occur, you may find that reading and seeing fine details more difficult. Although unlikely, if you experience any of these changes, stop using XALACOM and contact your doctor immediately.

XALACOM may cause the following side effects as well.

Common side effects: eye irritation, including burning and stinging, inflammation of the eye lid and eye pain, upper respiratory tract infection.

Effects on the body: headache and skin rash, loss of appetite, sore muscles, low blood sugar in diabetics, dry eyes, nervous system effects including anxiety, nervousness, dizziness, confusion, disorientation, insomnia, hallucinations.

Be sure to tell your doctor (or pharmacist) if you notice any other unwanted side effects.

Serious Side Effects, How Often They Happen and What Do About Them

Symptom/EffectTalk with your doctor or pharmacistStop taking the drug and seek emergency medical assistance
Only if severeIn all cases
RareHeart effects such as irregular heartbeat, high blood pressure and low blood pressure 
Severe respiratory reactions has been reported with administration of timolol
Allergic reactions with symptoms such as swelling of the mouth, and throat, difficulty breathing, hives, itching, rash.
Beta adrenergic blockers (e.g. timolol) have been reported to cause muscle weakness in those with myasthenia gravis or similar conditions

How to Store It

Always keep medicine well out of the reach of children.

Before XALACOM is first opened, keep it in a fridge (between 2°C and 8°C), out of direct light.

Once the bottle has been opened, XALACOM can be kept at normal room temperature up to 25°C, out of direct light. XALACOM must be used within 10 weeks after opening the bottle. Discard the bottle and/or unused contents after 10 weeks. XALACOM should not be used after the expiry date on the bottle.

Reporting Suspected Side Effects

You can report any suspected adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following 3 ways:

  • Report online at www.healthcanada.gc.ca/medeffect
  • Call toll-free at 1-866-234-2345
  • Complete a Canada Vigilance Reporting Form and:
    • Fax toll-free to 1-866-678-6789, or
    • Mail to: Canada Vigilance Program
                     Health Canada
                     Postal Locator 0701D
                     Ottawa, ON K1A 0K9

    Postage paid labels, Canada Vigilance Reporting Form and the adverse reaction reporting guidelines are available on the MedEffect Canada Web site at

    NOTE:Should you require information related to the management of side effects, contact your health professional. The Canada Vigilance Program does not provide medical advice.

    More Information

    Patients can refer to www.pfizer.ca for further information.

    This document plus the full product monograph, prepared for health professionals can be found at:


    or by contacting the sponsor, Pfizer Canada Inc., at: