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Ganfort (+Timolol)

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Ganfort (+Timolol)

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Method of action: Antiglaucomatous

Treatment option:

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

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Overview of Ganfort (+Timolol)

Identity Overview and Quick Facts

Ganfort (+Timolol) is a synthetic fixed-dose combination product intended for ocular administration, categorized by its pharmacological class as an Antiglaucoma preparation and Ocular hypotensive agent. The active ingredients are Bimatoprost (a Prostaglandin analog) and Timolol maleate (a Beta-adrenergic receptor blocker), presented in the form of a sterile ophthalmic solution. The product is defined by its structure, combining two distinct agents into a single bottle, a design clinically recognized for supporting patient consistency.

Composition: Bimatoprost, Timolol, and Their Classes

The medication's composition features the INN Bimatoprost and Timolol maleate, both of which are synthetic compounds suspended in an aqueous vehicle. Bimatoprost is classified as a Prostaglandin analog, while Timolol is a non-selective Beta-blocker. The single-bottle fixed combination represents a key differentiator from using two separate single-ingredient formulations, such as Lumigan (Bimatoprost only), simplifying the treatment process. This dual-agent structure is widely supported by pharmacological studies that demonstrate a powerful synergistic action in lowering eye pressure.

General Purpose of This Combination Product

The overarching purpose of this combination product is the robust and sustained management of elevated Intraocular Pressure (IOP) in adult patients. This therapeutic strategy relies on a dual mechanism: one component facilitates uveoscleral outflow (fluid drainage), while the other reduces aqueous humor production (fluid inhibition). The formulation is authorized as an effective second-line strategy for achieving controlled, necessary IOP reduction, which is the critical management goal in ocular hypertension.

Regulatory References

  1. EMA-EPAR
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What side effects are possible with Ganfort (+Timolol)?

Official Safety Profile and Adverse Reactions

The possible side effects associated with this fixed-dose combination are derived from the documented safety profiles of its two active components, Bimatoprost and Timolol. Adverse events are officially classified by frequency and the body system affected, consistent with regulatory guidelines.

Frequency Classification of Adverse Reactions

The most commonly reported effects are localized to the eye. According to regulatory documents, effects are categorized by frequency:

  • Very Common (Affecting more than 1 in 10 people): Conjunctival hyperaemia (eye redness).
  • Common (Affecting 1 to 10 in 100 people): Increased eyelash growth, headache, blepharal pigmentation (darkening of the eyelid skin), and eye pruritus (itching).
  • Uncommon: Increased iris pigmentation and shortness of breath (dyspnoea).

Systemic Safety and Serious Reactions

Adverse reactions that affect the body systemically are primarily associated with the absorption of the Timolol (beta-blocker) component. Serious adverse reactions documented in regulatory labeling include Cardiac Arrest, Cardiac Failure, and Bronchospasm (severe breathing difficulty), which are classified as having a frequency that cannot be estimated from available data. Other system-organ classes involved include the cardiac, respiratory, and nervous systems.

Population-Specific Safety Considerations

The official labeling defines specific safety constraints for certain patient populations. The medication is contraindicated in individuals with a history of bronchial asthma or severe Chronic Obstructive Pulmonary Disease (COPD), and in patients with specific severe heart conditions, such as Sinus bradycardia or Overt cardiac failure. Safety and efficacy have not been established in the pediatric population (under 18 years). Furthermore, caution is noted in patients with hepatic or renal impairment, as formal studies have not been conducted in these groups.

Exposure-Related Safety Patterns

The pigmentation of the iris is considered likely to be permanent. In contrast, changes to the eyelashes and periorbital tissue are typically noted as reversible upon discontinuation of the medication, according to official regulatory documentation.

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Overdose and Emergency Response

Overdose scope

Feature Official Regulatory Statement
Documented overdose presentations Systemic manifestations include bradycardia (slow heart rate), hypotension (low blood pressure), syncope, bronchospasm, and dizziness. Overdose may also involve the masking of clinical signs of hypoglycemia.
Physiological systems affected (as stated in label) Primarily the Cardiovascular system and the Respiratory system.
Dose-related or exposure-related factors (if applicable) Systemic effects are a result of excessive systemic absorption of the Timolol component; topical overdose is generally noted as unlikely to cause toxicity.
Population-specific overdose notes (if applicable) Risk of effects on the neonate when maternal exposure occurs near delivery. Risk of potentiated systemic beta-blockade when co-administered with CYP2D6 inhibitors.
Emergency-response statements (as written in official documents) Emergency medical care is required for severe systemic signs. The additive systemic effects may lead to marked hypotension and bradycardia.
When immediate medical help is required (label-derived phrasing only) Urgent help is required upon manifestation of severe cardiovascular outcomes such as cardiac arrest, overt cardiac failure, atrioventricular block, or severe respiratory distress.

Overdose classifications (high-level)

Classification Detail Official Regulatory Statement
Severity classification (as defined in official documents) The potential for life-threatening cardiovascular and respiratory consequences is documented.
Regulatory basis (EMA / FDA / etc.) The overdose profile is defined by information contained within the Summary of Product Characteristics (SmPC) and FDA Prescribing Information.
Overdose-context constraints (as defined in official documents) The effects of overdose are those generally seen with systemic beta-blockers. No specific antidote is known for the Bimatoprost component overdose.

Resulting overdose structure

Official overdose statements:

  • The overdose profile is characterized by severe systemic effects primarily related to the Timolol component, leading to potentially life-threatening cardiovascular and respiratory outcomes.
  • Documented severe manifestations include bradycardia, hypotension, atrioventricular block (second or third degree), overt cardiac failure, and bronchospasm.
  • Emergency medical care is required for accidental ingestion or severe signs of systemic exposure.
  • Treatment for overdose is symptomatic and supportive, and hospital monitoring may be required to manage the systemic effects.

Connection to the overall overdose profile (2–4 sentences):

Regulatory documents establish the overdose risk as primarily derived from the systemic absorption of the beta-blocker component, defining the need for urgent help based on specific, severe, label-documented cardiovascular and respiratory signs. The official labeling specifies the potential for life-threatening outcomes, necessitating immediate medical attention and limiting management to symptomatic and supportive treatment. This profile is consistent with the systemic effects of beta-adrenergic receptor blockade.

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Therapeutic Uses of Ganfort (+Timolol)

Quick Facts: Uses of Ganfort (+Timolol)

  • Intended to reduce elevated pressure within the eye (intraocular pressure).
  • An option for supporting the management of open-angle glaucoma.
  • Used in patients with ocular hypertension.
  • Often considered when prior monotherapy has been insufficiently responsive.

What Ganfort (+Timolol) treats: Main Uses and Benefits

Ganfort, a therapeutic choice combining bimatoprost and timolol, is used to support the management of certain eye conditions in adult patients. Its primary use is intended to reduce elevated intraocular pressure (IOP). Maintaining a managed IOP level is a key factor in supporting the long-term health of the optic nerve and visual function.

This medication is specifically approved for patients diagnosed with open-angle glaucoma or ocular hypertension. It may be prescribed when treatment with a single-component therapy, such as a topical beta-blocker or prostaglandin analog, has been insufficiently effective in achieving the desired pressure reduction. The use of this fixed combination is an established option for patients requiring additional support to control eye pressure.

This combination works by influencing the dynamics of fluid within the eye to help lower pressure, thereby helping to manage the risk of potential vision damage associated with sustained elevation of IOP. Consult a healthcare professional to determine if this option is suitable for your specific needs.

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Eligibility and Restrictions for Use

Official Eligibility and Restrictions

Ganfort (bimatoprost/timolol) is officially indicated for adult patients, including older adults, who have open-angle glaucoma or ocular hypertension and have not responded sufficiently to a single-component topical therapy.

Absolute Contraindications

Use is strictly contraindicated and must be avoided by patients with the following conditions, primarily due to the timolol component (a beta-blocker):

  • Respiratory Disease: Bronchial asthma (current or history) or severe chronic obstructive pulmonary disease (COPD).
  • Cardiac/Cardiovascular: Sinus bradycardia (slow heart rate), sick sinus syndrome, second or third-degree atrioventricular block not controlled by a pacemaker, overt cardiac failure, or cardiogenic shock.
  • Hypersensitivity: Known allergy to bimatoprost, timolol, any other beta-blocker, or any excipients in the solution.

Population Restrictions

Population Group Regulatory Status Restriction Basis
Paediatric (0-18 years) Not Recommended Safety and efficacy have not been established.
Pregnancy Should Not Be Used Only if clearly necessary; inadequate data available.
Breastfeeding Should Not Be Used Timolol may be excreted in human milk.
Renal/Hepatic Impairment Caution Should Be Used The medication has not been studied in these populations.

Conditional Use: Caution is also specifically advised in the labeling for patients with mild/moderate COPD, first-degree heart block, uncontrolled or labile diabetes, active intraocular inflammation (uveitis), and specific ocular risk factors such as known risk for macular oedema or a torn posterior lens capsule.

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What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory profile for Ganfort (bimatoprost/timolol) documents specific interaction patterns, primarily related to the systemic effects of its timolol component. These interactions are classified based on their functional outcome and mechanism as stated in official labeling.

Pharmacodynamic Additive Effects

The most prominent interactions involve the risk of additive effects when co-administered with certain cardiovascular medications. This potentiation may result in hypotension and/or marked bradycardia. Interacting product categories include oral calcium channel blockers, anti-arrhythmics, digitalis glycosides, and guanethidine. Furthermore, the co-administration of systemic beta-adrenergic blocking agents may potentiate effects on intra-ocular pressure or systemic beta-blockade; the use of two topical beta-adrenergic blocking agents is officially not recommended.

Metabolic and Exposure-Altering Interactions

The drug’s exposure is susceptible to alteration by agents that inhibit the CYP2D6 enzyme. Co-administration with specific CYP2D6 inhibitors, such as quinidine, fluoxetine, or paroxetine, may result in potentiated systemic beta-blockade.

Administration Timing Constraint

For co-administration with other ophthalmic preparations, a procedural requirement exists: if more than one topical medicinal product is used, each must be instilled with an interval of at least 5 minutes apart.

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Mechanism of Action

Ganfort's mechanism relies on a complementary dual-modality action that simultaneously modulates the two primary determinants of pressure inside the eye: fluid inflow (production) and fluid outflow (drainage). This complementary strategy produces a physiological adjustment of the ocular fluid balance, resulting in a reduction of the intraocular pressure ( IOP).

The Bimatoprost component acts as a specific agonist on Prostanoid FP receptors, initiating a signaling cascade that involves the remodeling of the extracellular matrix within the ciliary muscle. This molecular modification relaxes the tissue and opens the uveoscleral outflow pathway, thereby increasing the rate of fluid clearance from the eye. Conversely, the Timolol component is a non-selective beta-adrenergic antagonist that blocks beta1 and beta2 receptors located on the ciliary epithelium. This blockade interrupts the sympathetic signaling required for active ion transport, subsequently decreasing the amount of aqueous humor being secreted into the eye. The mechanism results in a direct inhibition of the fluid's rate of production (inflow).

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Dosage and Administration Information

How to Use Ganfort (+Timolol): Official Administration Guidelines

Ganfort (bimatoprost/timolol) is provided as a sterile topical ophthalmic solution for administration into the eye. This medication is intended for use as a long-term treatment plan.

Dosing and Frequency

The recommended standard dosage for adults, including older people, is one drop administered into the affected eye(s) once daily. The total daily dose must not exceed one drop in the affected eye(s), as more frequent administration may diminish the IOP-lowering effectiveness.

Treatment must be administered at the same time each day, either in the morning or in the evening. If a dose is missed, treatment should simply continue with the next dose as planned; a double dose must not be used to compensate.

Procedural Administration

When instilling the eye drop, a technique known as nasolacrimal occlusion, or gently closing the eyelids for two minutes immediately following application, is recommended to help reduce the drug's absorption into the bloodstream.

If other topical ophthalmic products are required, each product must be instilled with an interval of at least 5 minutes between applications. For patients who use soft contact lenses, they must be removed prior to application and may only be reinserted 15 minutes after the drops have been instilled. The multi-dose container must be discarded four weeks (28 days) after it is first opened.

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Recent Clinical Evidence

Research evidence / Overview of studies for Ganfort (+Timolol)


Evidence for use in Open-Angle Glaucoma and Ocular Hypertension

The key clinical research for this combination therapy primarily involved controlled trials where researchers explored the use of the fixed combination in adults diagnosed with ocular hypertension or open-angle glaucoma. Studies were designed to observe changes related to systemic or functional imbalance, specifically focusing on outcomes describing eye pressure measured at different time points throughout the day. The primary research goal was to evaluate changes in eye pressure readings over defined, short-term intervals, typically around twelve weeks. The initial findings describe patterns observed in the studies where a proportion of participants reached a predefined eye pressure measurement threshold by the end of the trial period. This research provides context on how eye pressure measurements were taken during the specific conditions under which these short-term studies were conducted.


Research Comparing Ganfort to Other Treatments

Research examined the fixed combination in direct comparison to its two components—bimatoprost and timolol—when each was used alone. These comparative studies report patterns related to eye pressure measurements, noting that the fixed combination was associated with patterns of measured eye pressure when compared against its two individual components (monotherapy) in some trials. Further studies monitored the use of the fixed combination against other dual-agent fixed-combination therapies approved for the same conditions. Research describes patterns of eye pressure measurements when the combination was compared against some other single-agent treatments. Findings related to these comparisons were observed in some studies to indicate variable measured changes.


Understanding Long-Term Study Durations and Follow-up

The primary clinical evidence supporting the use of the fixed combination is generally based on studies observing responses over defined short-term time intervals, most commonly 12 weeks. While a few observational or post-marketing surveillance studies have extended the observation period to six months or even one year, there is limited information for long-term outcomes beyond this period. Therefore, certainty remains low regarding the characteristics of the eye pressure measurements over several years. Research provides insight into short-term changes, but the characteristics of these patterns over a sustained, multi-year period are not fully established by the existing primary clinical trials.


Main Research Gaps and Uncertainties

A key research limitation frame is that follow-up durations were limited in the core studies, meaning the data available provides context but not individual predictions for decades of use. Furthermore, sample sizes were modest for many specific subgroups, making subgroup findings uncertain. Long-term comparative evidence is limited for head-to-head trials against all available alternative treatments. Research is ongoing to continue contributing to the broader evidence landscape, but study results reflect the specific conditions under which they were conducted and do not determine whether an individual will respond similarly over their lifetime.

Key Studies & References

  1. Ganfort, INN- Bimatoprost/timolol (Summary of Product Characteristics/Annex I)
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Frequently Asked Questions (FAQ)

Common questions about Ganfort (+Timolol) (FAQ)


Q: How quickly does Ganfort start to lower eye pressure?

Clinical studies indicate that the maximum pressure-lowering effect from the eye drops is typically observed approximately 8 hours after the drops are applied. The full pressure-lowering effect is achieved within this timeframe, according to regulatory data.


Q: Does Ganfort contain a preservative?

The multi-dose formulation of the eye drops contains the preservative benzalkonium chloride, as listed in the official composition documents. This ingredient is included to help maintain the solution’s stability and sterility.


Q: Can Ganfort be used by people who wear contact lenses?

If using soft contact lenses, official labeling advises removing them before applying the drops. The preservative in the multi-dose drops may be absorbed by the soft lenses and cause discoloration. The official instructions advise waiting at least 15 minutes before reinserting the soft lenses.


Q: Does the official safety information mention any risk of depression or mood changes?

Adverse events related to psychiatric disorders have been reported in official product information associated with the medicine’s components. These reported effects include the potential for insomnia, nightmares, and depression.


Q: What is the difference between Ganfort and the individual Bimatoprost and Timolol drops?

Ganfort is described as a fixed-dose combination product, which means it contains both active ingredients, Bimatoprost and Timolol, in a single bottle. The combination structure is described as simplifying the dosing regimen compared to using the two components separately.


Q: What kind of research has been done on Ganfort?

Clinical research has primarily involved controlled trials in adults diagnosed with open-angle glaucoma or ocular hypertension. These studies compared the fixed combination to its individual components and sometimes to other treatments, evaluating outcomes over defined short-term intervals, typically 12 weeks.


Q: Is the main goal of using Ganfort to prevent further vision loss?

The medicine's purpose is the sustained reduction of intraocular pressure (IOP). Lowering IOP is a primary therapeutic goal, as this reduction is related to reducing the risk of damage to the optic nerve and potential subsequent vision loss.


Q: Do Ganfort drops need to be stored in the refrigerator?

Official storage instructions state the drops should be kept in a cool, dry place, below 25 C, and protected from freezing. Refrigeration is not typically specified by regulatory documents.


Q: Is Ganfort different from Lumigan?

Yes, the two are different products. Lumigan contains only the active ingredient bimatoprost, while Ganfort is a fixed-dose combination that contains both bimatoprost and timolol in one formula.


Q: Can Ganfort affect the length or thickness of eyelashes?

Increased eyelash growth is a common side effect described in the official safety profile. This change may be noted as an increase in both the length and the thickness of the eyelashes.


Q: Can using this medication cause a feeling of a foreign object in the eye?

Yes. Reports of a feeling of a foreign body sensation in the eye, which is also referred to as ocular irritation or discomfort, are included in the list of known side effects in the official product information.


Q: Is Ganfort a treatment for all types of glaucoma?

No. The product’s official indication is specifically for the reduction of intraocular pressure in adult patients with open-angle glaucoma or ocular hypertension. It is not indicated for all forms of glaucoma.


Q: Can this medication affect the tear ducts or drainage system of the eye?

The bimatoprost component works by increasing the drainage of fluid out of the eye through a pathway called the uveoscleral outflow. Official administration instructions include a technique (nasolacrimal occlusion) that involves applying pressure to the tear duct to help minimize the drug’s absorption into the bloodstream.


Q: How long can I expect to use Ganfort?

Official information indicates this medicine is typically intended for long-term treatment and should be used every day as prescribed unless otherwise directed by a healthcare provider.


Q: If I stop using Ganfort, will my eye pressure return to where it was?

Official information states that the medicine’s effect on lowering intraocular pressure is reversible. This means that if the medication is discontinued, the pressure may return to the levels observed before treatment.


Q: Can Ganfort cause side effects that affect my general breathing?

Yes. Shortness of breath (dyspnoea) is a reported side effect. Severe breathing difficulties, such as bronchospasm, have also been reported, particularly in patients with pre-existing lung conditions like asthma or severe COPD.


Q: Can using this medicine cause dryness of the eyes?

Yes. Dry eye is listed as an adverse reaction in the official safety profile of the medication.


Q: Do studies show a difference in how well Ganfort works in different ethnic groups?

Official research programs have included studies focusing on specific populations, such as an evaluation of the safety of the medicine in Chinese patients with open-angle glaucoma or ocular hypertension.


Q: Is it normal to see blurred vision after applying the drops?

Yes. Vision blurred is a reported adverse reaction associated with the use of the eye drops. If this occurs, it is noted that the effect is usually temporary.


Q: Can Ganfort affect vision in low light conditions?

Official labeling advises that if transient blurred vision occurs immediately after instillation, one should wait until vision clears before engaging in activities like driving or operating machinery. A specific effect on low-light vision is not commonly listed as a distinct side effect.


Q: Is there a link between Ganfort and feeling dizzy or lightheaded?

Yes. Dizziness is listed as a common reported side effect of the medicine.


Q: Is it safe to drive after using Ganfort drops?

Official labeling states the medicine has a negligible influence on the ability to drive and use machines. However, if transient blurred vision occurs immediately after instillation, the official warning advises waiting until vision clears before driving or operating machinery.


Q: What are the signs of an allergic reaction to Ganfort?

Reported hypersensitivity reactions may include signs and symptoms such as allergic dermatitis (a skin reaction), angioedema (swelling), or a general eye allergy. If you suspect an allergic reaction, immediate professional advice is necessary.


Q: Has Ganfort been studied in elderly patients?

The medicine is officially indicated for use in adult patients, including the elderly, and clinical trials have included participants from this population group.

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How should Ganfort (+Timolol) be stored and disposed of?

Storage and Disposal of Ganfort Eye Drops

Ganfort eye drops must be stored according to official regulatory requirements to maintain product stability. The multidose bottle must be kept at a temperature not exceeding 25°C (77°F). It is mandatory to protect the product from freezing, heat, moisture, and direct sunlight.

Stability and Container Rules

Formulation Required Stability Rule
Multidose Bottle Discard contents 4 weeks (28 days) after initial opening.
Single-Dose Container Discard immediately after use (preservative-free).

For the single-dose formulation, containers must be kept in the original aluminum pouch to protect against light and moisture.

Safety and Disposal

All Ganfort formulations must be kept out of the sight and reach of children and pets. Unused or expired medicine must not be thrown away in household waste or flushed down the toilet. Disposal should follow local regulations or a government-approved pharmaceutical take-back program.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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