timolol (Rx)

Brand and Other Names:Blocadren, Timol
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 5mg
  • 10mg
  • 20mg

Hypertension

10-30 mg PO q12hr

Maintenance: 20-40 mg/day

No more than 60 mg/day

Acute Myocardial Infarction

10 mg PO q12hr

Angina (Off-label)

15-45 mg/day PO divided q6-8hr

Migraine, Prophylaxis

Initial: 10 mg PO q12hr

Titrate to 10-30 mg/day

Additional Information

Less effective than thiazide diuretics in black and geriatric patients

Shown to decrease mortality in hypertension and post-myocardial infarction

Other Indications & Uses

Off-label: angina pectoris

<18 years old: safety & efficacy not established

Hypertension

10-30 mg PO q12hr

Maintenance: 20-40 mg/day

No more than 60 mg/day

Acute Myocardial Infarction

10 mg PO q12hr

Angina (Off-label)

15-45 mg/day PO divided q6-8hr

Migraine, ProphylaxisInitial

10 mg PO q12hr

Titrate to 10-30 mg/day

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Interactions

Interaction Checker

and timolol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10% (selected)

            Arrythmia

            Bradycardia

            Syncope

            Fatigue

            Headache

            Dyspnea

            <1% (selected)

            Bronchospasm

            Chest pain

            Edema

            Paresthesia

            Nausea

            Rales

            Frequency Not Defined

            Depression, decreased exercise tolerance, Raynaud's phenomenon

            May increase triglyceride levels and insulin resistance, and decrease HDL levels

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            Warnings

            Black Box Warnings

            May exacerbate ischemic heart disease following abrupt withdrawal

            Hypersensitivity to catecholamines has been observed during withdrawal

            Exacerbation of angina and, in some cases, myocardial infarction occurrence after abrupt discontinuation

            When discontinuing chronically administered beta-blockers (particularly with ischemic heart disease) gradually reduce dose over 1-2 wk and carefully monitor

            If angina markedly worsens or acute coronary insufficiency develops, reinstate beta-blocker administration promptly, at least temporarily (in addition to other measures appropriate for unstable angina)

            Warn patients against interruption or discontinuation of beta-blocker without physician advice

            Because coronary artery disease is common and may be unrecognized, slowly discontinue beta-blocker therapy, even in patients treated only for hypertension

            Contraindications

            Bronchial asthma/COPD

            Overt cardiac failure, sinus bradycardia, 2°/3° heart block, cardiogenic shock

            Hypersensitivity

            Sick sinus syndrome without permanent pacemaker

            Cautions

            IDDM, peripheral vascular disease, cerebrovascular insufficiency, liver disease, renal impairment, CHF, thyrotoxicosis

            Sudden discontinuation can exacerbate angina and lead to myocardial infarction

            Anesthesia/surgery (myocardial depression)

            Use in pheochromocytoma

            Increased risk of stroke after surgery

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excreted in milk; Mfr's recommends avoid nursing (AAP Committee states compatible with nursing)

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Blocks response to beta-adrenergic stimulation to beta1 and beta2 receptors; may reduce blood pressure by decreasing sympathetic outflow; produces negative chronotropic and inotropic activity through unknown mechanism

            Pharmacokinetics

            Half-Life elimination: 2-2.7 hr

            Peak Plasma Time: 1-2 hr

            Duration: 4 hr

            Absorption: 90%

            Vd: 1.7 L/kg

            Bioavailability: 50%

            Protein Bound: 60%

            Dialyzable: No

            Metabolism: Liver, extensive first-pass

            Excretion: Urine (15-20%)

            Onset of Action

            • Hypotensive: 15-45 min
            • Peak effect: 0.5-2.5 hr
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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.