timolol ophthalmic (Rx)

Brand and Other Names:Timoptic, Timoptic in Ocudose, more...Timoptic XE, Betimol, Istalol
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.25%
  • 0.5%

gel forming solution

  • 0.25%
  • 0.5%

Ocular Hypertension

1 gtt affected eye(s) q12hr 0.25%, if not effective increase 0.5% 1 gtt q12hr THEN

Decrease to 1 gtt/day if IOP controlled

XE formulation (0.25% or 0.5%): 1 gtt qDay

Ocular hypertension

<2 years

  • Safety and efficacy not established

≥2 years

  • 1 gtt affected eye(s) q12hr 0.25%, if not effective increase 0.5% 1 gtt q12hr THEN
  • Decrease to 1 gtt/day if IOP controlled
Next:

Adverse Effects

>10%

Burning or stinging (38%)

>1%

Blurred vision (4-10%)

Cataract (4-10%)

Conjunctivitis (4-10%)

Decreased visual acuity (4-10%)

Headache (4-10%)

Hypertension (4-10%)

Infection (4-10%)

Itching (4-10%)

Frequency Not Defined

Ocular irritation

Blepharitis

Keratitis

Ocular pain

Discharge (e.g., crusting)

Foreign body sensation

Dry eyes

Eyelid erythema

Blepharoptosis

Decreased corneal sensitivity

Diplopia

Cystoid macular edema

Pseudopemphigoid

Choroidal detachment following filtration surgery

Epiphora

Photophobia

Conjunctival injection

Corneal fluorescein staining

Retinal vascular disorder

Ptosis

Previous
Next:

Warnings

Contraindications

Hypersensitivity to any component of this product; bronchial asthma; history of bronchial asthma; severe chronic obstructive pulmonary disease; sinus bradycardia; second or third degree atrioventricular block; overt cardiac failure; cardiogenic shock

Cautions

Observe patients receiving topical timolol and a systemic ß-adrenergic blocking agent concomitantly for potential additive effects on IOP and/or systemic effects of ß-adrenergic blockade

Severe respiratory reactions and cardiac reactions, including death due to bronchospasm in patients with asthma, and rarely death in association with cardiac failure, reported following systemic or ophthalmic administration of timolol maleate

Sympathetic stimulation may be essential for support of the circulation in individuals with diminished myocardial contractility, and its inhibition of beta-adrenergic receptor blockade may precipitate more severe failure

In Patients Without a history of cardiac failure continued depression of myocardium with beta-blocking agents over a period of time can, in some cases, lead to cardiac failure; at first sign or symptom of cardiac failure, therapy should be discontinued

Patients with chronic obstructive pulmonary disease (e.g., chronic bronchitis, emphysema) of mild or moderate severity, bronchospastic disease, or a history of bronchospastic disease (other than bronchial asthma or a history of bronchial asthma, in which timolol is contraindicated) should, in general, not receive beta-blockers

Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents; beta-adrenergic receptor blocking agents may mask signs and symptoms of acute hypoglycemia

Beta-adrenergic blocking agents may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism; patients suspected of developing thyrotoxicosis should be managed carefully to avoid abrupt withdrawal of beta-adrenergic blocking agents that might precipitate thyroid storm

Because of potential effects of beta-adrenergic blocking agents on blood pressure and pulse, these agents should be used with caution in patients with cerebrovascular insufficiency; if signs or symptoms suggesting reduced cerebral blood flow develop following initiation of therapy, alternative therapy should be considered

There have been reports of bacterial keratitis associated with use of multiple-dose containers of topical ophthalmic products; these containers had been inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of ocular epithelial surface

Choroidal detachment after filtration procedures has been reported with the administration of aqueous suppressant

In patients with angle-closure glaucoma, the immediate objective of treatment is to reopen the angle; this requires constricting the pupil; timolol maleate has little or no effect on the pupil; timolol should not be used alone in the treatment of angle-closure glaucoma

While taking beta-blockers, patients with a history of atopy or a history of severe anaphylactic reactions to a variety of allergens may be more reactive to repeated accidental, diagnostic, or therapeutic challenge with such allergens; such patients may be unresponsive to usual doses of epinephrine used to treat anaphylactic reactions

Beta-adrenergic blockade has been reported to potentiate muscle weakness consistent with certain myasthenic symptoms (e.g., diplopia, ptosis, and generalized weakness); timolol has been reported rarely to increase muscle weakness in some patients with myasthenia gravis or myasthenic symptoms

Remove contact lens prior to administration

Major surgery

  • Some authorities recommend gradual withdrawal of beta-adrenergic receptor blocking agents in patients undergoing elective surgery; may augment risk of general anesthesia in surgical procedures
  • Some patients receiving beta-adrenergic receptor blocking agents have experienced protracted severe hypotension during anesthesia; difficulty in restarting and maintaining heartbeat also reported
  • In patients undergoing elective surgery; gradual withdrawal of beta-adrenergic receptor blocking agents recommended; in patients undergoing elective surgery, some authorities recommend gradual withdrawal of beta-adrenergic receptor blocking agents; if necessary during surgery, effects of beta-adrenergic blocking agents may be reversed by sufficient doses of adrenergic agonists
Previous
Next:

Pregnancy & Lactation

Pregnancy Category: C

Lactation: Secreted in breast milk; Mfr advises against breast feeding (AAP Committee states compatible with breast feeding)

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.

Previous
Next:

Pharmacology

Mechanism of Action

Nonselective beta-adrenergic receptor blocker; reduces IOP by reducing production of aqueous humor

Pharmacokinetics

Absorption: Minimal systemic absorption detected

Onset: 30 min

Peak effect: 1-2hr

Duration: <24 hr

Previous
Next:

Images

BRAND FORM. UNIT PRICE PILL IMAGE
Timoptic ophthalmic (eye)
-
0.5 % drops
Timoptic ophthalmic (eye)
-
0.5 % drops
Timoptic ophthalmic (eye)
-
0.25 % drops
timolol oral
-
20 mg tablet
timolol oral
-
10 mg tablet
timolol oral
-
10 mg tablet
timolol oral
-
5 mg tablet
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % solution
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.25 % solution
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.5 % drops
timolol maleate ophthalmic
-
0.25 % drops
timolol maleate ophthalmic
-
0.5 % solution
Timoptic-XE ophthalmic (eye)
-
0.25 % solution
Istalol ophthalmic (eye)
-
0.5 % drops
Istalol ophthalmic (eye)
-
0.5 % drops

Copyright © 2010 First DataBank, Inc.

Previous
Next:

Patient Handout

Select a drug:
Patient Education
timolol oral

TIMOLOL - ORAL

(TIH-moe-lole)

COMMON BRAND NAME(S): Blocadren

WARNING: Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, your doctor may direct you to gradually decrease your dose over 1 to 2 weeks.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Seek immediate medical attention if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.

USES: Timolol is used with or without other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This medication is also used after a heart attack to help prevent another heart attack from occurring.This medication belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural chemicals in your body such as epinephrine on the heart and blood vessels. This effect lowers the heart rate, blood pressure, and strain on the heart.This medication is also used to prevent migraine headaches.

HOW TO USE: See also Warning section.Take this medication by mouth with or without food, usually once or twice a day or as directed by your doctor.Dosage is based on your medical condition and response to treatment. For the treatment of high blood pressure, do not take more than 60 milligrams a day. For the prevention of migraines, do not take more than 30 milligrams a day.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this drug. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.To prevent chest pain or migraine headaches, it is very important to take this medication regularly as prescribed. This drug should not be used to treat chest pain or migraines when they occur. Use other medications to relieve sudden attacks as directed by your doctor (for example, nitroglycerin tablets placed under the tongue for chest pain, "triptan" drugs such as sumatriptan for migraines). Consult your doctor or pharmacist for details.Tell your doctor if your condition does not improve or if it worsens (for example, if your routine blood pressure readings remain high or increase, if your chest pain or migraines occur more often).

SIDE EFFECTS: See also Warning and Precautions sections.Tiredness, slow heartbeat, and dizziness may occur. Decreased sexual ability has been reported rarely. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: very slow heartbeat, severe dizziness, fainting, blue fingers/toes, trouble breathing, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), mental/mood changes (such as confusion, mood swings, depression).A very serious allergic reaction to these drugs is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking timolol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as a slow heartbeat, second- or third-degree atrioventricular block), heart failure, breathing problems (such as asthma, chronic bronchitis, emphysema), kidney disease, liver disease, overactive thyroid disease (hyperthyroidism), serious allergic reactions including those needing treatment with epinephrine, blood circulation problems (such as Raynaud's disease, peripheral vascular disease), mental/mood disorders (such as depression), a certain muscle disease (myasthenia gravis).This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist that you are taking this medication.If you have diabetes, this product may mask the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness and sweating, are unaffected by this drug. This product may also make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be at greater risk for low blood sugar (hypoglycemia), especially if they are vomiting or not eating regularly. To help prevent low blood sugar, feed children on a regular schedule. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, seizures), stop this medication and tell the doctor right away.Older adults may be more sensitive to the side effects of this drug, including dizziness and tiredness.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. Discuss the risks and benefits with your doctor before breast-feeding.

DRUG INTERACTIONS: See also Precautions section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with these drugs are: fingolimod, drugs affecting liver enzymes that remove timolol from your body (such as quinidine, SSRI antidepressants such as fluoxetine).Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very slow heartbeat, severe dizziness, severe weakness, fainting, trouble breathing.

NOTES: Do not share this medication with others.Talk with your doctor about making changes to your lifestyle that may help this medication work better (such as stress reduction programs, exercise, and dietary changes).Have your blood pressure and pulse (heart rate) checked regularly while taking this medication. Learn how to check your own blood pressure and pulse at home, and share the results with your doctor.Laboratory and/or medical tests should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised January 2022. Copyright(c) 2022 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Previous
Next:

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.

Adding plans allows you to:

  • 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.
Additional Offers
Email to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Email Forms to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Previous
Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.