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Timolol (Ophthalmic route)

Pronunciation:

TIM-oh-lol

Brand Names:

  • Betimol
  • Istalol
  • Timoptic Ocudose
  • Timoptic Ocumeter
  • Timoptic Ocumeter Plus
  • Timoptic-XE Ocumeter
  • Timoptic-XE Ocumeter Plus

Dosage Forms:

  • Solution
  • Gel Forming Solution

Classifications:

Therapeutic—

Antiglaucoma

Pharmacologic—

Beta-Adrenergic Blocker, Nonselective

Uses of This Medicine:

Timolol is used alone or together with other medicines to treat increased pressure in the eye that is caused by open-angle glaucoma or a condition called ocular (eye) hypertension. This medicine is a beta-blocker .

This medicine is available only with your doctor's prescription .

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of timolol in the pediatric population. Safety and efficacy have not been established .

Older adults—

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of timolol in the elderly .

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Albuterol
  • Amiodarone
  • Arformoterol
  • Bambuterol
  • Clenbuterol
  • Clonidine
  • Colterol
  • Crizotinib
  • Diltiazem
  • Dronedarone
  • Epinephrine
  • Fenoldopam
  • Fenoterol
  • Fingolimod
  • Fluoxetine
  • Formoterol
  • Hexoprenaline
  • Indacaterol
  • Isoetharine
  • Levalbuterol
  • Metaproterenol
  • Pirbuterol
  • Procaterol
  • Reproterol
  • Ritodrine
  • Salmeterol
  • Terbutaline
  • Tretoquinol
  • Tulobuterol
  • Verapamil
  • Vilanterol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acarbose
  • Aceclofenac
  • Acemetacin
  • Acetohexamide
  • Acetyldigoxin
  • Alfuzosin
  • Amlodipine
  • Amtolmetin Guacil
  • Arbutamine
  • Aspirin
  • Benfluorex
  • Bromfenac
  • Bufexamac
  • Bunazosin
  • Celecoxib
  • Chlorpropamide
  • Choline Salicylate
  • Cimetidine
  • Clonixin
  • Deslanoside
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Digitoxin
  • Digoxin
  • Dipyrone
  • Doxazosin
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Felodipine
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Guar Gum
  • Ibuprofen
  • Ibuprofen Lysine
  • Indomethacin
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Glulisine
  • Insulin Lispro, Recombinant
  • Ketoprofen
  • Ketorolac
  • Lacidipine
  • Lercanidipine
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Manidipine
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Metformin
  • Methyldopa
  • Metildigoxin
  • Mibefradil
  • Miglitol
  • Morniflumate
  • Moxisylyte
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Nicardipine
  • Nifedipine
  • Niflumic Acid
  • Nilvadipine
  • Nimesulide
  • Nimodipine
  • Nisoldipine
  • Nitrendipine
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Phenoxybenzamine
  • Phentolamine
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Pranidipine
  • Pranoprofen
  • Prazosin
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Quinidine
  • Repaglinide
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • St John's Wort
  • Sulindac
  • Tamsulosin
  • Tenoxicam
  • Terazosin
  • Tiaprofenic Acid
  • Tolazamide
  • Tolbutamide
  • Tolfenamic Acid
  • Tolmetin
  • Trimazosin
  • Troglitazone
  • Urapidil
  • Valdecoxib

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma or
  • Bradycardia (slow heartbeat) or
  • Chronic obstructive pulmonary disease (COPD), severe or
  • Heart block or
  • Heart failure—Should not use in patients with these conditions .
  • Blood vessel disease (especially blood vessels of the brain) or
  • Stroke, history of—Use with caution. This medicine may worsen these conditions .
  • Diabetes or
  • Hyperthyroidism (overactive thyroid) or
  • Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat .
  • Lung disease—Use with caution. May cause difficulty with breathing in patients with this condition .
  • Myasthenia gravis—May worsen symptoms of this condition, such as muscle weakness .

Proper Use of This Medicine:

Shake the regular eye drops well just before each use. If you are using the gel-forming eye drops, turn the bottle upside down and shake it once. You do not need to shake the gel-forming eye drops more than once .

To use the eye drops (solution and gel):

  • First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
  • Immediately after using the medicine, wash your hands to remove any medicine that may be on them.
  • To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed. Serious damage to the eye and possible loss of vision may result from using contaminated eye medicines .

If your doctor ordered two different eye medicines to be used together, wait at least 10 minutes after the regular eye drops before using the second medicine. This will help prevent the second medicine from “washing out” the first one. The gel-forming eye drops should always be the last medicine used if two medicines are ordered. Wait 10 minutes before using the gel-forming eye drops .

You should not use the regular eye drops if you have contact lenses in your eyes. Remove your contact lenses before you use this medicine. Wait at least 15 minutes after you use the medicine before putting the contact lenses back in .

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For glaucoma or ocular hypertension:
    • For ophthalmic gel-forming solution dosage form (eye drops):
      • Adults—One drop in the affected eye(s) once a day.
      • Children—Use and dose must be determined by your doctor .
    • For ophthalmic solution dosage form (eye drops):
      • Adults—One drop in the affected eye(s) two times a day.
      • Children—Use and dose must be determined by your doctor .

Missed dose—

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects .

If itching, redness, swelling, or other signs of eye or eyelid irritation occur, stop using this medicine and check with your doctor. These signs may mean that you are allergic to this medicine .

Timolol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing .

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests .

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery .

The gel-forming eye drops may cause blurred vision or other vision problems that last about 30 seconds to 5 minutes after you put them in your eye. If any of these occur, do not drive, use machines, or do anything else that could be dangerous if you are not able to see well. If these eye changes are bothersome, check with your doctor .

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Blurred vision
burning or stinging in eye
Less common
Arm, back, or jaw pain
blisters, hives, welts, or itching
blue lips, fingernails, or skin
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in vision
chest pain or discomfort
chest tightness or heaviness
confusion about identity, place, and time
continuing ringing or buzzing or other unexplained noise in ears
coughing that sometimes produces a pink frothy sputum
depression
difficult, fast, noisy breathing, sometimes with wheezing
difficulty in chewing, swallowing, or talking
dilated neck veins
discharge, excessive tearing
disturbed color perception
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
double vision
drooping eyelids
dry or itching eyes
extreme fatigue
false sense of well-being
fast, slow, irregular, pounding, or racing heartbeat or pulse
fear, nervousness
feeling of having something in the eye
fever and chills
flashes of light, floaters in vision
general feeling of discomfort or illness
hair loss
halos around lights
headaches
inability to speak
increased sweating
irregular, fast or slow, or shallow breathing
large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
lightheadedness, dizziness, or fainting
loss of vision
memory loss
mood swings
muscle or joint pain
muscle weakness
nausea
night blindness
no blood pressure or pulse
overbright appearance of lights
pain, tension, and weakness upon walking that subsides during periods of rest
pale skin
paleness or cold feeling in fingertips, toes, hands, and feet
personality changes
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
redness of skin
redness, pain, swelling or irritation of eye, eyelid, or inner lining of eyelid
seeing double
seeing, hearing, or feeling things that are not there
seizures
severe numbness, especially on one side of the face or body
severe or sudden headache
severe tiredness
shortness of breath or troubled breathing
skin irritation or rash, including rash that looks like psoriasis
slurred speech
sore throat
stopping of heart
sweating
swelling of face, fingers, feet, lower legs, and ankles
swollen glands
temporary blindness
tingling or pain in fingers or toes when exposed to cold
tunnel vision
unconsciousness
unusual tiredness or weakness
weakness in arm and/or leg on one side of the body, sudden and severe
weight gain
wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
Acid or sour stomach
belching
body aches or pain
diarrhea
dry mouth
ear congestion
hearing loss
heartburn
indigestion
lack or loss of strength
loss of appetite
loss of voice
nightmares
runny nose
sleepiness or unusual drowsiness
sleeplessness
sneezing
stomach discomfort, upset, or pain
stuffy nose
trouble sleeping
unable to sleep
weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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