Loading…
TIMOLOL is a brand name for Timolol. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Timolol maleate ophthalmic solution is a beta-adrenergic receptor antagonist used topically for the reduction of elevated intra-ocular pressure in various conditions including patients with ocular hypertension; patients with chronic open-angle glaucoma including patients with aphakia; and some patients with secondary…
Verbatim from this product's MHRA label. Tap a section to expand.
25%w/v in the affected eye(s) twice daily. 5% w/v in the affected eye twice daily. If required, timolol maleate may be used with miotics, adrenaline or systemically administered carbonic anhydrous inhibitors. 4 ‘Special Warnings and Precautions for Use’) When using nasolacrimal occlusion or closing the eyelids for 2 minutes, the systemic absorption is reduced.
This may result in a decrease in systemic side effects and an increase in local activity. Intra-ocular pressure should be reassessed approximately four weeks after starting treatment because response to Timolol Eye Drops may take a few weeks to stabilise.
Provided that intra-ocular pressure is maintained at satisfactory levels, many patients can then be placed on once-a-day therapy. 25% w/v started the next day with one drop twice daily in the affected eye(s). 5% w/v twice daily. 25% w/v in the affected eye(s) twice daily.
On the following day the previous agent should be discontinued and Timolol Eye Drops continued. 5% w/v twice daily if the clinical response is inadequate. Paediatric Population Due to limited data, Timolol could only be recommended for use in Primary congenital and primary juvenile glaucoma for a transitional period while decision is made on a surgical approach and in case of failed surgery while awaiting further options.
Posology:
Clinicians should strongly evaluate the risks and benefits when considering medical therapy with Timolol in paediatric patients. A detailed paediatric history and examination to determine the presence of systemic abnormalities should precede the use of Timolol.
1). However, if benefit outweighs the risk, it is recommended to use the lowest active agent concentration available once daily. If IOP could not be sufficiently controlled, a careful up titration to a maximum of two drops daily per affected eye has to be considered.
If applied twice daily, an interval of 12 hours should be preferred. Furthermore the patients, especially neonates, should be strongly observed after the first dose for one to two hours in the office and closely monitored for ocular and systemic side effects until surgery is performed.
1% active agent concentration might already be sufficient.
Like other topically applied ophthalmic drugs, Timolol Maleate is absorbed into the systemic circulation. This may cause similar undesirable effects as seen with systemic beta blocking agents. Incidence of systemic ADRs after topical ophthalmic administration is lower than for systemic administration.
Listed adverse reactions include reactions seen within the class of ophthalmic beta-blockers. Timolol Eye Drops is usually well tolerated. The following adverse reactions have been reported with ocular administration of this or other timolol maleate formulations, either in clinical trials or since the drug has been marketed.
Additional side effects have been reported in clinical experiences with systemic timolol maleate, and may be considered potential effects of ophthalmic timolol maleate: Blood and lymphatic system disorders Non-thrombocytopenic purpura.
Immune system disorders:
Systemic allergic reactions including angioedema, urticaria, localized and generalized rash, systemic lupus erythematosus, pruritus, anaphylactic reaction.
Metabolism and nutrition disorders:
Hypoglycaemia and hyperglycaemia.
Psychiatric disorders:
Insomnia, depression, nightmares, memory loss, increased dreaming, hallucination.
Nervous system disorders:
Syncope, cerebrovascular accident, cerebral ischemia, increases in signs and symptoms of myasthenia gravis, dizziness, diminished concentration, vertigo, paraesthesia, and headache. g. 4 Special warnings and special precautions for use).
Visual disturbances, including refractive changes (due to withdrawal of miotic therapy in some cases). Decreased corneal sensitivity, dry eyes, corneal erosion ptosis, and diplopia.
Like other topically applied ophthalmic agents Timolol Maleate is absorbed systemically. Due to beta-adrenergic component, Timolol Maleate, the same types of cardiovascular, pulmonary and other adverse reactions seen with systemic beta- adrenergic blocking agents may occur.
Incidence of systemic ADRs after topical ophthalmic administration is lower than for systemic administration. 2. g. coronary heart disease, Prinzmetal's angina and cardiac failure) and hypotension therapy with beta- blockers should be critically assessed and the therapy with other active substances should be considered.
Patients with cardiovascular diseases should be watched for signs of deterioration of these diseases and of adverse reactions. Due to its negative effect on conduction time, beta blockers should only be given with caution to patients with first degree heart block.
e. severe forms of Raynaud’s disease or Raynaud’s syndrome) should be treated with caution.
Respiratory disorders:
Respiratory reactions, including death due to bronchospasm in patients with asthma have been reported following administration of some ophthalmic beta-blockers. Timolol Eye Drops should be used with caution, in patients with mild/moderate chronic obstructive pulmonary disease (COPD) and only if the potential benefit outweighs the potential risk.
Hypoglycaemia/diabetes Beta-blockers should be administered with caution in patients subject to spontaneous hypoglycaemia or to patients with labile diabetes, as beta-blockers may mask the signs and symptoms of acute hypoglycaemia.
Beta-blockers may also mask the signs of hyperthyroidism.
Corneal diseases:
Ophthalmic β-blockers may induce dryness of eyes. Patients with corneal diseases should be treated with caution.
Hypersensitivity to the active substance (substances), or to any of the excipients. Reactive airway disease including bronchial asthma or a history of bronchial asthma, severe chronic obstructive pulmonary disease. Sinus bradycardia, sick sinus syndrome sino-atrial block, second or third degree atrioventricular block not controlled with pace-maker.
Overt cardiac failure, cardiogenic shock.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Timolol in United Kingdom.
Know a brand we are missing in United Kingdom? Suggest a brand →
Brand names are compiled from public regulatory records for active-ingredient mapping only. Drugvu is not affiliated with any manufacturer. This is not medical advice.
Method of administration:
To limit potential adverse effects only one drop should be instilled per dosing time. g. for 3 - 5 minutes) after instillation of drops. 2. 2 “Paediatric Population”)”. Use in the elderly There has been wide experience with the use of timolol maleate in elderly patients.
The dosage recommendations above reflect the clinical data derived from this experience.
Cardiac disorders:
B Bradycardia, chest pain, palpitations, oedema, arrhythmia, congestive heart failure, claudication, sino-atrial block, pulmonary oedema, worsening of arterial insufficiency, worsening of angina pectoris, vasodilation, atrioventricular block, cardiac arrest, cardiac failure.
Vascular disorders:
Ocular: Hypotension, Raynaud's phenomenon, cold hands and feet.
Respiratory, thoracic, and mediastinal disorders:
Bronchospasm (predominantly in patients with pre-existing bronchospastic disease), dyspnoea, cough, respiratory failure, rales, Gastrointestinal disorders: Dysgeusia, nausea, dyspepsia, diarrhoea, dry mouth, abdominal pain, vomiting.
Skin and subcutaneous tissue disorders:
Alopecia, psoriasiform rash or exacerbation of psoriasis, skin rash, sweating, exfoliative dermatitis Musculoskeletal and connective tissue disorders: Myalgia, arthralgia Ear and labyrinthine disorders Tinnitus Reproductive system and breast disorders: Sexual dysfunction, decreased libido, Peyronie’s disease, impotence, micturition difficulties.
General disorders and administration site conditions:
Asthenia/fatigue, extremity pain, decreased exercise tolerance.
Other beta-blocking agents:
The effect on intra-ocular pressure or the known effects of systemic beta-blockade may be potentiated when Timolol Maleate is given to the patients already receiving a systemic beta-blocking agent. The response of these patients should be closely observed.
5). Anaphylactic reactions While taking beta-blockers, patients with history of atopy or a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated challenge with such allergens and unresponsive to the usual dose of adrenaline used to treat anaphylactic reactions.
g. timolol, acetazolamide) after filtration procedures. g. of adrenaline. The anaesthesiologist should be informed when the patient is receiving Timolol Maleate. If timolol maleate ophthalmic solution is used to reduce elevated intra-ocular pressure in angle closure glaucoma they should be used with a miotic and not alone.
There have been reports of skin rashes and/or dry eyes associated with the use of beta-adrenergic receptor blocking drugs. The reported incidence is small and in most cases the symptoms have cleared when treatment was withdrawn. Discontinuation of the drug should be considered if any such reaction is not otherwise explicable.
Cessation of therapy involving beta-blockade should be gradual. Timolol Eye Drops contain benzalkonium chloride as a preservative, which may be deposited in soft contact lenses. Therefore, timolol eye drops should not be used while wearing soft contact lenses.
The lenses should be removed before application of the drops and not reinserted earlier than 15 minutes after use. Timolol Eye Drops have generally been well tolerated in glaucoma patients wearing conventional hard contact lenses. Timolol maleate ophthalmic solution has not been studied in patients wearing lenses made of material other than polymethylmethacrylate (PMMA) which is used to make hard contact lenses.
2). It is important to notify the parents of potential side effects so they can immediately discontinue the drug therapy. Signs to look for are for example coughing and wheezing. Because of the possibility of apnoea and Cheyne-Stokes breathing, the drug should be used with extreme caution in neonates, infants and younger children.
A portable apnoea monitor may also be helpful for neonates on Timolol.