Timolol Ophthalmic

Timolol Ophthalmic is a prescription medication used for the treatment of ocular hypertension. 

• Timolol Ophthalmic is available under various brand names: Timoptic, Timoptic in Ocudose, Timoptic XE, Betimol, Istalol

Common side effects of Timolol Ophthalmic include:

• burning or stinging in the eye,
• dry eyes,
• itching in the eye,
• feeling like something is in the eye,
• red or puffy eyelids, and
• headache

Serious side effects of Timolol Ophthalmic include:

• wheezing,
• chest pain,
• trouble breathing,
• slow heartbeats,
• lightheadedness,
• muscle weakness,
• depression,
• confusion,
• hallucinations,
• unusual thoughts or behavior,
• numbness or cold feeling in your hands and feet,
• severe stinging or burning after using the eye drops,
• eye swelling, redness, severe discomfort, crusting or drainage,
• blurred vision,
• tunnel vision,
• eye pain, and
• seeing halos around lights

Rare side effects of Timolol Ophthalmic include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Ophthalmic solution

• 0.25%
• 0.5%

Gel-forming solution

• 0.25%
• 0.5%

Ocular Hypertension

Adult dosage

• 1 drop affected eye(s) every 12 hours 0.25%, if not effective increase 0.5% 1 drop every 12 hours THEN
• Decrease to 1 drop/day if IOP controlled
• XE formulation (0.25% or 0.5%): 1 drop once daily

Pediatric dosage

Below 2  years

• Safety and efficacy not established

Above 2 years

• 1 drop affected eye(s) every 12 hours 0.25%, if not effective increase 0.5% 1 drop every 12 hours THEN
• Decrease to 1 gtt/day if IOP controlled

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Timolol Ophthalmic has no noted severe interactions with any other drugs.
• Timolol Ophthalmic has no noted serious interactions with any other drugs.
• Timolol Ophthalmic has no noted moderate interactions with any other drugs.
• Timolol Ophthalmic has no noted minor interactions with any other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

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

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Timolol Ophthalmic?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Timolol Ophthalmic?”

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 the 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, were reported following systemic or ophthalmic administration of timolol maleate
• Sympathetic stimulation may be essential for the support of 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 the myocardium with beta-blocking agents over some time can, in some cases, lead to cardiac failure; at the 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 the 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 a thyroid storm
• Because of the 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 the 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 the ocular epithelial surface
• Choroidal detachment after filtration procedures has been reported with the administration of an 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 challenges 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 lenses before administration
• Major surgery
  • Some authorities recommend gradual withdrawal of beta-adrenergic receptor blocking agents in patients undergoing elective surgery; this may augment the 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 was 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

Pregnancy & Lactation

• Use with caution if the benefits outweigh the risks during pregnancy
• Lactation
  • Secreted in breast milk; Mfr advises against breastfeeding (AAP Committee states compatible with breastfeeding)