timolol
Timolol gel is a beta blocker that's used to lower pressure within the eye and treat glaucoma. It's a gel-forming eye drop that can be used by itself or together with other eye drops that aren't beta blockers. The brand name, Timoptic-XE, was discontinued, but the generic version is still available. The usual dosage is a drop of timolol gel in the eye(s) once a day. A common side effect is blurry vision, but it often doesn't last longer than 5 minutes after using the medication.
What is Timolol gel?
What is Timolol gel used for?
- High pressure in the eye caused by ocular hypertension (high pressure inside the eye) or open-angle glaucoma (the most common type of glaucoma)
How Timolol gel works
Timolol gel is a beta blocker that lowers the amount of fluid in the eye. When there's less fluid inside the eye, the eye pressure goes down.
This particular timolol product becomes a gel when it makes contact with your eye, and it gets washed away by your tears.
Drug facts
Side effects of Timolol gel
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Temporary blurry vision
- Temporary burning or stinging in the eye after using
Less Common Side Effects
- Red eyes
- Crusty lashes
- Eye pain
- Feeling like there's something in your eye
- Itchy eyes
- More tears than usual
- Headache
- Dizziness
- Common cold symptoms
Timolol gel serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Trouble breathing: shortness of breath, wheezing, chest tightness
- Heart failure: shortness of breath; fatigue; swelling in the legs, ankles and feet
- Allergic reactions: rash around your eyes or face, closing of the throat, hives, swelling
More on Timolol gel side effects
The following Timolol gel side effects have also been reported
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
Chest pain or discomfort
lightheadedness, dizziness, or fainting
shortness of breath
slow or irregular heartbeat
unusual tiredness
Rare
Noisy breathing
small clicking, bubbling, or rattling sounds in the lung when listening with a stethoscope
swelling of hands, ankles, feet, or lower legs
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blurred vision
continuing ringing or buzzing or other unexplained noise in ears
headache
hearing loss
nervousness
pounding in the ears
sweating
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:
Rare
Acid or sour stomach
belching
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
decreased interest in sexual intercourse
feeling of constant movement of self or surroundings
inability to have or keep an erection
indigestion
lack or loss of strength
loss in sexual ability, desire, drive, or performance
sensation of spinning
stomach discomfort, upset, or pain
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.
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Pros and cons of Timolol gel
Pros
- Works well to treat high eye pressure
- Only used once daily
- Can use in people as young as 2 years of age
- Lower-cost generic version available
Cons
- Common to have blurry vision as a side effect
- Shouldn't use if you have asthma or other lung problems
- Risk of similar side effects as timolol tablets since some medication can absorb into your bloodstream
- Hasn't been studied in people who wear contact lenses
Pharmacist tips for Timolol gel
- Wash your hands before each time you use timolol gel. Don't let the bottle tip touch your eye or any other surface, and avoid touching the tip with your hands. This prevents the medication from getting contaminated with germs and is helpful for avoiding eye infections.
- Remove your contact lenses before applying timolol gel. Wait 15 minutes after you use the medication to put your lenses back in. This medication wasn't studied for use in people who wear contact lenses, but it contains a preservative that might cause damage to your lenses.
- Before each time you use timolol gel, turn the bottle upside down and shake it once.
- If you need to use other eye drop medications in addition to timolol gel, wait 10 minutes after you use them before you place timolol gel into your eye(s).
- It's not easy to tell whether your eye pressure is improving at home. Make sure to use timolol gel as prescribed, even if you don't notice any difference in your symptoms or vision right away.
- Don't try to make the hole on the tip of the timolol gel bottle larger. The tip makes sure one drop comes out at a time, and making a larger hole can cause you to use too much medication.
Common questions about Timolol gel
When it's used as an eye drop, timolol gel mainly lowers the pressure in your eyes. But some of the medication might get absorb into your bloodstream and affect other areas of the body like the heart. So it's possible that the medication can lower your blood pressure. In addition, low heart rate can be a side effect of taking timolol tablets by mouth, so it's possible that the eye drops can also lower heart rate. Let your primary care provider know if you feel dizzy or have a slower pulse and it bothers you or makes it harder for you to do normal daily activities.
You don't need to refrigerate timolol gel. It's best to keep it at room temperature away from light. Also make sure to keep the bottle in an upright position. Don't freeze timolol gel because this could damage the medication.
No, timolol gel isn't an over-the-counter medication. You'll need a prescription from your optometrist or ophthalmologist for glaucoma eye drops like timolol gel.
Hair loss isn't a common side effect of timolol gel, but some people have reported this effect while using timolol (both the eye drops and the tablets). Tell your primary care provider about new or worsening hair loss after you start using timolol gel. They might want to examine you to see whether there are other possible causes for your hair loss before recommending a treatment option or before switching you to a different eye pressure-lowering medication.
Not typically. Keep in mind that weight loss can be a potential side effect of taking timolol tablets by mouth. And although timolol gel works locally in your eyes, it's possible for some of the medication to get absorbed into your bloodstream and cause similar side effects as timolol tablets. Talk with your primary care provider if you notice concerning changes to your weight while you're using this medication.
Beta blocker medications like timolol gel can cause the airways to become narrower and make it harder to breathe. This can cause any lung conditions to worsen, which is why timolol gel isn't usually recommended for people with asthma or chronic obstructive pulmonary disease (COPD). Although timolol gel is used on the eyes and mainly works in the eyes, some medication might get absorbed into your bloodstream and affect your lungs. For this reason, make sure your care team knows if you've ever had any lung conditions or breathing problems before you start using timolol gel.
There are a few different timolol eye drop medications that are all used to lower pressure in the eyes. Timolol gel is a gel-forming solution that's used once daily. Generic timolol eye drops (formerly known as Timoptic) is a once- or twice-daily eye drop. Betimol is used twice daily, and its timolol has a slightly different chemical structure than the others. Talk to your optometrist or ophthalmologist if you're unsure which timolol product you have or how often you need to use it.
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Risks and warnings for Timolol gel
Timolol gel can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Higher risk for heart failure
- Risk factors: Congestive heart failure | Second- or third-degree heart block
In rare cases, some people developed heart failure while they used beta-blocking medications like timolol gel. People who already have heart failure might be at risk for worsening heart problems with this medication. Tell your healthcare team about your medical history. And talk to your primary care provider if you notice swelling in your feet or ankles, a fast or irregular pulse, or shortness of breath when you lie down or exercise. These might be signs of heart problems.
Not recommended for people with breathing problems
- Risk factors: History of asthma | History of chronic obstructive pulmonary disease (COPD) | History of other lung problems
Beta blocker medications like timolol gel usually aren't recommended for people with lung problems, like asthma and COPD. This is because beta blockers can cause the airways to become narrower, which can make it harder to breathe. But the risk for breathing problems specifically with timolol gel isn't well known. So make sure your healthcare team knows if you have or have ever had any lung problems or conditions before you start using this medication to check whether it's safe for you.
Hidden symptoms of low blood sugar
- Risk factors: Diabetes
Beta blockers can cause people with diabetes to not notice symptoms of low blood sugar, except for sweating and dizziness. It's possible for some timolol gel to be absorbed into your bloodstream and cause this effect. So though rare, it's important to be aware of this risk. Talk to your primary care provider to see whether you should check your blood sugar more often if you're using timolol gel.
Hidden symptoms of overactive thyroid
Beta blockers can cause people with an overactive thyroid to not recognize the signs of hyperthyroidism, such as a fast heart rate. It's possible for some timolol gel to be absorbed into your bloodstream and cause this effect. Although rare, it's good to be aware of this risk. Make sure your primary care provider knows that you're using timolol gel so they can monitor your thyroid problem more closely.
Worsening of myasthenia gravis
In some rare cases, timolol gel can worsen symptoms like muscle weakness in people who have myasthenia gravis. Watch out for worsening symptoms if you have myasthenia gravis and let the specialist who's monitoring your condition know if this happens to you.
Timolol gel dosage
Bottle of gel| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5ml of 0.25% | 1 bottle | $44.72 | $44.72 |
| 5ml of 0.5% | 1 bottle | $43.57 | $43.57 |
Typical dosage for Timolol gel
The typical dose is 1 drop in the affected eye(s) once daily.
Interactions between Timolol gel and other drugs
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
- Ceritinib
- Crizotinib
- Dronedarone
- Fenoldopam
- Fingolimod
- Formoterol
- Indacaterol
- Iobenguane I 131
- Iohexol
- Lacosamide
- Levalbuterol
- Olodaterol
- Oxymetazoline
- Paroxetine
- Ponesimod
- Rivastigmine
- Salmeterol
- Terbutaline
- 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.
- Aceclofenac
- Acemetacin
- Amtolmetin Guacil
- Aspirin
- Bromfenac
- Bufexamac
- Celecoxib
- Choline Salicylate
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Pranoprofen
- Proglumetacin
- Propyphenazone
- Proquazone
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- St John's Wort
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Valdecoxib
How much does Timolol gel cost?
Timolol gel contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Timolol gel will not be safe for you to take.
- Asthma
- Severe chronic obstructive pulmonary disease (COPD)
- Sinus bradycardia (slow heart rate)
- Second- or third-degree heart block
- Heart failure
- Cardiogenic shock
What are alternatives to Timolol gel?
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