timolol
Timolol is an eye drop medication that's used to lower pressure within the eye and treat glaucoma. This medication belongs to the drug class called beta blockers. Timolol can be used by itself or together with other eye drops. The usual dosage is a drop of timolol into the eye(s) once or twice a day. Common side effects include burning or stinging after you put in the eye drops, but this is generally a temporary feeling. Although the brand name Timoptic was discontinued, the generic version is still available.
What is Timolol?
What is Timolol 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 works
Timolol 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.
Drug facts
Side effects of Timolol
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 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
- Changes in vision (e.g., double vision)
- Headache
- Dizziness
Timolol 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 side effects
The following Timolol 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
Pros
- Works well to treat high eye pressure
- Usually only need to take once or twice daily
- Lower-cost generic version available
Cons
- Can cause some burning and stinging in the eye
- Shouldn't use if you have asthma or other lung problems
- Shouldn't take if you have uncontrolled heart failure, second- or third-degree heart block, or sinus bradycardia (a chronically low heart rate)
Pharmacist tips for Timolol
- Wash your hands before putting timolol drops in your eyes. Don't let the dropper tip touch your eye or any other surface, and don't touch the tip with your hands. This will prevent the solution from getting contaminated with germs, which can help you avoid eye infections.
- If you wear contacts, remove them before you use timolol. Then, wait 15 minutes to put your contacts back in your eyes.
- After placing a drop of timolol in the eye, close your eye and press one finger to the inner corner of your eye by the nose and press lightly for 1 minute. This helps make sure your eye absorbs the drop.
- If you have other eye drop medications that you need to use in addition to timolol, wait 10 minutes between each drop to give your eyes time to absorb each medication.
- It's not easy to tell whether your eye pressure is improving at home. Make sure to use timolol as prescribed, even if you don't immediately notice any difference in your symptoms or vision.
- Don't try to make the hole on the timolol bottle tip larger. The tip is made to pre-measure your drop, and making a larger hole can cause you to use too much medication.
Common questions about Timolol
Glaucoma treatment with eye drops like timolol is usually long term, or for as long as the pressure in your eye is still too high. You'll probably need to continue taking timolol every day even if your eye pressure improves so that it stays this way (as long as you're not having bothersome side effects). You'll need eye exams periodically so your optometrist or ophthalmologist can keep checking your eye pressure.
When it's used as an eye drop, timolol mainly lowers the pressure in your eyes. But it's possible for some of the medication to absorb into your bloodstream and affect other areas of the body like the heart. If this happens, the medication might lower your blood pressure. Low heart rate is another common 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 notice dizziness or a slower heart rate and it bothers you or makes it harder for you to do normal daily activities.
No. You don't need to refrigerate timolol. It's best to store the eye drops at room temperature away from light and in an upright position. Never freeze timolol because this could damage the medication.
You can continue to use timolol until the expiration date that's written on the bottle. Expired medication might not work as well or can sometimes be harmful. It's best to throw away any expired timolol. Ask your optometrist or ophthalmologist for a new prescription, or ask your pharmacist for a refill.
After you place timolol into the eye, the pressure in your eye will start to go down within half an hour. It can take a few weeks for the pressure to be consistently lower while you're using this medication, so your optometrist or ophthalmologist will recheck your eye pressure after you've been using timolol for about 4 weeks.
No. Glaucoma eye drops like timolol are only available with a prescription from your optometrist or ophthalmologist.
Your optometrist or ophthalmologist might recommend that you take latanoprost (Xalatan) along with timolol to help lower the pressure in your eyes. These two medications work differently so using the two eye drops at the same time can be beneficial for your eye pressure. Latanoprost (Xalatan) is unique in that it helps fluid drain from inside the eye. If you're prescribed both medications, wait 10 minutes between each drop to give your eyes time to absorb each medication.
There are a few different eye products with timolol as the main ingredient, which can all lower the pressure in your eye. Timolol is a once- or twice-daily eye drop. Timolol gel-forming solution and Istalol (timolol) are used once daily. And Betimol contains timolol with a slightly different chemical structure than the others and is used twice daily. Talk to your optometrist or ophthalmologist if you're unsure which timolol medication you have or how often you need to use it.
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Risks and warnings for Timolol
Timolol 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 timolol. People who already have heart failure might be at risk for worsening heart problems with this medication. Tell your care team about your medical history. And talk to your 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 usually aren't recommended for people with lung problems, such as 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 isn't well known. 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 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.
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 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 whether you have thyroid problems before you start timolol.
Worsening of myasthenia gravis
In some rare cases, timolol can worsen symptoms like muscle weakness in people who have myasthenia gravis. Watch out for worsening symptoms if you have myasthenia gravis and let your care team know if this happens to you.
Timolol dosage
Eye dropper| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 15ml of 0.5% | 1 eye dropper | $9.96 | $9.96 |
| 5ml of 0.5% | 1 eye dropper | $8.28 | $8.28 |
| 10ml of 0.5% | 1 eye dropper | $7.65 | $7.65 |
| 15ml of 0.25% | 1 eye dropper | $12.43 | $12.43 |
| 5ml of 0.25% | 1 eye dropper | $7.60 | $7.60 |
| 10ml of 0.25% | 1 eye dropper | $12.70 | $12.70 |
| 2.5ml of 0.5% | 1 eye dropper | $36.91 | $36.91 |
Typical dosage for Timolol
The typical dose is 1 drop into the affected eye(s) twice daily.
If your eye pressure comes down and stays down, your dose might be lowered to 1 drop in the affected eye(s) once a day.
Interactions between Timolol 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 cost?
Timolol 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 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?
News about Timolol
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