TIMOLOL

COMMON BRAND NAME(S): Blocadren

GENERIC NAME(S): TIMOLOL MALEATE

Description: Timolol is a non-selective β-adrenergic receptor blocker. It is though that it reduces aqueous humour formation. β-blockade also causes lowering of BP.

Onset: Ophth: 30 min. Oral: 15-45 min.

Duration: Ophth: 24 hr. Oral: Approx 4 hr.

Pharmacokinetics:

Absorption: Oral: Almost completely absorbed from the GI tract (approx 90%). Oral bioavailability: 50%. Time to peak plasma concentration: Approx 1-2 hr. Ophth: Found in plasma at low concentrations.

Distribution: Crosses the placenta and enters breast milk. Volume of distribution: 1.7 L/kg. Plasma protein binding: 60%.

Metabolism: Extensively metabolised via CYP2D6 isoenzyme.

Excretion: Via urine (as metabolites and unchanged drug). Plasma half-life: 4 hr.

Uses

Timolol, a beta blocker, treats high blood pressure (hypertension) with or without other medications. This medication can also prevent another heart attack from occurring. It works by lowering the heart rate, blood pressure, and strain on the heart. This medication can also prevent migraine headachesand chest pain(chronic stable angina).

How to use timolol

See also Warning section.

Take this medication by mouth with or without food, usually once or twice a day or as directed by your doctor.

Dosage is based on your medical condition and response to treatment. For the treatment of high blood pressure, do not take more than 60 milligrams a day. For the prevention of migraines, do not take more than 30 milligrams a day.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this drug. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

To prevent chest pain or migraine headaches, it is very important to take this medication regularly as prescribed. This drug should not be used to treat chest pain or migraines when they occur. Use other medications to relieve sudden attacks as directed by your doctor (for example, nitroglycerin tablets placed under the tongue for chest pain, “triptan” drugs such as sumatriptan for migraines). Consult your doctor or pharmacist for details.

Tell your doctor if your condition does not improve or if it worsens (for example, if your routine blood pressure readings remain high or increase, if your chest pain or migraines occur more often).

Warnings

Do not stop taking this medication without consulting your doctor.

Temporarily limit physical activity when gradually stopping this medication to decrease strain on the heart.

Side Effects

Tell your doctor or pharmacist promptly if any of these effects persist or worsen:

tiredness
slow heartbeat
dizziness
decreased sexual ability

This drug may reduce blood flow to your hands and feet, causing them to feel cold.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

very slow heartbeat
severe dizziness
fainting
blue fingers/toes
trouble breathing
new or worsening symptoms of heart failure (such as swelling ankles/feet, severe tiredness, shortness of breath, unexplained/sudden weight gain)
mental/mood changes (such as confusion, mood swings, depression)

A very serious allergic reaction to this drug is rare.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Precautions:

Allergic reaction to this medication
Patients with:
- certain types of heart rhythm problems (such as a slow heartbeat, second- or third-degree atrioventricular block)
- severe heart failure
- breathing problems (such as asthma, chronic bronchitis, emphysema)
- diabetes
Patients with medical history of:
- treated stable heart failure
- kidney disease
- liver disease
- overactive thyroid disease (hyperthyroidism)
- serious allergic reactions including those needing treatment with epinephrine
- blood circulation problems (such as Raynaud’s disease, peripheral vascular disease)
- mental/mood disorders (such as depression)
- a certain muscle disease (myasthenia gravis)
Tell your doctor or dentist that you are taking this medication before having surgery
This drug may make you dizzy
older adults may be more sensitive to dizziness and tiredness
This medication should be used only when clearly needed during pregnancy
Discuss the risks and benefits with your doctor before breast-feeding

Consult your doctor regarding the precautions mentioned above.

Interactions:

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of fingolimod and drugs affecting liver enzymes that remove timolol from your body (such as quinidine, SSRI antidepressants such as fluoxetine).

Check the labels on all your medicines (such as cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs such as ibuprofen for pain/fever reduction) because they may contain ingredients that could increase your blood pressure or heart rate. Ask your pharmacist about using those products safely.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Overdose & Brands

Overdose:

If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include: very slow heartbeat, severe dizziness, severe weakness, fainting, trouble breathing.

Notes

Do not share this medication with others.

Talk with your doctor about making changes to your lifestyle that may help this medication work better (such as stress reduction programs, exercise, and dietary changes).

Have your blood pressure and pulse (heart rate) checked regularly while taking this medication. Learn how to check your own blood pressure and pulse at home, and share the results with your doctor.

Laboratory and/or medical tests should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Brands:

Available Brands

Celsus Timolol Maleate [ Ashford ]
Optamol [ Marck Biosciences ]
Timoptol [ Merck Sharp & Dohme ]

Also marketed as

Elevex [ SENSOMED ]
Glaucare [ FDC Limited ]
Glocure-Opta [ Pascual ]
I-Supres [ Medilife ]
Normopres [ Vista Pharma ]
Nyolol [ Novartis Healthcare ]
Ocuper [ Ashford ]
Oftan [ Santen ]
Timabak 0.5% [ Thea ]
Vendizol [ Ashford ]