What is Timoptic (timolol)?
Timoptic, Timoptic-XE, Timoptic in Ocudose (timolol) is a beta-adrenergic blocking agent (beta-blocker) that blocks the action of the sympathetic (adrenergic) nervous system, for example, on the heart.
In addition to its effect on the heart, timolol causes a reduction of the pressure within the eye (intraocular pressure). This effect may result from a reduction in production of the liquid (aqueous humor) within the eye. The precise mechanism of this effect is not known. The reduction in intraocular pressure reduces the risk of damage to the optic nerve and loss of vision in patients with glaucoma.
Common side effects of Timoptic include:
Serious side effects of Timoptic are rare and may include side effects seen with oral beta-adrenergic blockers such as:
- slow heart rate,
- low blood pressure,
- cold extremities, and
- shortness of breath or wheezing.
Drug interactions of Timoptic include oral beta-adrenergic blocking agents, for example, propranolol, atenolol, metoprolol, or carvedilol taken with Timoptic can result in additive effects and patients may experience excessively low blood pressure or reductions in heart rate. Combining calcium channel blockers with Timoptic may increase the risk of abnormal heart beats.
Although there are no human studies that have examined the effects of oral timolol on the fetus, animal studies have shown adverse effects. A physician must weigh the potential risks to the fetus against the potential benefits to the mother. It is unknown if the small amount of Timoptic that penetrates into the blood after administration into the eye affects the fetus.
Concentrations of timolol in breast milk can be three times those in the mother's blood after oral administration. It is unknown how much, if any, timolol appears in breast milk after administration into the eye. Ideally, patients taking Timoptic should avoid breastfeeding.
What are the important side effects of Timoptic (timolol)?
Common side effects include:
- blurred vision, and
- burning or stinging in the eye.
Ophthalmic timolol can cause irritation to the eye which may manifest as pain or dryness in some people.
Rarely, timolol eye drops can result in side effects that are seen with other oral beta adrenergic blockers. For example, persons can experience:
Timoptic (timolol) side effects list for healthcare professionals
The most frequently reported adverse experiences have been burning and stinging upon instillation (approximately one in eight patients).
The following additional adverse experiences have been reported less frequently with ocular administration of this or other timolol maleate formulations:
Body As A Whole
Bradycardia, arrhythmia, hypotension, hypertension, syncope, heart block, cerebral vascular accident, cerebral ischemia, cardiac failure, worsening of angina pectoris, palpitation, cardiac arrest, pulmonary edema, edema, claudication, Raynaud's phenomenon, and cold hands and feet.
Dizziness, increase in signs and symptoms of myasthenia gravis, paresthesia, somnolence, insomnia, nightmares, behavioral changes and psychic disturbances including depression, confusion, hallucinations, anxiety, disorientation, nervousness, and memory loss.
Masked symptoms of hypoglycemia in diabetic patients.
Signs and symptoms of ocular irritation including conjunctivitis, blepharitis, keratitis, ocular pain, discharge (e.g., crusting), foreign body sensation, itching and tearing, and dry eyes; ptosis; decreased corneal sensitivity; cystoid macular edema; visual disturbances including refractive changes and diplopia; pseudopemphigoid; choroidal detachment following filtration surgery; and tinnitus.
The following additional adverse effects have been reported in clinical experience with ORAL timolol maleate or other ORAL beta-blocking agents and may be considered potential effects of ophthalmic timolol maleate:
Body as a Whole
Worsening of arterial insufficiency, vasodilatation.
Nonthrombocytopenic purpura; thrombocytopenic purpura, agranulocytosis.
Pruritus, skin irritation, increased pigmentation, sweating
Vertigo, local weakness, diminished concentration, reversible mental depression progressing to catatonia, an acute reversible syndrome characterized by disorientation for time and place, emotional lability, slightly clouded sensorium, and decreased performance on neuropsychometrics.
Rales, bronchial obstruction.
What drugs interact with Timoptic (timolol)?
Although Timoptic used alone has little or no effect on pupil size, mydriasis resulting from concomitant therapy with Timoptic and epinephrine has been reported occasionally.
Beta-Adrenergic Blocking Agents
Patients who are receiving a beta-adrenergic blocking agent orally and Timoptic should be observed for potential additive effects of beta-blockade, both systemic and on intraocular pressure. The concomitant use of two topical beta-adrenergic blocking agents is not recommended.
Caution should be used in the coadministration of beta-adrenergic blocking agents, such as Timoptic, and oral or intravenous calcium antagonists because of possible atrioventricular conduction disturbances, left ventricular failure, and hypotension. In patients with impaired cardiac function, coadministration should be avoided.
Close observation of the patient is recommended when a beta blocker is administered to patients receiving catecholamine-depleting drugs such as reserpine, because of possible additive effects and the production of hypotension and/or marked bradycardia, which may result in vertigo, syncope, or postural hypotension.
Digitalis And Calcium Antagonists
The concomitant use of beta-adrenergic blocking agents with digitalis and calcium antagonists may have additive effects in prolonging atrioventricular conduction time.
Oral beta-adrenergic blocking agents may exacerbate the rebound hypertension which can follow the withdrawal of clonidine. There have been no reports of exacerbation of rebound hypertension with ophthalmic timolol maleate.
See product packaging for more information.
Timoptic, Timoptic-XE, Timoptic in Ocudose (timolol) is a beta-adrenergic blocking agent (beta-blocker) that blocks the action of the sympathetic (adrenergic) nervous system, for example, on the heart. Timolol also causes a reduction of the pressure within the eye (intraocular pressure) in patients with glaucoma. Common side effects of Timoptic include blurred vision, burning or stinging in the eye, irritation to the eye, pain or dryness in the eye. Drug interactions of Timoptic include oral beta-adrenergic blocking agents. Although there are no human studies that have examined the effects of oral timolol on the fetus, animal studies have shown adverse effects. Patients taking Timoptic should avoid breastfeeding.
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.