Indications
Timolol eye drops lower raised pressure inside the eye in open-angle glaucoma and in ocular hypertension (high eye pressure without nerve damage yet). Lowering eye pressure helps protect the optic nerve and sight. It is often combined with other glaucoma drops such as Dorzolamide, Brimonidine, Latanoprost or Travoprost. Timolol tablets exist in some countries for high blood pressure and heart conditions, but the eye drop is the common form.
How It Works
Timolol is a beta-blocker. In the eye it reduces the amount of aqueous humour (the clear fluid that fills the front of the eye), so the pressure falls. Some of each drop is absorbed into the bloodstream, which is why it can affect the heart and lungs.
Dosage and Administration
Eye drops (0.25% or 0.5%): usually 1 drop in the affected eye or eyes twice a day. Long-acting gel-forming drops are usually used once a day. Always follow the eye doctor’s instructions.
- Wash your hands, tilt your head back, pull down the lower eyelid and put in 1 drop.
- Close the eye and press gently on the inner corner of the eye for 1 to 2 minutes. This keeps more medicine in the eye and less in the body.
- If you use other eye drops, wait at least 5 to 10 minutes between them.
- Remove soft contact lenses before use and wait 15 minutes before putting them back.
- Use it every day, even if your eyes feel fine. Do not stop without asking your doctor.
Tablets: only as prescribed.
Interactions
Tell your doctor about all medicines you take. Beta-blocker tablets (such as Propranolol or Atenolol) add to the effect. Verapamil, Diltiazem, Digoxin and Amiodarone can slow the heart further. Quinidine, Fluoxetine and Paroxetine can raise timolol levels in the body. Timolol can hide the warning signs of low blood sugar in people using Insulin or diabetes tablets. Suddenly stopping Clonidine while using timolol can raise blood pressure.
Contraindications
- Asthma, or a past history of asthma, or severe chronic obstructive pulmonary disease (COPD).
- Slow heart rate, heart block (second or third degree) or sick sinus syndrome without a pacemaker.
- Uncontrolled heart failure or cardiogenic shock.
- Allergy to timolol or any ingredient of the product.
Side Effects
Common: burning, stinging, itching or redness of the eye, short-lived blurred vision and dry eyes. Less common: slow heartbeat, tiredness, dizziness, headache, cold hands and feet, low mood and sleep problems.
Get urgent medical help if you have wheezing or difficulty breathing, a very slow or irregular heartbeat, fainting, chest pain, swelling of the face, lips or tongue, or severe eye pain or a sudden change in vision.
Pregnancy and Lactation
Use in pregnancy only if the doctor decides it is needed. If used close to delivery, the newborn may have a slow heartbeat or low blood sugar, so tell the birth team. Small amounts pass into breast milk; ask your doctor before breastfeeding. Pressing on the inner corner of the eye after each drop lowers the amount that reaches the baby.
Precautions and Warnings
Tell your doctor if you have diabetes, an overactive thyroid, myasthenia gravis, poor circulation, heart disease or any breathing problem. Tell the doctor or anaesthetist that you use timolol before any operation. Do not drive until blurred vision clears. Do not let the dropper tip touch the eye or any surface. Have your eye pressure checked regularly.
Overdose
Using far too many drops, or swallowing the solution, can cause a slow heartbeat, low blood pressure, wheezing and dizziness. Seek medical help urgently, especially if a child has swallowed it.
Therapeutic Class
Beta-blocker (antiglaucoma eye preparation).
Storage
Store below 30°C, away from light, and do not freeze. Keep out of the reach of children. Throw away the bottle 4 weeks after first opening, or as the leaflet says.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.