Timolol
About
Timolol belongs to a class of anti-hypertensive drugs called 'beta-blockers' primarily used to treat increased pressure in the eye in conditions of glaucoma (damage of optic nerve) and ocular hypertension (high fluid pressure inside the eye). Glaucoma is an eye condition which causes damage to the optic nerve (essential for good vision) due to abnormally increased pressure in the eye. Ocular hypertension is increased pressure in the eye due to poor drainage of aqueous humour (fluid in the eye that maintains normal pressure by its continuous flow).
Timolol works by decreasing the secretion of aqueous humour (a liquid that maintains normal pressure in the eyeball) by the ciliary body into the eyeball. Thereby lowers the pressure in the eye by reducing aqueous humour entry into the eyeball.
Use Timolol as prescribed. Your doctor will advise you on how many drops to instill based on your medical condition. In some cases, you may experience redness, itching, stinging or burning in the eyes, swelling of the eyelid and dry eyes. Most of these side effects of Timolol do not require medical attention and gradually resolve over time. However, if the side effects worsen or persist, please consult your doctor.
If you are known to be allergic to Timolol or any other medicines, please tell your doctor. Timolol should be used with caution in children. Your doctor will estimate the benefits and risks of Timolol in children, and if Timolol is used in newborn, they should be under close observation for 1 to 2 hours after the first dose and adverse effects should be monitored. If you are pregnant or breastfeeding, please inform your doctor before taking Timolol. You are advised to remove soft contact lenses before using Timolol as it may cause discolouration of soft contact lens.
Uses of Timolol
Medicinal Benefits
Timolol is used to treat increased pressure in the eye in conditions such as glaucoma (damage of optic nerve) and ocular hypertension (high fluid pressure inside the eye). Timolol decreases the secretion of aqueous humour (a liquid that maintains normal pressure in the eyeball) by ciliary body into eyeball. Thereby, lowers pressure in the eye by reducing aqueous humour entry into the eyeball.
Directions for Use
Storage
Side Effects of Timolol
- Redness, itching, stinging or burning in the eyes
- Swelling of eyelid
- Dry eyes
In-Depth Precautions and Warning
Drug Warnings
If you have diabetes, asthma, heart problems, Raynaud's disease (poor blood circulation), and hyperthyroidism (overactive thyroid gland), please inform your doctor before taking Timolol. Pregnant or nursing mothers are advised to consult a doctor before taking Timolol. If you get any new eye problem, an eye infection, or notice any allergic reactions such as itching or redness of the eye and skin rash, please consult your doctor immediately. You are advised to remove soft contact lenses before using Timolol as it may cause discoloration of soft contact lenses. In sporadic cases, you may notice cloudy patches on the cornea (transparent layer at the front of the eye) due to the accumulation of calcium as Timolol contains phosphates responsible for causing such severe damage to the cornea.
Drug Interactions
Drug-Drug Interaction: Timolol may have interaction with high blood pressure-lowering medicines (clonidine, reserpine, amlodipine, nifedipine, diltiazem, metoprolol, verapamil), heart-related medicines (digoxin), antidepressants (paroxetine, fluoxetine), antimalarial drugs (quinidine), and medicines for severe allergic reaction (adrenaline).
Drug-Food Interaction: Timolol may interact with marijuana. Therefore, avoid marijuana intake while taking Timolol as it may decrease the effect of Timolol and cause increased heart rate, high blood pressure or other heart-related problems.
Drug-Disease Interaction: Inform your doctor if you have diabetes, asthma, heart problems, Raynaud's disease or Raynaud's syndrome (poor blood circulation) and hyperthyroidism (overactive thyroid gland) before taking Timolol.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionInteraction of alcohol with Timolol is unknown. Please consult a doctor before consuming alcohol with Timolol.
Pregnancy
cautionTimolol is a Category C pregnancy drug and is not recommended for use during pregnancy unless your doctor considers it essential.
Breast Feeding
unsafeAvoid breastfeeding while taking Timolol as it may be excreted in breast milk and cause adverse effects in the baby.
Driving
cautionTimolol may cause tiredness, dizziness, drowsiness or changes in vision such as blurred vision, double vision and drooping of upper eyelid (eye stays half closed) in some people. So, drive only when your vision is clear and are alert after taking Timolol.
Liver
cautionInform your doctor if you have a history of Liver diseases/conditions.
Kidney
cautionInform your doctor if you have a history of Kidney diseases/conditions.
Children
cautionTimolol should be used with extreme caution in children if prescribed by a doctor.
Habit Forming
Diet & Lifestyle Advise
- Avoid intake of baked foods such as cakes, cookies, donuts or fried items such as French fries and stick margarine as these foods may worsen glaucoma and damage optic nerve.
- Cut down your coffee intake as it may increase pressure in the eye and replace coffee with green tea.
- Avoid exercises such as any position where head is lower than body like inverted yoga pose as it may increase pressure in the eye. Doing selective exercises is advised for glaucoma patients.
Special Advise
- Timolol should be used with extreme caution in children and if you notice abnormal breathing, wheezing, coughing or unusual pauses in breathing, stop using Timolol and consult a doctor immediately.
- If you have an injury to the eye or eye infection, inform your doctor.
- You are advised to inform your doctor before any operation that you are using Timolol as it may alter the effects of some medicines that are used during anesthesia
- Routine eye tests are recommended at least every 2 years to detect glaucoma as it does not show any symptoms initially.
Patients Concern
Disease/Condition Glossary
Glaucoma: It is an eye condition that causes damage to the optic nerve (essential for good vision) due to abnormally increased pressure in the eye. If it is not treated in time, it may cause blindness. Usually, there are no symptoms of glaucoma initially except the slow loss of vision gradually. However, some symptoms include visible rainbow-colored circles around bright lights or blurred vision. Rarely, glaucoma can develop suddenly with intense pain in the eye, visual disturbance, or nausea. Ocular hypertension is a condition caused due to poor drainage of aqueous humor (fluid in the eye that maintains normal pressure by its continuous flow). This leads to the build-up of excess fluid in the eye resulting in increased pressure inside the eye without any damage to the optic nerve. If ocular hypertension is not controlled, it may lead to glaucoma.
FAQs
You are recommended to wash your hands first and tilt your head back and gently pull the lower eyelid downwards. Then, squeeze the bottle gently by holding it upside down to instil one drop into the affected eye without touching the tip of bottle to eye or surrounding areas in order to avoid contamination. Finally, replace the cap tightly after use. After applying Timolol, you are advised to close your eyes for minimum 3 to 5 minutes and pressure should be applied to the corner of the eye by pressing a finger to stop eye drops spreading into rest of the body.
No, you are not recommended to wear contact lenses while using Timolol as it contains benzalkonium chloride, a preservative that causes colour change of contact lens as it may be absorbed by soft contact lens. Benzalkonium chloride also causes irritation in the eye especially if you have disorders of cornea (transparent layer at the front of eye) or dry eyes. Therefore, you are advised to remove contact lenses before applying Timolol and reinsert after 15 minutes of using Timolol. Also, inform your doctor if you experience pain or stinging in the eye, abnormal sensation in the eye after using Timolol.
Yes, you may need to stop using Timolol before surgery as it may alter the effects of certain medicines that are used during anaesthesia. Therefore, you are recommended to inform your doctor or dentist that you are using Timolol before any surgery or dental procedure.
Yes, Timolol may cause temporary blurred vision, double vision or drooping of upper eyelid (eye is half closed). Therefore, you are recommended to wait until your vision is clear before driving or operating machinery.
You are advised not to use more than the prescribed dose as it may cause adverse effects such as dizziness, light-headedness, headache, chest pain, difficulty in breathing or slow heart rate. However, if you experience any of these symptoms, please consult a doctor immediately.
