Timolol Ophthalmic

(tye' moe lole)

Brand Name(s): Betimol^®, Timoptic^®, Timoptic^® GFS, Timoptic-XE^®, Combigan^® (as a combination product containing Timolol and Brimonidine), Cosopt^® (as a combination product containing Timolol and Dorzolamide)

WHY is this medicine prescribed?

Ophthalmic timolol is used to treat glaucoma, a condition in which increased pressure in the eye can lead to gradual loss of vision. Timolol is in a class of medications called beta-blockers. It works by decreasing the pressure in the eye.

Are there OTHER USES for this medicine?

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Ophthalmic timolol comes as a solution (liquid) and an extended-release (long-acting) gel-forming solution (liquid that thickens to a gel when instilled in the eye). Timolol eye drops are usuallyinstilled once or twice a day, at evenly spaced intervals, until pressure in the eye is controlled (about 4 weeks). Then it may be instilled once a day. Timolol gel-forming solution is usually instilled once a day. Follow the directions on your prescription label carefully, and ask doctor or pharmacist to explain any part you do not understand. Use timolol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Timolol eye drops and gel-forming solution control glaucoma but do not cure it. Continue to use timolol even if you feel well. Do not stop using the medication without talking to your doctor.

To instill the eye drops or eye gel, follow these steps:

1. Wash your hands thoroughly with soap and water.
2. If you are using the gel-forming solution, invert the container and shake it once. (There is no need to shake the eye-drops.) Make sure that the end of the dropper is not chipped or cracked.
3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
6. Brace the remaining fingers of that hand against your face.
7. If you are using the eye drops, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. If you are using the gel-forming solution, check the directions that came with your medication to see whether you should push the bottom of the bottle so that a single drop falls out or press a specially marked area on the side of the bottle. If you are using the type of bottle that must be pushed from the bottom, be careful not to squeeze the sides of the bottle. Remove your index finger from the lower eyelid.
8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
9. Place a finger on the tear duct and apply gentle pressure.
10. Wipe any excess liquid from your face with a tissue.
11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
13. Wash your hands to remove any medication.

What SPECIAL PRECAUTIONS should I follow?

Before using timolol eye drops or gel-forming solution,

• tell your doctor and pharmacist if you are allergic to timolol, beta blockers, or any other drugs.

• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially beta blockers such as atenolol (Tenormin), carteolol (Cartrol), esmolol (Breviblic), labetalol (Normodyne, Trandate), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), and timolol (Blocadren); quinidine (Quinidex, Quinaglute Dura-Tabs); verapamil (Calan, Isoptin); and vitamins.

• if you are using another topical eye medication, instill it at least 10 minutes before or after you instill timolol eye drops or gel-forming solution.

• tell your doctor if you have or have ever had thyroid, heart, or lung disease; congestive heart failure; myasthenia gravis; or diabetes.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using timolol, call your doctor immediately.

• if you have eye surgery, an eye injury, or develop an eye infection while using timolol eye drops or gel-forming solution, ask your doctor if you can continue using the same container of timolol.

• you should know that your vision may be blurred during your treatment with timolol gel-forming solution. Avoid rubbing your eyes even if your vision is blurred. Do not drive a car or operate machinery if you are unable to see clearly.

• if you wear soft contact lenses, remove them before instilling timolol eye drops or gel-forming solution, and wait until 15 minutes after using timolol to put them back in.

What should I do IF I FORGET to take a dose?

Instill the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Timolol eye drops or gel-forming solution may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• eye irritation
• double vision
• headache
• depression
• dizziness
• nausea

Some side effects can be serious. If you experience any of the following symptoms, stop using timolol and call your doctor immediately:

• slow or irregular heartbeat
• difficulty breathing
• sudden weight gain
• swelling of the feet or lower legs
• fainting

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). If it becomes discolored or cloudy, obtain a fresh bottle.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor. Your doctor will order certain eye tests to check your response to timolol.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: April 15, 2017.