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Timolol

    Brands

    DEA Class;  Rx

    Common Brand Names; Blocadren (DSC), Timoptic, Timoptic in Ocudose, Timoptic XE, Betimol, Istalol

    • Beta-Blockers, Nonselective

    Nonselective, beta-blocker similar to propranolol and nadolol
    Lacks appreciable intrinsic sympathomimetic or membrane-stabilizing activities; relatively high lipid solubility; primarily metabolized
    Available for oral and ophthalmic use

    Indicated for the treatment of hypertension.

    For reduction of cardiovascular mortality and to reduce the risk of reinfarction (i.e., myocardial infarction prophylaxis) after an acute myocardial infarction in patients who are clinically stable.
    For migraine prophylaxis.
    For the treatment of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.
    For the management of chronic stable angina.
    For the treatment of essential tremor.

    Bronchial asthma/COPD

    Overt cardiac failure, sinus bradycardia, 2°/3° heart block, cardiogenic shock

    Hypersensitivity

    Sick sinus syndrome without permanent pacemaker

    • Arrythmia
    • Bradycardia
    • Syncope
    • Fatigue
    • Headache
    • Dyspnea
    • Bronchospasm
    • Chest pain
    • Edema
    • Paresthesia
    • Nausea
    • Rales
    • Depression, decreased exercise tolerance, Raynaud’s phenomenon
    • May increase triglyceride levels and insulin resistance, and decrease HDL levels

    IDDM, peripheral vascular disease, cerebrovascular insufficiency, liver disease, renal impairment, CHF, thyrotoxicosis

    Sudden discontinuation can exacerbate angina and lead to myocardial infarction

    Anesthesia/surgery (myocardial depression)

    Use in pheochromocytoma

    Increased risk of stroke after surgery

    Pregnancy Category: C

    Lactation: excreted in milk; Mfr’s recommends avoid nursing (AAP Committee states compatible with nursing)

    Adults

    60 mg/day PO for hypertension or angina; 30 mg/day PO for migraine prophylaxis; 20 mg/day PO for postmyocardial infarction or myocardial infarction prophylaxis; 1 drop per eye twice daily of Timoptic or Betimol 0.5% ophthalmic solution; 1 drop per eye per day of Timoptic-XE 0.5% gel forming ophthalmic solution or Istalol ophthalmic solution.

    Geriatric

    60 mg/day PO for hypertension or angina; 30 mg/day PO for migraine prophylaxis; 20 mg/day PO for postmyocardial infarction or myocardial infarction prophylaxis; 1 drop per eye twice daily of Timoptic or Betimol 0.5% ophthalmic solution; 1 drop per eye per day of Timoptic-XE 0.5% gel forming ophthalmic solution or Istalol ophthalmic solution.

    Adolescents

    1 drop per eye twice daily of Timoptic (timolol maleate) 0.5% ophthalmic solution; 1 drop per eye per day of Timoptic-XE (timolol maleate) 0.5% gel forming ophthalmic solution; safety and efficacy of other ophthalmic formulations and the oral formulation have not been established.

    Children

    Children 2 years and older: 1 drop per eye twice daily of Timoptic (timolol maleate) 0.5% ophthalmic solution; 1 drop per eye per day of Timoptic-XE (timolol maleate) 0.5% gel forming ophthalmic solution; safety and efficacy of other ophthalmic formulations and the oral formulation have not been established.
    Children 1 year: Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Timolol maleate

    tablet

    • 5mg
    • 10mg
    • 20mg

    ophthalmic solution

    • 0.25%
    • 0.5%

    gel forming solution

    • 0.25%
    • 0.5%