Timolol Maleate 0.5% Ophth Soln 5ml

Timolol maleate is a non-selective beta-adrenergic receptor blocking agent. When applied topically to the eye, it reduces elevated and normal intraocular pressure (IOP), whether or not accompanied by glaucoma. The precise mechanism of action in lowering IOP is not definitively established, but it is believed to be primarily due to a reduction of aqueous humor production. Some studies suggest a slight increase in aqueous outflow facility may also contribute.

Urgent Side Effects: Seek Medical Attention Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Neurological symptoms, including:
+ Weakness on one side of the body
+ Trouble speaking or thinking
+ Change in balance
+ Drooping on one side of the face
+ Blurred eyesight
Eye problems, such as:
+ Change in eyesight
+ Eye pain
+ Severe eye irritation
Cardiovascular symptoms, including:
+ Very bad dizziness or passing out
+ Slow heartbeat
+ Abnormal heartbeat
+ Chest pain
+ Muscle weakness
Heart failure, which can be fatal. Seek immediate medical attention if you experience:
+ Shortness of breath
+ Sudden weight gain
+ Swelling in the arms or legs
+ Bulging neck veins

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical help:

Burning or stinging
Eye irritation
Dry eyes
Feeling that something is in the eye
Dizziness or headache
* Signs of a common cold

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
Certain health conditions, including:
+ Respiratory issues like asthma or chronic obstructive pulmonary disease (COPD)
+ Heart block or heart failure (a weakened heart)
+ Shock caused by heart problems
+ Slow heartbeat
If you are currently using a similar medication. If you are unsure, consult your doctor or pharmacist.

Please note that this is not an exhaustive list of all potential interactions with this medication. To ensure your safety, it is crucial to:

Inform your doctor and pharmacist about all medications you are taking, including prescription and over-the-counter drugs, natural products, and vitamins.
Discuss all your health problems with your doctor and pharmacist.
Verify that it is safe to take this medication with your existing medications and health conditions.
* Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. When performing tasks that require clear vision, such as driving, exercise caution to ensure your safety.

This medication may mask certain symptoms of low blood sugar, including a rapid heartbeat, which can increase the risk of severe or prolonged hypoglycemia. This risk is particularly elevated in individuals with diabetes, children, and those who are fasting, undergoing surgery, or experiencing nausea and vomiting. If you have any questions or concerns, consult your doctor.

If you have diabetes, it is crucial to closely monitor your blood sugar levels. Additionally, follow your doctor's recommendations for regular eye pressure and vision checks.

Notify your doctor if you have an eye infection, eye injury, or are scheduled to undergo eye surgery. Although rare, this medication has been associated with severe respiratory problems, which can be life-threatening, especially in individuals with asthma. If you have any questions, discuss them with your doctor.

This medication may also conceal symptoms of hyperthyroidism, such as a rapid heartbeat. If you have hyperthyroidism and suddenly stop taking this medication, your condition may worsen and become life-threatening. Consult your doctor for guidance.

If you have a history of severe allergic reactions, inform your doctor, as you may be at risk of an even more severe reaction if you are re-exposed to the allergen. If you use epinephrine to treat severe allergic reactions, discuss this with your doctor, as the medication may be less effective while taking this drug.

If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby.

• Oral beta-blockers (additive systemic effects, e.g., bradycardia, hypotension).
• Calcium channel blockers (e.g., verapamil, diltiazem) (increased risk of AV conduction disturbances, bradycardia, hypotension).
• Catecholamine-depleting drugs (e.g., reserpine, guanethidine) (additive hypotensive and/or bradycardic effects).
• Digitalis (increased risk of bradycardia and AV block).

• Quinidine (inhibits CYP2D6, potentially increasing systemic timolol levels and enhancing beta-blockade).
• Clonidine (paradoxical hypertension upon clonidine withdrawal if beta-blocker is not also withdrawn gradually).
• Adrenergic psychotropic drugs (e.g., MAOIs, TCAs) (potential for enhanced pressor response or hypotension).

• Not available

• Blurred vision
• Eye irritation (stinging, burning)
• Bradycardia (slow heart rate)
• Hypotension (dizziness, lightheadedness)
• Bronchospasm (shortness of breath, wheezing, difficulty breathing)
• Fatigue
• Depression
• Headache

Category C. Use only if the potential benefit justifies the potential risk to the fetus. Systemic absorption occurs, and beta-blockers can cause adverse effects in the fetus/neonate (e.g., bradycardia, hypoglycemia, respiratory depression).

Excreted in human milk. Caution should be exercised when timolol maleate is administered to a nursing mother. Potential for serious adverse reactions in the infant (e.g., bradycardia, respiratory depression). Consider discontinuing nursing or the drug, weighing the importance of the drug to the mother.

Use with extreme caution, especially in infants and young children, due to increased systemic absorption and potential for severe systemic adverse reactions (e.g., apnea, bradycardia, hypotension, hypothermia). Close monitoring is essential. Not recommended for routine use in neonates and infants.

Generally well-tolerated, but elderly patients may be more susceptible to systemic adverse effects (e.g., bradycardia, hypotension, bronchospasm) due to decreased renal/hepatic function or concomitant medications. Start with lower concentrations and monitor closely.

• Timolol is often a first-line agent for glaucoma due to its efficacy and once or twice daily dosing.
• Despite being an ophthalmic preparation, significant systemic absorption can occur, leading to systemic beta-blockade effects. Always inquire about patient's cardiac and respiratory history.
• Patients with asthma, COPD, severe bradycardia, or heart block should generally avoid timolol. If used, monitor closely.
• Occluding the nasolacrimal duct (pressing on the inner corner of the eye for 1-2 minutes after instillation) can help minimize systemic absorption and maximize ocular bioavailability.
• Inform patients about the potential for transient stinging or burning upon instillation.
• Regular IOP monitoring is crucial to ensure therapeutic efficacy.

• Prostaglandin analogs (e.g., Latanoprost, Travoprost, Bimatoprost)
• Alpha-2 adrenergic agonists (e.g., Brimonidine)
• Carbonic anhydrase inhibitors (e.g., Dorzolamide, Brinzolamide)
• Rho kinase inhibitors (e.g., Netarsudil)
• Cholinergic agonists (e.g., Pilocarpine)
• Laser trabeculoplasty
• Glaucoma filtration surgery

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to ensure you receive the best possible care.