Timolol Maleate 10mg Tablets

Timolol is a non-selective beta-adrenergic receptor blocking agent. It competitively blocks both beta-1 and beta-2 adrenergic receptors, leading to a decrease in heart rate, myocardial contractility, and cardiac output. It also reduces sympathetic outflow from the central nervous system and inhibits renin release from the kidneys, contributing to its antihypertensive effects. For migraine prophylaxis, its mechanism is not fully elucidated but is thought to involve modulation of central adrenergic activity and vascular tone.

Urgent Side Effects: Seek Medical Attention Immediately

Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience 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
Severe dizziness or fainting
Shortness of breath, sudden weight gain, or swelling in the arms or legs
Chest pain or pressure
Slow heartbeat
Abnormal heartbeat
Muscle weakness
Changes in vision
Feeling cold

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 unusual symptoms that bother you or do not go away, contact your doctor:

Dizziness
Fatigue
Weakness
* Upset stomach

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult 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 allergic reaction you experienced, including any symptoms that occurred.
Certain health conditions, including:
+ Breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)
+ Heart block or heart failure (weak heart)
+ Shock caused by heart problems
+ Slow heartbeat

This list is not exhaustive, and it is crucial to discuss all your health problems with your doctor.

Additionally, provide your doctor and pharmacist with a comprehensive list of all the medications you are taking, including:
Prescription and over-the-counter (OTC) drugs
Natural products
* Vitamins

It is vital to verify that it is safe to take this medication with all your other medications and health conditions. Never start, stop, or change the dose 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.

To ensure your safety, avoid driving and other activities that require alertness until you understand how this medication affects you. When changing positions, such as standing up from a sitting or lying down position, do so slowly to minimize the risk of dizziness or fainting. Be cautious when using stairs.

Regularly monitor your blood work and other laboratory tests as directed by your doctor. Additionally, check your blood pressure and heart rate as instructed by your healthcare provider.

Before consuming alcohol, discuss its potential effects with your doctor. This medication may mask certain symptoms of low blood sugar, such as 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 concerns, consult your doctor.

If you have diabetes, it is crucial to closely monitor your blood sugar levels. If you are taking this medication and have high blood pressure, consult your doctor before using over-the-counter products that may increase blood pressure, such as cough and cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

This medication may make it more challenging to recognize symptoms of an overactive thyroid, such as a rapid heartbeat. If you have an overactive thyroid and suddenly stop taking this medication, your condition may worsen and become life-threatening. Discuss this with your doctor.

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 exposed to the allergen again. If you use epinephrine to treat severe allergic reactions, consult your doctor, as this medication may reduce the effectiveness of epinephrine.

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

• Bronchial asthma
• Severe chronic obstructive pulmonary disease (COPD)
• Sinus bradycardia
• Second or third degree atrioventricular (AV) block
• Overt cardiac failure
• Cardiogenic shock

• Non-dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem): Increased risk of bradycardia, AV block, and heart failure.
• Other beta-blockers (oral or ophthalmic): Additive systemic effects.
• Digoxin: Additive bradycardia.
• Clonidine: Risk of rebound hypertension if clonidine is withdrawn abruptly while on timolol.
• Monoamine Oxidase Inhibitors (MAOIs): Potential for significant hypertension or bradycardia.

• CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine): May increase plasma concentrations of timolol.
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): May reduce the antihypertensive effect of timolol.
• Insulin and oral hypoglycemic agents: Beta-blockers may mask symptoms of hypoglycemia (e.g., tachycardia, palpitations).
• Sympathomimetics (e.g., epinephrine, norepinephrine): Reduced beta-agonist effect, potential for severe hypertension with alpha-agonists.
• Amiodarone: Increased risk of bradycardia and AV block.

• Alcohol: May enhance hypotensive effects.

• Dizziness
• Lightheadedness
• Fatigue
• Bradycardia (slow heart rate)
• Hypotension (low blood pressure)
• Shortness of breath
• Wheezing
• Cold extremities
• Masked symptoms of hypoglycemia (in diabetics)
• Depression

Timolol is classified as Pregnancy Category C (older classification). While adequate and well-controlled studies in pregnant women are lacking, animal studies have shown adverse effects. Beta-blockers, including timolol, have been associated with fetal growth restriction, bradycardia, and hypoglycemia in neonates when used in late pregnancy. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Timolol is excreted into breast milk. The amount is generally low, but there is a potential for adverse effects in the breastfed infant, particularly bradycardia, hypotension, and hypoglycemia. Monitor the infant for these signs. Use with caution, or consider an alternative if possible, especially in premature or medically fragile infants.

Safety and effectiveness of systemic timolol in pediatric patients have not been established for hypertension, angina, or migraine prophylaxis. Use is generally not recommended.

Elderly patients may be more sensitive to the effects of beta-blockers, including timolol, and may have an increased risk of adverse effects such as bradycardia, hypotension, and central nervous system effects. Start with lower doses and titrate slowly, monitoring closely for adverse reactions.

• Timolol is a non-selective beta-blocker, meaning it blocks both beta-1 and beta-2 receptors. This makes it effective for various conditions but also increases the risk of bronchospasm in patients with asthma or severe COPD.
• Always warn patients about the dangers of abrupt discontinuation, especially if they have underlying coronary artery disease, due to the risk of exacerbation of angina, MI, or arrhythmias.
• Can mask signs of hyperthyroidism (e.g., tachycardia) and hypoglycemia (e.g., tremors, palpitations) in diabetic patients.
• Use with caution in patients with peripheral vascular disease as it may exacerbate symptoms.
• While primarily used for hypertension, angina, and migraine prophylaxis, timolol is also widely used topically for glaucoma (as eye drops).

• For Hypertension: Other beta-blockers (e.g., metoprolol, atenolol, carvedilol), ACE inhibitors (e.g., lisinopril), Angiotensin Receptor Blockers (ARBs) (e.g., losartan), Calcium Channel Blockers (e.g., amlodipine, nifedipine), Diuretics (e.g., hydrochlorothiazide).
• For Angina: Other beta-blockers, Calcium Channel Blockers, Nitrates.
• For Migraine Prophylaxis: Other beta-blockers (e.g., propranolol), Topiramate, Valproic acid, CGRP inhibitors (e.g., erenumab, fremanezumab), Triptans (for acute treatment, not prophylaxis).

If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with 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 information about what was taken, the amount, and the time it occurred.