Timolol
TIMOPTIC
What it isBeta-receptor antagonist eye drop that reduces aqueous production; open-angle glaucoma.
Why this oneThe benchmark ocular beta blocker, it is inexpensive and adds effectively to a prostaglandin analog.
What limits itEye drops can still cause bradycardia and bronchospasm; use punctal occlusion and avoid in asthma or heart block.
FDA-approved for
- hypertension (1978)
- glaucoma (1978)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | Adults | 10 mg BID | 20-40 mg/day | 60 mg/day divided BID |
| Myocardial infarction (post-MI prophylaxis) | Adults | 10 mg BID | 10 mg BID | |
| Migraine prophylaxis | Adults | 10 mg BID | 20 mg/day (may give QD) | 30 mg/day divided |
Titration For hypertension, at least 7 days between dose increases
Renal Undefined
Hepatic Undefined
Instructions
- Do not discontinue abruptly in patients with coronary artery disease; taper
- Discontinue migraine therapy if no satisfactory response after 6-8 weeks at maximum dose
Contraindications
- Bronchial asthma or history of bronchial asthma; severe COPD
- Sinus bradycardia; second- and third-degree AV block
- Overt cardiac failure
- Cardiogenic shock
Cautions
- Abrupt withdrawal may exacerbate angina/precipitate MI
- Bronchospasm in patients with bronchospastic disease
- Cardiac failure; may mask hypoglycemia and hyperthyroidism symptoms
- May worsen AV block
Adverse reactions
- Bradycardia
- Fatigue/tiredness
- Dizziness
- Dyspnea, bronchial spasm
- Cold hands and feet
Pregnancy No adequate human studies; use only if potential benefit justifies potential fetal risk
Lactation Undefined
NO BOXED WARNINGS
Principal riskSystemic beta blockade from eye drops: bradycardia and bronchospasm
Cost, est. cash$200–$1,000/month
Generic entry2016
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Mechanism of action: Timolol ballicule
Open Timolol in the interactive console ↗
Memory aids: mascots and interaction avatars
LOL cap → β blocker
