Timolol, eye drops 0.5% 10 ml

Nonselective beta-adrenoblocker. It has antianginal, hypotensive and antiarrhythmic effects. It reduces automatism of the sinus node, decreases heart rate, slows AV conduction, reduces myocardial contractility and myocardial oxygen demand.

When used topically in ophthalmology, it reduces both normal and elevated intraocular pressure by reducing intraocular fluid formation and improving its outflow; it has no effect on accommodation and pupil size.

Indications

For use in ophthalmology: increased intraocular pressure, chronic open-angle glaucoma, closed-angle glaucoma (as an additional agent in combination with miotics), secondary glaucoma (including aphasic), congenital glaucoma (when other therapeutic measures are not effective).

Active ingredient

Composition

1 ml of eye drops contains:

active ingredients:

timolol maleate (in terms of timolol) – 5.0 mg.

excipients:

dodecahydrate phosphate disodium,

sodium dihydrophosphate monohydrate,

disodium edetate dihydrate,

How to take, the dosage

Adults and children over 10 years of age are injected into the conjunctival sac with 1 drop of 0.25% solution 2 times a day. In case of insufficient effectiveness – 1 drop of 0.5% solution 2 times per day. At normalization of intraocular pressure the maintenance dose of the drug is 1 drop of 0.25% solution 1 time/day.

Interaction

When concomitant use of Timolol, epinephrine, pilocarpine, systemic beta-adrenoblockers increase its effect.

Concomitant use of Timolol with Reserpine may result in marked bradycardia or arterial hypotension (the combination requires close medical supervision).

The concomitant use of Timolol with calcium channel blockers or cardiac glycosides may cause AV conduction abnormalities, acute left ventricular failure or arterial hypotension.

The concomitant use of Timolol increases the effects of muscle relaxants (the drug should be discontinued 48 hours before the intended general anesthesia with peripheral muscle relaxants).

When using local anesthetics, the potential for increased cardiovascular adverse effects should be considered.

It is not recommended to take ethanol during treatment with Timolol to avoid a sharp decrease in BP.

Special Instructions

With caution is used in patients with liver and kidney function abnormalities, diabetes mellitus (especially of labile course). With long-term use increases the level of triglycerides in the blood plasma.

The safety and effectiveness in children has not been studied.

In ophthalmology it is used for a long time, therefore during the period of treatment at least once in 6 months a corneal examination should be carried out, the lacrimation function and the state of the fields of vision should be controlled.

Influence on driving and operating machinery

At the time of treatment, one must refrain from potentially dangerous activities requiring increased attention and quick psychomotor reactions.

When used in ophthalmology immediately after instillation, visual acuity may decrease and psychomotor reactions may slow down, so refrain for 30 minutes from engaging in potentially hazardous activities requiring increased attention.

Contraindications

Av-blockade of degree II and III, sinoatrial block, bradycardia, CCSU, arterial hypotension, chronic heart failure stage IIB-III, acute heart failure, vasomotor rhinitis, Raynaud’s disease and other obliterating vascular diseases, metabolic acidosis, lactation.

Side effects

Overlooking organ:In local use irritation and hyperemia of conjunctiva, eyelid skin, burning and itching in the eyes, lacrimation, photophobia, corneal epithelium edema, pitting superficial keratopathy, corneal hypoesthesia, diplopia, ptosis, dry eyes are possible. In case of fistulizing antiglaucoma operations retinal detachment may develop in the postoperative period.

In systemic use heart failure, bradycardia, AV blockade, arterial hypotension; headache, sleep disturbances, nightmares, asthenia, agitation, depression, paresthesias and coldness of extremities may occur; nausea, vomiting, diarrhea; shortness of breath, bronchospasm; muscle weakness; skin allergic reactions, exacerbation of psoriasis, dry conjunctivae.

Overdose

When administered topically at the recommended dose, no symptoms of overdose have been reported.

Inadvertent ingestion may cause the following symptoms: nausea, vomiting, dizziness, headache, decreased BP, bronchospasm, bradycardia.

Treatment:Symptomatic therapy is administered. To eliminate marked bradycardia or bronchospasm – IV isoprenaline, to treat arterial hypotension – dobutamine.

Similarities