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TIMOLOL MALEATE

Brand Name(s) : Betim, Nyogel, Timoptol, Timoptol-LA
Warnings
Uses
Side Effects
Precautions
Interactions
Overdose

TIMOLOL MALEATE WARNINGS

Timolol maleate should be used with caution in:

  • Asthma and lung problems
  • Heart or circulation problems
  • Liver or kidney problems
  • Diabetes
  • The skin condition psoriasis
  • Allergies to any medicines
  • People who wear contact lenses (eye drops or gel only)

Timolol maleate should not be used in:

  • Allergy (hypersensitivity) to timolol maleate, any of the ingredients in the eye drops/gel/tablets or to any other beta-blockers
  • Heart problems, such as severe heart failure, very low blood pressure (cardiogenic shock), irregular heart rhythms (sick sinus syndrome) or very slow heart rate (severe bradycardia)
  • Low blood pressure (hypotension)
  • Breathing problems, such as asthma, wheezing and chronic obstructive pulmonary disease (COPD)
  • A type of chest pain called Prinzmetal's angina
  • High blood pressure due to a tumour of the adrenal glands (phaeochromocytoma)
  • A type of heart rhythm problem that blocks the electrical messages in the heart, unless an artificial pacemaker has been fitted (2nd or 3rd degree atrioventricular heart block)
  • Problems with your blood circulation
  • Taking a particular type of drug for depression called monoamine oxidase inhibitors
  • Numb or cold toes and fingers (Raynaud's syndrome)
  • An eye disorder called corneal dystrophy (eye drops or gel only)
  • A condition that causes the blood to be acidic called metabolic acidosis
  • Symptoms such as runny nose, sneezing, itching of the nose, eyes, throat or roof of mouth (eye drops or gel only)
  • Pregnancy
  • Breast-feeding

Also see list of precautions and interactions

STORAGE

Store timolol maleate eye drops/gel below 25°C.

TIMOLOL MALEATE USES

What is it used for?

  • Timolol maleate tablets are used to treat high blood pressure (hypertension), chest pain (angina), to reduce the number of migraine attacks and to prevent a heart attack in people who already had one.
  • Timolol maleate eye drops and eye gel are used to treat conditions where there is an increased pressure inside the eye (glaucoma and ocular hypertension).
  • It is a type of beta-adrenergic blocking agent, sometimes known as beta-blockers.
  • It is used to reduce the workload on the heart by slowing the heart rate and lowering blood pressure. It also lowers the pressure in the eye.
  • In general timolol maleate tablets are used to treat high blood pressure (hypertension), chest pain (angina), to reduce the number of migraine attacks in people who have migraines and to prevent heart attacks in people who have already experienced one.

Listed below are the typical uses of timolol maleate.

  • High blood pressure (hypertension)
  • Chest pain (angina)
  • To prevent migraine headache attacks (prophylaxis)
  • To prevent heart attacks in people who have experienced one (prophylaxis)
  • Conditions where there is an increased pressure inside the eye (glaucoma and ocular hypertension)

HOW TO USE/TAKE

How often do I take it?

  • Timolol maleate eye drops or gel are for use in the eyes only and should be administered exactly as your doctor has told you.
  • Timolol maleate tablets should be taken exactly as your doctor has told you. The tablets should be swallowed whole with a glass of water.
  • Use this medication for the duration of the prescription in order to get the most benefit from it.
  • Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
  • Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • Timolol maleate tablets may cause tiredness or dizziness. If this occurs, you should not drive or operate machinery. Consult your doctor or pharmacist for more details.
  • Timolol maleate eye drops and gel may cause visual disturbances, including blurred vision, double vision, drooping eyelids, and dizziness or tiredness. If this happens, do not drive or operate machinery. Consult your doctor of pharmacist for more details.

When can I stop?

  • It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.

TIMOLOL MALEATE SIDE EFFECTS

  • Fatigue and weakness
  • Allergic (hypersensitive) reactions, such as skin rash
  • Severe allergic reactions, such as difficulty in breathing or dizziness
  • Heart and circulation problems, such as chest pain, heart attack, fainting, irregular heart beat, slowing of your heart rate, palpitations, low blood pressure, accumulation of fluid in your body, swelling or coldness of your hands, feet and extremities
  • Breathing problems, such as wheezing, shortness of breath, difficulty breathing and cough
  • Stomach problems, such as nausea, diarrhoea, indigestion and dry mouth
  • Low blood sugar
  • Decreased sex drive
  • Hair loss
  • A skin disease called psoriasis or worsening of psoriasis
  • Depression
  • Unable to sleep (insomnia)
  • Nightmares
  • Memory loss
  • Tingling sensation
  • Headache
If any of these persist or you consider them severe then inform doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms:

  • Difficulty in breathing or your asthma gets worse
  • Slow heart rate or the heart slows so much that you faint
  • Heart failure
  • Other heart problems
  • Severe allergic reactions, such as breathing difficulties and swelling mainly of the face and throat
  • Low blood sugar
  • Eye infection (eye drops or gel only)

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website

TIMOLOL MALEATE PRECAUTIONS

Before taking timolol maleate, tell your doctor or pharmacist if you are allergic to it; or to other beta-blockers; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have:

  • Heart problems, such as severe heart failure, irregular heart rhythms (sick sinus syndrome) or very slow heart rate (severe bradycardia)
  • Numb or cold toes (Raynaud's syndrome)
  • Low blood pressure (hypotension)
  • Breathing problems, such as asthma and wheezing
  • A type of chest pain called Prinzmetal's angina
  • High blood pressure due to a tumour of the adrenal glands (phaeochromocytoma)
  • Problems with your blood circulation
  • An eye disorder called corneal dystrophy
  • A condition that causes the blood to be acidic called metabolic acidosis
  • Symptoms such as runny nose, sneezing, itching of the nose, eyes, throat or roof of mouth
  • Pregnancy
  • Breast-feeding

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following:

  • Heart problems, including heart failure or a slow heart rate
  • Diabetes
  • Any allergies
  • A skin condition called psoriasis
  • Wheezing or asthma
  • Liver problems
  • Kidney problems
  • An overactive thyroid (hyperthyroidism)
  • If you wear soft contact lenses

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • You should avoid excessive alcohol consumption while taking timolol maleate tablets.

Diabetes. Timolol maleate should be used with caution in people with diabetes as it may hide some of the usual signs that you blood sugar level is too low. It can also increase the effectiveness of some anti-diabetic drugs, so their dose may need to be changed.

Any allergies. Timolol maleate should be used with caution in people with any allergies, such as hayfever, as it may increase the symptoms of the allergic reaction.

Heart failure. Timolol maleate should be used with caution in people with heart problems as it may cause heart failure.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

Timolol maleate tablets are not safe to take if you are, or are planning to become, pregnant.

Timolol maleate eye drops/gel are not safe to take if you are, or are planning to become, pregnant.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Timolol maleate tablets are not safe to take if you are breastfeeding.

Timolol maleate eye drops/gel are not safe to take if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

TIMOLOL MALEATE INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

  • A type of drug for depression called monoamine oxidase inhibitors

If you are currently using any of these medications, tell your doctor or pharmacist before starting timolol maleate:

  • Drugs for heart problems (verapamil, disopyramide, lignocaine, tocainide, diltiazem, quinidine, amiodarone, nifedipine, digoxin, or any other drugs that are known as class I antiarrhythmic agents)
  • Other beta-blockers
  • Other medicines to treat high blood pressure
  • Drugs used to treat depression or mental problems such as tricyclic antidepressants and phenothiazines
  • Medicines used to treat sleep problems (barbiturates)
  • Drugs used to treat diabetes, such as insulin and oral antidiabetic agents
  • A drug used to treat ulcers called cimetidine
  • An antibiotic used to treat infections called rifampicin
  • Drugs used to improve your circulation
  • Drugs used to treat breathing difficulties, such as salbutamol and isoprenaline
  • Drugs used to treat migraine (ergot preparations)
  • Drugs that are known as prostaglandin synthetase inhibitors, such as ibuprofen, aspirin and indomethacin

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use.

This information does not contain all possible interactions. Therefore, before using timolol maleate, tell your doctor or pharmacist of all the products you use.

TIMOLOL MALEATE OVERDOSE

If you take more than the recommended dose of timolol maleate tablets, then you may feel dizzy or light-headed, have a headache, have trouble breathing, feel like your heart rate has slowed down, faint, experience heart failure or coma. These symptoms will appear about 20 minutes to 2 hours after you take too much of the drug. If this happens, call your doctor immediately or go to your nearest hospital casualty department.

If you put too many drops of timolol maleate eye drops/gel in your eye or swallow some, you may have a headache, feel dizzy or light-headed, have difficulty breathing or feel like your heart rate has slowed down. If this happens, contact your doctor immediately.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of timolol maleate or intentional overdose is suspected, contact your local hospital, GP or if in England call 111 or NHS Direct. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

MISSED DOSE

If you miss a dose of timolol maleate tablets, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

If you miss a dose of timolol maleate eye drops/gel, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited or TicTac Communications Ltd. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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