Timolol Maleate(tim’ oh lol)
Apo-Timol (CAN), Apo-Timop (CAN), Betimol, Blocadren, Gen-Timolol (CAN), Istalol, PMS-Timolol (CAN), Timoptic, Timoptic Ocudose, Timoptic-XE
PREGNANCY CATEGORY C
Drug Classes
Antiglaucoma drug
Antihypertensive
Beta-adrenergic blocker
Therapeutic Actions
Competitively blocks beta-adrenergic receptors in the heart and juxtaglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues and decreasing the excitability of the heart, decreasing cardiac output and oxygen consumption, decreasing the release of renin, and lowering BP; reduces IOP by decreasing the production of aqueous humor and possibly by increasing aqueous humor outflow.
Indications
Hypertension, used alone or in combination with other antihypertensives, especially thiazide-type diuretics
Prevention of reinfarction in MI patients who are hemodynamically stable
Prophylaxis of migraine
Ophthalmic solution: Reduction of IOP in open-angle glaucoma, ocular hypertension
Contraindications and Cautions
Contraindicated with hypersensitivity to components of the drug, sinus bradycardia (HR less than 45 beats/min), second- or third-degree heart block (PR interval greater than 0.24 sec), cardiogenic shock, HF, asthma, COPD, pregnancy, lactation.
Use cautiously with diabetes or thyrotoxicosis (timolol can mask the usual cardiac signs of hypoglycemia and thyrotoxicosis), with general anesthesia in major surgery.
Available Forms
Tablets—5, 10, 20 mg; ophthalmic solution, gel—0.25%, 0.5%
Dosages
Adults
Oral
Hypertension: Initially, 10 mg PO bid. Increase dosage at 1-wk intervals to a maximum of 60 mg/day PO divided into two doses, as needed. Usual maintenance dose is 20–40 mg/day given in two divided doses.
Prevention of reinfarction in MI (long-term prophylaxis in patients who survived the acute phase): 10 mg bid PO within 1–4 wk of infarction.
Migraine: 10 mg PO bid; during maintenance, the 20 mg/day may be given as a single dose. May be increased to a maximum of 30 mg/day in divided doses or decreased to 10 mg/day. Discontinue if satisfactory response is not obtained after 6–8 wk.
Ophthalmic
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