Uses
What is timolol ophthalmic (eye) used for?
Timolol ophthalmic is commonly used to lower pressure inside the eye in people with open-angle glaucoma or ocular hypertension. These conditions cause increased pressure inside the eye.

Timolol ophthalmic may also be used for other conditions as determined by your healthcare provider.

How does timolol ophthalmic work (mechanism of action)?
High pressure inside the eye can lead to nerve damage and vision loss. Timolol ophthalmic helps to lower pressure inside the eye. It works by reducing the amount of fluid in your eye.

How is timolol ophthalmic supplied (dosage forms)?
Brands and other names

• Betimol
• Istalol
• Timoptic
• Timoptic-XE
• Timoptic in Ocudose

Dosage forms and strengths

• 0.25% ophthalmic gel forming solution (eye drops)
• 0.5% ophthalmic gel forming solution (eye drops)
• 0.25% ophthalmic solution (eye drops)
• 0.5% ophthalmic solution (eye drops)

See Timolol for information on other dosage forms.

How should I store timolol ophthalmic?
Timolol ophthalmic should be stored at temperatures between 59 F to 77 F (15 C to 25 C). Protect from light. Do not freeze.

Some timolol ophthalmic products are packaged in foil to protect them from light. It is best to keep the medicine in the foil pouch until you are ready to use it. If you open the foil pouch ahead of time, the medicine should be used within a month. Ask your pharmacist if you are unsure how to store your timolol eye drops.

Side Effects
What are the most common side effects of timolol ophthalmic?
The most common side effects of timolol ophthalmic are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Blurry vision
• Burning and stinging after you put the drop in your eye
• Other eye discomforts, such as redness, itching, dryness, or feeling like something is in your eye 
• Headache

There may be other side effects of timolol ophthalmic that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of timolol ophthalmic?

While less common, the most serious side effects of timolol ophthalmic are described below, along with what to do if they happen.

New or Worsening Heart Failure. Timolol ophthalmic mainly works in the eye, but may be absorbed into the blood and affect other parts of the body, such as the heart. While rare, timolol ophthalmic may cause or worsen heart failure, which is a condition where the heart is not pumping as well as it should. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.

• Shortness of breath or trouble breathing, especially while lying down
• Swelling in your feet, ankles, or legs
• Unusually fast weight gain
• Unusual tiredness

Breathing Problems. While rare, timolol ophthalmic may cause the muscles around the airways to tighten (bronchospasm). Stop using timolol ophthalmic and get help right away if you have sudden breathing problems.

Low Blood Pressure. Timolol ophthalmic may rarely cause low blood pressure (hypotension). If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

• Dizziness, feeling lightheaded, or fainting
• Confusion
• Feeling weak or tired

Heart Rate Changes. Timolol ophthalmic may rarely make your heart beat slower than normal (bradycardia). Call your healthcare provider right away if you have any of the following symptoms. 

• Feeling lightheaded, dizziness, or fainting
• Confusion
• Feeling weak or easily tired 
• Chest pain
• Shortness of breath

Severe Allergic Reactions. Timolol ophthalmic may cause allergic reactions, which can be serious. Stop using timolol ophthalmic and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Warnings & Precautions
Who should not use timolol ophthalmic?
Allergies to Ingredients. People who are allergic to any of the following should not use timolol ophthalmic.

• Betimol
• Timolol
• Istalol
• Timoptic
• Timoptic-XE
• Timoptic in Ocudose
• Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific timolol ophthalmic products they stock.

Breathing Problems. Timolol ophthalmic should not be used by people with asthma or severe chronic obstructive pulmonary disease (COPD).

Certain Heart Problems. Timolol ophthalmic should not be used by people with the following heart conditions.

• Heart failure, which is when your heart is not pumping as well as it should
• Bradycardia, which is when your heart is beating too slow
• Heart block, which is when the electrical signals in your heart are slowed
• Cardiogenic shock, which is when your heart cannot pump enough blood to the rest of your body

What should I know about timolol ophthalmic before using it?
Do not use timolol ophthalmic unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share timolol ophthalmic with other people, even if they have the same condition as you. It may harm them.

Keep timolol ophthalmic out of the reach of children.

Timolol ophthalmic is an eye drop medicine. Make sure that you or a caregiver understands how to properly administer eye drops. If you have any questions, talk to your healthcare provider.

If you use more than one eye medicine, administer them at least ten minutes apart. Ask your healthcare provider if you are unsure about when to use your eye medicines.

Eye infections may occur if your timolol eye drop container gets contaminated with bacteria or other germs. In some cases, eye infections may become severe and lead to vision loss. To help prevent eye infections, be careful not to let the tip of the eye drop container touch your eye, fingers, or any other surfaces. Wash your hands before each use. Tell your healthcare provider right away if you have an eye infection, eye injury, vision changes, or need to have eye surgery. Symptoms of an eye infection may include pink or itchy eyes, blurry vision or irritation, eye discharge, swollen eyelids, and fever.

Timolol ophthalmic may cause blurry vision as a temporary side effect. Do not drive or do other activities that require clear vision until you know how timolol ophthalmic affects you.

Remove contact lenses before using timolol eye drops. Then wait at least 15 minutes before you put your contacts back in.

Some timolol ophthalmic products come in single-use containers, such as Timoptic in Ocudose. These products are preservative-free, which means they can go bad quickly after the container is opened. Use the medicine as soon as you open it, in one or both eyes as prescribed, then throw away the container. Do not save any leftover medicine.

What should I tell my healthcare provider before using timolol ophthalmic?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if timolol ophthalmic is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

• Heart problems
• Breathing problems
• Problems with blood circulation, such as Raynaud's syndrome
• Diabetes
• Thyroid disorders
• Myasthenia gravis
• Angle-closure glaucoma

Past or Planned Surgery. Using timolol ophthalmic may raise the risk of problems following a certain type of eye surgery for glaucoma. Also, using timolol ophthalmic may increase the risks with medicines commonly used during major surgery (anesthesia). Tell your healthcare provider if you had eye surgery in the past or if you have major surgery planned.

Other Medicines and Supplements. Timolol ophthalmic may interact with other medicines and supplements. Before using timolol ophthalmic, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how timolol ophthalmic could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. Timolol ophthalmic passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use timolol ophthalmic while breastfeeding.

Interactions
Does timolol ophthalmic interact with foods or drinks?
There are no known interactions between timolol ophthalmic and foods or drinks.

It is unknown if drinking alcohol will affect timolol ophthalmic.

Does timolol ophthalmic interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

 In particular, make sure that you discuss if you are taking any of the following medicines before using timolol ophthalmic.

• A beta-blocker that you take by mouth, such as atenolol (Tenormin) or metoprolol (Lopressor, Toprol XL, and others), which is a medicine commonly used for high blood pressure or certain heart conditions
• Other beta-blocker eye drops, such as levobunolol (AKBeta, Betagan) or betaxolol (Betoptic)
• A calcium channel blocker, such as diltiazem (Cardizem CD and others) or verapamil (Verelan, Verelan PM), which is a medicine used for high blood pressure or other conditions
• Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
• Quinidine, which is a medicine used to control your heart rate or rhythm (antiarrhythmic)
• A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine (Prozac), which is a medicine commonly used for anxiety and depression
• Epinephrine injection (Epipen, Auvi-Q, and others)

Some other medicines may alter the blood levels of timolol ophthalmic. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with timolol ophthalmic. Always check with your healthcare provider.

Overdose/ Missed Dose
What should I do if I accidentally use too much timolol ophthalmic?
If you or someone else has used too much timolol ophthalmic, get medical help right away, call 123, or contact a Poison Control center.

What should I do if I miss a dose of timolol ophthalmic?
If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.

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