Timolol Maleate

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Sep 08, 2022

Warnings

Timolol Risks, Warnings, and Complications

Timolol ophthalmic solution can cause serious medical problems in some people. Keep in mind that this eye medication can cause some of the same adverse reactions as oral beta blockers. Talk to your doctor about other options to treat ocular hypertension or glaucoma if you are at increased risk of complications. Some of the risks of timolol use include:

HEART FAILURE: Rarely, using timolol can lead to diminished myocardial contractility and impaired cardiac function (heart failure). The risk is greater in people with pre-existing congestive heart failure or second or third-degree heart block. Tell your doctor if you have a history of heart problems before systemic or ophthalmic administration of beta-adrenergic blocking agents. Call your healthcare professional if you notice swelling in your ankles or feet, an irregular or fast pulse, or shortness of breath with exercise or lying down.
TROUBLE BREATHING: Beta blockers like timolol can cause difficulty breathing. These medicines may not be suitable for asthma and chronic obstructive pulmonary disease patients. Timolol ophthalmic solution has a lower chance of causing breathing problems than timolol maleate administered orally (oral beta blockers) because very little of the ophthalmic solution is absorbed into the bloodstream. However, make sure your doctor knows about any history of asthma, chronic obstructive pulmonary disease (COPD), or other lung problems before starting timolol ophthalmic solution.
MASKING OF SYMPTOMS OF LOW BLOOD SUGAR: In people with diabetes, beta blockers like timolol maleate ophthalmic solution can mask or hide the symptoms of low blood sugar (other than dizziness and sweating). The risk is low with timolol eye drops because very small amounts are absorbed into the bloodstream. However, if you have diabetes, talk to your healthcare professionals about how often you should monitor your blood glucose levels after starting timolol maleate ophthalmic solution.
MASKING OF SYMPTOMS OF OVERACTIVE THYROID: Beta-adrenergic blocking agents like timolol can mask or hide symptoms of hyperthyroidism (overactive thyroid), such as fast heart rate. The risk is low with timolol because very small amounts of the medicine are absorbed from the eye drops into the bloodstream. However, you should tell your healthcare professional if you have thyroid problems before starting any beta-adrenergic blocking agents like timolol.

Precautions Before Starting Timolol

Tell your doctor if you have had an allergic reaction to timolol, any of the active or inactive ingredients in timolol preparations, other beta-adrenergic blocking agents, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor a complete medical history. An adrenergic receptor blocking agent like timolol may not be right for people with certain health conditions, such as thyroid disease, heart disease, congestive heart failure, lung disease, diabetes, and myasthenia gravis (a condition characterized by muscle weakness).

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions between timolol and your other medicines.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breastfeeding.

Precautions During Use of Timolol

Keep all your healthcare appointments while taking timolol. Your doctor may want to adjust your dose and monitor you for any adverse reactions.

If you are also using other eye drops, make sure you apply them at least 10 minutes away from timolol.

If you wear soft contact lenses, remove them before applying timolol ophthalmic solution. Wait at least 15 minutes before putting your contact lenses back in.

Tell your healthcare professional if you become pregnant while on timolol. Let your doctors know that you are using timolol before any surgery, including dental procedures. If you have eye surgery, an eye infection, or an eye injury while on timolol eye drops, ask your healthcare professionals if you can continue using the same bottle of timolol eye drops.

Timolol can cause temporary blurring of vision. Do not drive, operate machinery, or do other activities that require clear vision until you can see clearly.

Timolol Drug Interactions

Concomitant administration of timolol eye drops with certain other medicines can affect how the medicines work. Possible drug interactions between timolol and other medicines can also increase the risk of severe adverse events. Your doctor may change the dose of your medications or monitor you carefully for possible side effects if there are known interactions between timolol and your other medicines.

The following medications can have interactions with timolol:

Other beta-blockers such as metoprolol (Lopressor), atenolol (Tenormin), esmolol (Brevibloc), carteolol (Cartrol), labetalol (Trandate, Normodyne), propranolol (Inderal), nadolol (Corgard), sotalol (Betapace), and timolol oral (Blocadren)
Heart medications like verapamil (Calan, Isoptin) and quinidine (Quinaglute Dura-Tabs, Quinidex)
Vitamins

The above list may not include all the possible interactions of timolol. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, non-prescription medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.

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