Timolol - instructions for use, reviews, analogs and forms of release (eye drops 0.25% and 0.5% Oftan, Teva, Akos, Timogel gel) drugs for the treatment of glaucoma or lowering of intraocular pressure in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Timolol. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of physicians specialists on the use of Timolol in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Timolol in the presence of existing structural analogues. Use to treat primary and secondary glaucoma or reduce intraocular pressure in adults, children, as well as during pregnancy and lactation.Composition of the preparation.

Timolol - antiglaucoma preparation, non-selective beta-blocker. Has no internal sympathomimetic and membrane-stabilizing activity. With topical application in the form of eye drops, timolol reduces both normal and increased intraocular pressure by reducing the formation of intraocular fluid. Does not affect the size of the pupil and accommodation.

The effect of the drug manifests itself 20 minutes after instillation into the conjunctival cavity. The maximum decrease in intraocular pressure occurs after 1-2 hours and persists for 24 hours.

Has antianginal, hypotensive and antiarrhythmic effects, which are manifested in systemic application. Reduces the automatism of the sinus node, reduces heart rate, slows AV-conduction, reduces contractility and the need for myocardium in oxygen.

Composition

Timolol maleate + auxiliary substances.

Pharmacokinetics

When topical application of timolol maleate quickly penetrates through the cornea. After instillation of eye drops, the maximum concentration of timolol in the aqueous humor of the eye is achieved after 1-2 hours.80% of timolol, used in the form of eye drops, enters the systemic bloodstream by absorption through the vessels of the conjunctiva, the nasal mucosa and the lacrimal tract. The excretion of timolol metabolites is mainly carried out by the kidneys. In newborns and small children, the concentration of timolol, as an active substance, significantly exceeds its maximum concentration (Cmax) in adult blood plasma.

Indications

• increased intraocular pressure (ophthalmic hypertension);
• open-angle glaucoma;
• glaucoma on the aphakic eye and other types of secondary glaucoma;
• as an additional means to reduce intraocular pressure in closed-angle glaucoma (in combination with miotics);
• Congenital glaucoma (with ineffectiveness of other agents).

Forms of release

Eye drops in a solution of 0.25% and 0.5%.

Eye Gel Oftan Timogel.

Instructions for use and how to use them

At the beginning of treatment, 1-2 drops are prescribed to the affected eye in the form of drops of the eye 0.25% or drops of the eye 0.5% 2 times a day.

If intraocular pressure with normal use is normalized, you should lower the dose to 1 drop 1 time per day in the morning.

Treatment with Timolol is carried out, as a rule, for a long time. A break in treatment or a change in the dosage of the drug is carried out only on the instructions of the attending physician.

Side effect

Local Reactions

• blurring of vision;
• irritation and congestion hyperemia;
• burning and itching of the eyes;
• lacrimation;
• edema of the epithelium of the cornea;
• point surface keratopathy;
• hyperesthesia of the cornea;
• dry eye syndrome;
• blepharitis;
• conjunctivitis;
• keratitis;
• development of ptosis and rarely - diplopia;
• when performing fistulizing (penetrating) antiglaucomal operations, it is possible to develop a detachment of the choroid in the postoperative period.

Systemic reactions

• bradycardia;
• bradyarrhythmia;
• a decrease in blood pressure;
• collapse;
• heart block;
• transient disorders of cerebral circulation;
• exacerbation of chronic heart failure;
• chest pain;
• nausea;
• diarrhea;
• nasal congestion;
• dyspnea;
• bronchospasm;
• pulmonary insufficiency;
• headache;
• dizziness;
• weakness;
• confusion of consciousness;
• hallucinations;
• insomnia;
• anxiety;
• mood change;
• paresthesia;
• alopecia;
• psoriasis-like rashes and exacerbation of psoriasis;
• Peyronie's disease;
• decreased potency;
• generalized or localized rash;
• itching;
• myasthenia gravis;
• tinnitus.

Contraindications

• bronchial asthma or other severe chronic obstructive airway disease;
• sinus bradycardia;
• AV-blockade of 2 and 3 degrees;
• Decompensated heart failure;
• dystrophic processes in the cornea;
• children and adolescents under 18 years (due to the lack of data on the effectiveness and safety of the drug in children and adolescents);
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

There is no sufficient experience in the use of the drug during pregnancy and lactation, but it has been established that timolol penetrates the placental barrier and is excreted in breast milk. By appointment, the treating doctor Timolol can be used during pregnancy and during breastfeeding in cases where the expected therapeutic effect for the mother justifies the potential risk to the fetus and the baby.

If the drug was used immediately before delivery or during breastfeeding, newborns should be closely monitored for several days after birth and for the entire treatment period of nursing mothers with Timolol.

Use in children

Due to the lack of data on efficacy and safety, the use of the drug in children and adolescents under the age of 18 is contraindicated.

special instructions

It is recommended to control the effectiveness of the drug approximately 3-4 weeks after the start of therapy (not earlier than in 1-2 weeks). With prolonged use of timolol, the effect may be weakened.

When applying, it is necessary to monitor the function of tearing, the condition of the cornea and to assess the magnitude of the visual fields at least once every 6 months.

Timolol contains a preservative of benzalkonium chloride, which can cause eye irritation, absorbed by soft contact lenses, causing a change in their color, and have an adverse effect on the tissues of the eye. Contact lenses should be removed before using the drug and, if necessary, set them again not earlier than 15 minutes after instillation.

When translating patients for treatment with timolol, correction of refractive changes caused by previously used miotics may be required.

Gel Oftan Timogel can be used to treat skin hemangiomas in children with adequate protection of the eyes from getting medication in them.

Timolol, like other beta-blockers, can mask possible symptoms of hypoglycemia in patients with diabetes mellitus.

In the case of an upcoming surgical intervention under general anesthesia, it is necessary to cancel the drug 48 hours prior to surgery, because Timolol enhances the action of muscle relaxants and general anesthetics.

Do not bury two different beta-blockers in the same eye.

Impact on the ability to drive vehicles and manage mechanisms

During the period of treatment, care must be taken when driving vehicles and during work with complex equipment requiring increased concentration of attention, rapidity of psychomotor reactions and good vision (within 30 minutes after instillation into the eye), since the drug can reduce blood pressure, cause fatigue and dizziness.

Drug Interactions

The combined use of Timolol with eye drops that contain epinephrine may cause a dilated pupil.

With simultaneous use of eye drops containing epinephrine and pilocarpine, it is possible to increase the decrease in intraocular pressure.

Arterial hypotension and bradycardia can increase with the simultaneous use of Timolol with calcium antagonists, reserpine and systemic beta-blockers.

Inhibitors of the CYP2D6 isoenzyme, such as quinidine and cimetidine, can increase the concentration of timolol in the plasma.

Simultaneous use with insulin or oral hypoglycemic agents can lead to hypoglycemia.

Timolol strengthens the action of muscle relaxants, so it is necessary to cancel the drug 48 hours before the planned surgical intervention under general anesthesia. These data can also refer to medicines that were applied shortly before.

Analogues of the drug Timolol

Structural analogs for the active substance:

• Arutimol;
• Glaumol;
• Glautam;
• Gullet;
• Cusimolol;
• Niolol;
• Okumed;
• Okumol;
• Ocupresse E;
• Optimol;
• Oftan Timogel;
• Oftan Timolol;
• Otrensin;
• Rotima;
• TimoGexal;
• Thymol;
• Timolol buffous;
• Timolol Akos;
• Timolol Betalek;
• Timolol Dia;
• Timolol Lance;
• Timolol MEZ;
• Timolol PIC;
• Timolol Solofarm;
• Timolol Teva;
• Timolola maleate;
• Timololong;
• Timothy;
• Timothy Depot.

Analogues on the curative effect (agents for the treatment of open-angle glaucoma):

• Azarga;
• Asopt;
• Amylonosar;
• Betoptik;
• Betoptik C;
• Histochrome;
• Dorzopt Plus;
• Clopheline;
• Kosopt;
• Xalacom;
• Xalatamax;
• Xalatan;
• Xoneuf;
• Xoneuf BC;
• Cusimolol;
• Lanotan;
• Mexidol;
• Oftan Dipivefrin;
• Oftan Pilocarpine;
• Oftan Timolol;
• Pikamilon;
• Pikago;
• Pilocarpine;
• Pilotimol;
• Pilotimol mini;
• Proserin;
• Proxodolol;
• Proksokarpin;
• Proxopheline;
• Retinalamine;
• Strix;
• Strix forte;
• Timpilo;
• Travatane;
• Trusopt;
• Fotil;
• Fotil forte.

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