Timolol

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

CAS number: 26839-75-8

Definition
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Timolol belongs to the group of beta-adrenoceptor antagonists (beta blockers) and blocks the action of the stress hormones adrenaline and noradrenaline. As a result, their activating effect, especially on the heart, is dampened. Timolol is used in the eye to reduce increased intraocular pressure. It is available as a solution with a concentration between 0.1-0.5%.

Pharmacodynamics (Effect)
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Beta-blockers have been used since 1978 as eye drops to reduce intraocular pressure in the treatment of open-angle glaucoma. Timolol reduces the production of aqueous humor by inhibiting the beta-receptor-mediated stimulation of the Na+ - K+-ATPase in the ciliary body.

Pregnancy/nursing period
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Timolol should not be used during pregnancy unless clearly necessary. If Timolol is administered until birth, the newborn baby should be carefully monitored during the first days of life.

Lactation: Beta-blockers pass into breast milk and may cause serious adverse effects in the breastfed infant.

Dosage and method of use
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The following dosage recommendations are given:

Start of treatment:

  • Infants from the 5th week, children and adults1111
  • Single dose: 1 drop
  • Total dose: 2 times a day
  • Time: spread over the day

Undesirable effects
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Due to the reduction of tear production, keratoconjunctivitis sicca (dry eye syndrome) can occur. Systemic effects (e.g. bradycardia, asthmatic complaints) may occur. change: Other beta-blockers: In patients already treated with systemic beta-blockers, the use of Timolol may potentiate the effect on intraocular pressure or the known effects of a systemic beta-blockade. The response of these patients should be closely monitored. The use of two local beta blockers is not recommended.

Anaphylactic reactions During treatment with beta-blockers, patients with atopy or severe anaphylactic reactions to various allergens in their medical history may react more violently to repeated administration of such allergens. These patients may not respond to the usual dose of adrenaline used to treat anaphylactic reactions.

Muscle weakness/myasthenia gravis In patients with muscle weakness, increased muscle weakness in the sense of myasthenic symptoms such as diplopia, ptosis and general weakness has been reported under beta-receptor blockade

Newer eye drops combine beta blockers with other substances. It is feared that systemic side effects caused by new combination preparations might not be recognized or that patients might not mention their eye drops in their medical history.

Contraindication
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Bronchial asthma, bradycardia (<50 beats/min), chronic obstructive pulmonary disease, AV block II or III degree.

Preparations
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ArucomĀ® 50 micrograms/ml + 5 mg/ml eye drops, solution

Patientinformation
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Nature of the application? Drop the medicine into the conjunctival sac of the affected eye. Put your head back for the application. Close your eye slowly and press lightly with your finger on the tear duct between your nose and inner eyelid.

Literature
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  1. Schwabe U et al (2006) (Ed.): Arzneiverordnungs-Report 2006, Berlin, Heidelberg, New York: Springer-Verlag.
  2. Muller ME et al. (2006) Syncope and falls due to timolol eye drops. BMJ 332: 960-961.
  3. Goldberg I (2002) Should beta blockers be abandoned as initial monotherapy in chronic open angle glaucoma? The controversy. Br J Ophthalmol86: 691-692.

Incoming links (1)

Beta-receptor blockers;

Authors

Last updated on: 29.10.2020