Select therapeutic use:

CHF and arrhythmias:

Hypertension:

Indications for: Timolol

Hypertension.

Clinical Trials:

Clinical studies indicate that timolol maleate at a dosage of 20-60 mg/day reduces blood pressure (BP) without causing postural hypotension in most patients with essential hypertension. Administration of timolol results initially in a decrease in cardiac output, little immediate change in BP, and an increase in calculated peripheral resistance. 

With continued administration, BP decreases within a few days, cardiac output usually remains reduced, and peripheral resistance falls toward pretreatment levels. Plasma volume may decrease or remain unchanged during therapy. Timolol also decreases plasma renin activity in the majority of patients with hypertension. 

Dosage adjustment to achieve optimal antihypertensive effect may require a few weeks. When therapy with timolol is discontinued, BP tends to return to pretreatment levels gradually. In most patients the antihypertensive activity of timolol is maintained with long-term therapy and is well tolerated.

Adult Dosage:

Initially 10mg twice daily. Increase weekly if needed. Usual maintenance: 20–40mg/day; max 60mg/day in 2 divided doses.

Children Dosage:

Not recommended.

Timolol Contraindications:

Asthma. Severe COPD. Sinus bradycardia. 2nd- or 3rd-degree AV block. Overt heart failure. Cardiogenic shock.

Timolol Warnings/Precautions:

CHF. Ischemic heart disease. Bronchospastic disease, COPD. Renal or hepatic dysfunction. Diabetes. Hyperthyroidism. Cerebrovascular insufficiency. Surgery. SLE. Avoid abrupt cessation. Pregnancy (Cat.C). Nursing mothers: not recommended.

Timolol Classification:

Beta-blocker.

Timolol Interactions:

Hypotension, bradycardia with catecholamine-depleting drugs. May increase cardiac effects of calcium channel blockers, digitalis. May be potentiated by quinidine. Increased rebound hypertension with clonidine withdrawal. Antagonized by NSAIDs. Adjust antidiabetic medications. May interfere with glaucoma screening tests. May block epinephrine.

Adverse Reactions:

Cardiac failure, bronchospasm, asthenia, bradycardia, dizziness, arrhythmia, heart block, dyspnea, muscle weakness, cold extremities, decreased libido, chest pain, syncope, pruritus.

Note:

Formerly known under the brand name Blocadren.

Metabolism:

Hepatic.

Drug Elimination:

Renal. Half-life: ~4hrs.

How Supplied:

Contact supplier

Migraine and headache:

Indications for: Timolol

Migraine prophylaxis.

Clinical Trials:

The efficacy of timolol for the prophylactic treatment of migraine was evaluated in a placebo-controlled clinical trial that included 400 patients (18-66 years old; mostly female). The most frequent diagnosis was common migraine with all patients having at least 2 headaches per month at baseline. 

Findings showed a greater proportion of timolol-treated patients had a reduction in the frequency of migraine headache of at least 50%, compared with those who received placebo (50% vs 30%, respectively). The most common cardiovascular adverse effect was bradycardia (5%).

Adult Dosage:

Initially 10mg twice daily. Increase weekly if needed; max 30mg daily in 2 divided doses. Evaluate at 6–8 wks.

Children Dosage:

Not recommended.

Timolol Contraindications:

Asthma. Severe COPD. Sinus bradycardia. 2nd- or 3rd-degree AV block. Overt heart failure. Cardiogenic shock.

Timolol Warnings/Precautions:

CHF. Ischemic heart disease. Bronchospastic disease, COPD. Renal or hepatic dysfunction. Diabetes. Hyperthyroidism. Cerebrovascular insufficiency. Surgery. SLE. Avoid abrupt cessation. Pregnancy (Cat.C). Nursing mothers: not recommended.

Timolol Classification:

Beta-blocker.

Timolol Interactions:

Hypotension, bradycardia with catecholamine-depleting drugs. May increase cardiac effects of calcium channel blockers, digitalis. May be potentiated by quinidine. Increased rebound hypertension with clonidine withdrawal. Antagonized by NSAIDs. Adjust antidiabetic medications. May interfere with glaucoma screening tests. May block epinephrine.

Adverse Reactions:

Cardiac failure, bronchospasm, asthenia, bradycardia, dizziness, arrhythmia, heart block, dyspnea, muscle weakness, cold extremities, decreased libido, chest pain, syncope, pruritus.

Note:

Formerly known under the brand name Blocadren.

Metabolism:

Hepatic.

Drug Elimination:

Renal. Half-life: ~4hrs.

How Supplied:

Contact supplier

Thromboembolic disorders:

Indications for: Timolol

In stabilized patients after MI, to reduce mortality and risk of reinfarction.

Clinical Trials:

Timolol maleate was compared with placebo In a double-blind study that included 1884 patients (20-75 years old) who had survived the acute phase of a myocardial infarction. Treatment with timolol, started 7 to 28 days following infarction, resulted in reduced overall mortality when compared with placebo; this effect was primarily attributable to a reduction in cardiovascular mortality.

Timolol also significantly reduced the incidence of sudden death and the incidence of nonfatal reinfarction. An analysis of data showed that the treatment effect was clearest for patients with a first infarction who were considered at a high risk of dying.

Adult Dosage:

10mg twice daily.

Children Dosage:

Not recommended.

Timolol Contraindications:

Asthma. Severe COPD. Sinus bradycardia. 2nd- or 3rd-degree AV block. Overt heart failure. Cardiogenic shock.

Timolol Warnings/Precautions:

CHF. Ischemic heart disease. Bronchospastic disease, COPD. Renal or hepatic dysfunction. Diabetes. Hyperthyroidism. Cerebrovascular insufficiency. Surgery. SLE. Avoid abrupt cessation. Pregnancy (Cat.C). Nursing mothers: not recommended.

Timolol Classification:

Beta-blocker.

Timolol Interactions:

Hypotension, bradycardia with catecholamine-depleting drugs. May increase cardiac effects of calcium channel blockers, digitalis. May be potentiated by quinidine. Increased rebound hypertension with clonidine withdrawal. Antagonized by NSAIDs. Adjust antidiabetic medications. May interfere with glaucoma screening tests. May block epinephrine.

Adverse Reactions:

Cardiac failure, bronchospasm, asthenia, bradycardia, dizziness, arrhythmia, heart block, dyspnea, muscle weakness, cold extremities, decreased libido, chest pain, syncope, pruritus.

Note:

Formerly known under the brand name Blocadren.

Metabolism:

Hepatic.

Drug Elimination:

Renal. Half-life: ~4hrs.

How Supplied:

Contact supplier