Index of drugs

Decrease in intraocular pressure in patients with ocular hypertension and chronic open-angle glaucoma.

1 g of eye gel contains 1 mg of Timolol in the form of maleate.

A non-selective β-adrenergic receptor antagonist for topical use. It does not have a significant stimulating effect or direct inhibitory effect on the heart, there is no membrane stabilization activity. It lowers normal and elevated intraocular pressure. The mechanism of pressure reduction in the eye has not been fully understood; probably it mainly consists in reducing the amount of aqueous humor produced. Timolol may also modify the outflow of aqueous humor to a lesser extent. The drug has little effect on pupil size or visual acuity. The reduction of intraocular pressure after local instillation of timolol is usually detectable as early as 30 minutes after administration of the drug to the eye; maximal effect of the drug is obtained within about 2 hours after administration, and a significant reduction in intraocular pressure may persist for up to 24 h. The preparation is maximally absorbed by the eye tissue, while the systemic absorption of the drug is reduced. Absorption of timolol 0.1% in the form of an eye gel to the systemic circulation is 90% lower compared with timolol 0.5% given in the form of eye drops. This is due to the fact that the daily dose of timolol maleate is 10-fold lower.

Hypersensitivity to timolol or any of the components of the drug and / or to other beta blockers. Bronchial asthma, a positive history of bronchial asthma or severe obstructive pulmonary disease. Sinus bradycardia, atrio-ventricular block IIst. or third-century, overt cardiac failure, cardiogenic shock. Severe peripheral circulation disorders (Raynaud's disease) and (or) other forms of these disorders. Printzmetal Angels. Untreated phaeochromocytoma. Hypotension. Severe corneal diseases. Severe allergic rhinitis or hyperresponsiveness of the bronchi. Concomitant use of amiodarone.

The preparation should be used with caution in patients with sick sinus syndrome, metabolic acidosis or low blood pressure. Before starting treatment, patients should be excluded from heart failure. Patients with a history of severe cardiac disease should be monitored for early signs of possible heart failure. β-blockers may mask some of the symptoms of hyperthyroidism, eg tachycardia - patients with suspected thyrotoxicosis should be monitored so that they do not suddenly withdraw from β-blockers, which could cause a thyroid disorder. When used to reduce intraocular pressure in patients with angle-closure glaucoma, it should be used in combination with a pupil constricting agent. By taking β-blockers, patients with a history of atopy or severe anaphylactic reactions due to various allergens may be more susceptible to allergic reactions after repeated exposure to allergens. Exposure to a sensitizing factor may be accidental, it may also occur during diagnostic tests or during therapy. The dose of epinephrine usually used to treat anaphylactic reactions may be too low in these patients. It is not recommended to use the preparation with other topical β-blockers. Caution is advised when used with systemic beta-blockers. Concomitant administration of MAO inhibitors should be avoided. Patients with diabetes should carefully monitor their blood Glucose levels at the start of treatment; Timolol therapy may mask the signs and symptoms of hypoglycaemia, especially tachycardia, palpitations and excessive sweating. Consider discontinuation of beta blockers prior to extensive surgical procedures, please inform the anesthetist that you are using the preparation. It is not recommended for use in children under 12 years.The preparation contains sorbitol - do not use in patients with rare hereditary fructose intolerance.

It should not be used during pregnancy unless clearly necessary. Use during breastfeeding is not recommended.

Eye disorders: conjunctivitis, blepharitis, keratitis, decreased corneal sensation, visual disturbances, including refractive changes (associated in some cases with discontinuation of the miotics), double vision and ptosis. In 30-50% of patients, short-term blurred vision may occur. During β-blocker therapy, cases of dry eye syndrome have been reported. Other side effects include: bradycardia, atrioventricular conduction slowing or exacerbation of the existing atrio-ventricular block, hypotension, heart failure, arrhythmia, syncope, cerebral circulation, cerebral ischemia, palpitations, Raynaud's phenomenon, cold hands and feet, intermittent claudication, retention heart rate, bronchospasm (mainly in patients with obstructive pulmonary disease and bronchitis), respiratory failure, shortness of breath, cough, fatigue, headaches, weakness, chest pain, dizziness, depression, insomnia, nightmares, memory loss, paresthesia, worsening of signs and symptoms of myasthenia gravis, nausea, diarrhea, indigestion, dry mouth, sexual dysfunction, Peyronie's syndrome, systemic lupus erythematosus, hypersensitivity reactions, local and generalized erythema, including urticaria, alopecia, psoriatic-like lesions or exacerbation existing psoriasis, allergic reactions induced by benzalkonium chloride. After systemic exposure to Timolol, the following side effects were noted: cystoid macular edema in the lens without eyesight, dry mouth, nasal congestion, anorexia, indigestion, effect on o.u.n. (confusion, hallucinations, anxiety, confusion, nervousness, drowsiness and other psychiatric disorders), hypertension and retroperitoneal fibrosis.

Adults and children over 12 years: 1 drop into the conjunctival sac of the affected eye (eyes) once a day, preferably in the morning. After instillation of the drug, it is recommended to compress the nasolabial duct or close the eyelids for 3 minutes. Intraocular pressure should be measured again 2-4 weeks after the start of treatment, because the response to treatment may stabilize several weeks after the start of therapy. If necessary, the preparation may be used in combination with miocinatricators, adrenaline, prostaglandin analogs, alpha-2-agonists and / or carbonic anhydrase inhibitors. If several medications are administered to the eye, a 5-minute interval should be observed between the administration of subsequent preparations; timolol in the form of eye gel should be given last.
When changing other topical β-blockers to timolol in the form of eye gel, these products should be discontinued after a full day of treatment, and timolol should be started the Next day. When switching from an anti-glaucoma drug to a non-beta-blocker for topical use, the drug should be continued, adding 1 drop of the formulation to the conjunctival sac of the affected eye (s) once a day; the next day stop using the anti-glaucoma drug and continue treatment with timolol.