Timolide (Oral)

Timolol and hydrochlorothiazide combination is used to treat high blood pressure (hypertension). High blood pressure increases the strain on the heart and arteries. If it lasts for a long time, the heart and arteries may not work properly. This can harm the blood vessels in the brain, heart, and kidneys, leading to a stroke, heart failure, or kidney failure. High blood pressure may also raise the risk of heart attacks. Controlling blood pressure may help reduce these risks.

Timolol is a beta-blocker. It works by changing how some nerve signals affect certain areas of the body, such as the heart. This causes the heart to beat slower and lowers blood pressure. When blood pressure goes down, more blood and oxygen reach the heart.

Hydrochlorothiazide is a diuretic (water pill). It decreases the amount of water in the body by increasing urine flow, which helps lower blood pressure.

This medicine is available only with your doctor's prescription.

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

This medicine may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

In deciding to use a medication, the chances of using the medicine must be weighed against the beneficial it will do. This is a decision you and your physician will make. For this medicine, the following should be considered:

Allergies

Inform your clinician if you have ever had any unusual or allergic reaction to this drug or any other drugs. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of timolol and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of timolol and hydrochlorothiazide combination in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment of dosage in patients receiving timolol and hydrochlorothiazide combination.

Breast Feeding

There are no adequate studies in women for determining infant chance when using this medication during breastfeeding. Weigh the potential benefits against the potential chances before using this drug while breastfeeding.

Interactions with Medications

Although certain drugs should not be used together at all, in other cases two different medications may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using this medicine, it is especially important that your healthcare professional know if you are taking any of the drugs listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medication with any of the following medications is not advised. Your physician may decide not to treat you with this medication or change some of the other medications you take.

• Dofetilide

Using this medicine with any of the following medications is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your physician may change the dose or how frequently you use one or both of the medications.

• Abiraterone Acetate
• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Albuterol
• Alogliptin
• Amphetamine
• Amtolmetin Guacil
• Arsenic Trioxide
• Aspirin
• Benzphetamine
• Bromfenac
• Bromocriptine
• Bufexamac
• Buprenorphine
• Bupropion
• Canagliflozin
• Celecoxib
• Ceritinib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Cobicistat
• Codeine
• Crizotinib
• Dapagliflozin
• Darunavir
• Deslanoside
• Desmopressin
• Desvenlafaxine
• Dexibuprofen
• Dexketoprofen
• Dextroamphetamine
• Diclofenac
• Diflunisal
• Digitalis
• Digitoxin
• Digoxin
• Diltiazem
• Dipyrone
• Dronedarone
• Droperidol
• Droxicam
• Dulaglutide
• Duloxetine
• Empagliflozin
• Escitalopram
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Fedratinib
• Felbinac
• Fenoldopam
• Fenoprofen
• Fepradinol
• Feprazone
• Fingolimod
• Flecainide
• Floctafenine
• Flufenamic Acid
• Fluoxetine
• Flurbiprofen
• Formoterol
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indacaterol
• Indomethacin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Iobenguane I 131
• Iohexol
• Ketanserin
• Ketoprofen
• Ketorolac
• Lacosamide
• Levalbuterol
• Levomethadyl
• Linagliptin
• Liraglutide
• Lisdexamfetamine
• Lithium
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Methamphetamine
• Methotrexate
• Metildigoxin
• Miglitol
• Morniflumate
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Olodaterol
• Ouabain
• Oxaprozin
• Oxymetazoline
• Oxyphenbutazone
• Parecoxib
• Paroxetine
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Ponesimod
• Porfimer
• Pramlintide
• Proglumetacin
• Propyphenazone
• Proquazone
• Proscillaridin
• Repaglinide
• Rivastigmine
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salmeterol
• Salsalate
• Saxagliptin
• Sertraline
• Sitagliptin
• Sodium Salicylate
• Sotalol
• Sulindac
• Tapentadol
• Tenoxicam
• Terbutaline
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Topiramate
• Valdecoxib
• Venlafaxine
• Verapamil
• Vilanterol
• Vildagliptin

Using this drug with any of the following drugs may cause an increased chance of certain adverse effects, but using both drugs may be the best therapy for you. If both medicines are prescribed together, your clinician may change the dose or how frequently you use one or both of the medications.

• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Aminolevulinic Acid
• Amtolmetin Guacil
• Aspirin
• Bepridil
• Bromfenac
• Bufexamac
• Carbamazepine
• Celecoxib
• Cholestyramine
• Choline Salicylate
• Clonixin
• Deslanoside
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitoxin
• Digoxin
• Dipyrone
• Droxicam
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Ginkgo
• Gossypol
• Ibuprofen
• Indomethacin
• Ketoprofen
• Ketorolac
• Licorice
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metildigoxin
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Piketoprofen
• Piroxicam
• Pranoprofen
• Proglumetacin
• Propyphenazone
• Proquazone
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• St John's Wort
• Sulindac
• Tenoxicam
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Valdecoxib

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may additionally cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Issues

The presence of other medical issues may affect the use of this medication. Make sure you tell your clinician if you have any other medical issues, especially:

• Angina (serious chest pain)—May provoke chest pain if stopped too quickly.

• Anuria (not capable to form urine) or
• Asthma or
• Bradycardia (slow heartbeat) or
• Chronic obstructive pulmonary disease (COPD), serious or
• Heart block or
• Heart failure—Should not use in patients with these conditions.

• Blood vessel disease (especially blood vessels in the brain) or
• Gout or
• High cholesterol or
• Hyperuricemia (high uric acid in the blood) or
• Hypochloremia (low chloride in the blood) or
• Hypokalemia (low potassium in the blood) or
• Hypomagnesemia (low magnesium in the blood) or
• Hyponatremia (low sodium in the blood) or
• Parathyroid disease or
• Stroke, history of or
• Systemic lupus erythematosus—Use with caution. This medicine may make these conditions worse.

• Diabetes or
• Hyperthyroidism (overactive thyroid) or
• Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat.

• Kidney disease, serious or
• Liver disease—Use with caution. The effects may be increased since of slower removal of the medication from the body.

• Lung disease (e.g. bronchitis, emphysema)—May cause difficulty with breathing in patients with this condition.

• Myasthenia gravis—May worsen symptoms of this condition, such as muscle weakness.

• Sympathectomy—Use with caution. The effects of this drug may be increased.

Along with its needed effects, Timolide (Oral) may cause some unwanted effects. Not all of these side effects may occur, but if they do, they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

• Blurred vision
• Chest pain or discomfort
• Confusion
• Cough
• Difficult or labored breathing
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Lightheadedness, dizziness, or fainting
• Noisy breathing
• Shortness of breath
• Slow or irregular heartbeat
• Sweating
• Tightness in chest
• Unusual tiredness or weakness
• Wheezing

Rare

• Bloody or cloudy urine
• Dilated neck veins
• Extreme fatigue
• Fast heartbeat
• Irregular breathing
• Pain in lower back or side
• Small clicking, bubbling, or rattling sounds in the lung when listening with a stethoscope
• Swelling of face, fingers, feet, or lower legs
• Weight gain

Incidence not determined

• Ankle, knee, or great toe joint pain
• Fixed position of eye
• Headache
• Inability to speak
• Joint stiffness or swelling
• Muscle cramps
• Seizures
• Severe numbness, especially on one side of the face or body
• Severe or sudden headache
• Slurred speech
• Temporary blindness
• Weakness in arm and/or leg on one side of the body, sudden and severe

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to Timolide (Oral). Your health care professional may also be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

Less common

• Lack or loss of strength

Rare

• Acid or sour stomach
• Belching
• Darkening of skin color
• Decreased interest in sexual intercourse
• Diarrhea
• Difficulty having a bowel movement (stool)
• Difficulty in moving
• Having a hard time focusing or doing everyday activities
• Heartburn
• Inability to have or keep an erection
• Indigestion
• Joint pain
• Loss in sexual ability, desire, drive, or performance
• Muscle aching, pains, or stiffness
• Nausea
• Nervousness
• Rash
• Sleepiness or unusual drowsiness
• Sleeplessness
• Stomach discomfort, upset, or pain
• Swollen joints
• Trouble sleeping
• Unable to sleep

Incidence not determined

• Earache

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Timolide

Pharmacologic Class: Diuretic

Chemical Class: Thiazide

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

Do not interrupt or stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):For high blood pressure: Adults—One tablet two times a day, or two tablets once a day. Your doctor may adjust your dose if needed. Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.