Timoptic Ocudose (Ophthalmic)

Timolol eye drops are used by themselves or with other medicines to treat high pressure in the eye caused by open-angle glaucoma or a condition known as ocular (eye) hypertension. This medicine is a beta-blocker.

Timolol (Timoptic® in Ocudose®) can be used if you are sensitive to the preservative in Timoptic®, benzalkonium chloride, or if you need eye drops that do not contain preservatives.

This medicine is available only with a prescription from your doctor.

It is very important that your doctor checks your progress at regular visits to ensure this medicine is working properly and to look for unwanted effects.

Do not use this medicine if you are also using a beta-blocker medicine that you take by mouth.

If you experience itching, redness, swelling, or other signs of eye or eyelid irritation, stop using this medicine and consult your doctor. These signs may indicate that you are allergic to this medicine.

Timolol may cause heart failure in some patients. Contact your doctor immediately if you experience chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, swelling of the face, fingers, feet, or lower legs, weight gain, or trouble breathing.

This medicine may cause changes in your blood sugar levels. Additionally, this medicine may hide signs of low blood sugar, such as a rapid pulse rate. Speak with your doctor if you have these issues or if you notice changes in your blood or urine sugar test results.

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

The gel-forming eye drops may cause blurred vision or other vision problems lasting about 30 seconds to 5 minutes after you put them in your eye. If any of these happen, do not drive, operate machinery, or do anything else that could be dangerous if you are unable to see well. If these eye changes are bothersome, consult your doctor.

In deciding to use a medicine, you and your doctor must consider the risks versus the benefits. Here are some important points to think about for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

Studies done so far have not shown any specific problems that would limit the use of timolol eye drops in children aged 2 years and older. However, safety and effectiveness have not been determined for children younger than 2 years old.

Geriatric

Studies done so far have not shown any specific problems that would limit the use of timolol eye drops in older adults.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medicine while breastfeeding. Weigh the potential benefits against the potential risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if there might be interactions. In these cases, your doctor may need to adjust the dose or take other precautions. When taking this medicine, it is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are noted for their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you take one or both of the medicines.

• Abiraterone Acetate
• Albuterol
• Bupropion
• Ceritinib
• Clonidine
• Cobicistat
• Crizotinib
• Darunavir
• Desvenlafaxine
• Diltiazem
• Dronedarone
• Duloxetine
• Epinephrine
• Escitalopram
• Fedratinib
• Fenoldopam
• Fingolimod
• Fluoxetine
• Formoterol
• Indacaterol
• Iobenguane I 131
• Iohexol
• Lacosamide
• Levalbuterol
• Olodaterol
• Oxymetazoline
• Paroxetine
• Ponesimod
• Rivastigmine
• Salmeterol
• Sertraline
• Terbutaline
• Venlafaxine
• Verapamil
• Vilanterol

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both medications may be the best treatment option for you. If both medicines are prescribed together, your doctor may change the dose or how often you take one or both of the medicines.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Alfuzosin
• Alogliptin
• Amtolmetin Guacil
• Aspirin
• Bromfenac
• Bufexamac
• Bunazosin
• Canagliflozin
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Cimetidine
• Clonixin
• Dapagliflozin
• Deslanoside
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitoxin
• Digoxin
• Dipyrone
• Doxazosin
• Droxicam
• Dulaglutide
• Empagliflozin
• Ertugliflozin
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indomethacin
• Insulin Aspart, Recombinant
• Insulin Degludec
• Insulin Detemir
• Insulin Glargine, Recombinant
• Insulin Glulisine
• Insulin Human Inhaled
• Insulin Human Isophane (NPH)
• Insulin Human Regular
• Insulin Lispro, Recombinant
• Ketoprofen
• Ketorolac
• Linagliptin
• Liraglutide
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metformin
• Methyldopa
• Metildigoxin
• Miglitol
• Morniflumate
• Moxisylyte
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenoxybenzamine
• Phentolamine
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Pramlintide
• Pranoprofen
• Prazosin
• Proglumetacin
• Propyphenazone
• Proquazone
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• St John's Wort
• Sulindac
• Tamsulosin
• Tenoxicam
• Terazosin
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Trimazosin
• Urapidil
• Valdecoxib
• Vildagliptin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used around the time of eating food or certain types of food due to possible interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect the use of this medicine. Make sure to inform your doctor if you have any other medical problems, especially:

• Asthma, or a history of
• Bradycardia (slow heartbeat) or
• Cardiogenic shock (shock from a heart attack) or
• Chronic obstructive pulmonary disease (COPD), severe or
• Heart block or
• Heart failure—Should not be used in patients with these conditions.

• Allergic reaction (e.g., anaphylaxis, atopy), or history of—May increase the risk of an allergic reaction happening again.

• Blood vessel disease (especially in the brain) or
• Lung disease or
• Myasthenia gravis (muscle weakness) or
• Stroke, history of—Use with caution as it may worsen these conditions.

• Diabetes or
• Hyperthyroidism (overactive thyroid) or
• Hypoglycemia (low blood sugar)—May hide some signs and symptoms of these conditions, such as a rapid heartbeat.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, you may need medical attention.

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

More common

• Blurred vision
• Burning or stinging in the eye

Less common

• Arm, back, or jaw pain
• Blisters, hives, welts, or itching
• Blue lips, fingernails, or skin
• Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• Change in vision
• Chest pain or discomfort
• Chest tightness or heaviness
• Confusion about identity, place, and time
• Continuing ringing or buzzing or other unexplained noise in ears
• Coughing that sometimes produces a pink frothy sputum
• Depression
• Difficult, fast, noisy breathing
• Difficulty with chewing, swallowing, or talking
• Dilated neck veins
• Discharge, excessive tearing
• Disturbed color perception
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Double vision
• Drooping eyelids
• Dry or itching eyes
• Extreme fatigue
• False sense of well-being
• Fast, slow, irregular, pounding, or racing heartbeat or pulse
• Fear or nervousness
• Feeling of having something in the eye
• Fever and chills
• Flashes of light, floaters in vision
• General feeling of discomfort or illness
• Hair loss
• Halos around lights
• Headache
• Inability to speak
• Increased sweating
• Irregular, fast or slow, or shallow breathing
• Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• Lightheadedness, dizziness, or fainting
• Loss of vision
• Memory loss
• Mood swings
• Muscle or joint pain
• Muscle weakness
• Nausea
• Night blindness
• No blood pressure or pulse
• Overbright appearance of lights
• Pain, tension, and weakness upon walking that subsides during periods of rest
• Pale skin
• Paleness or cold feeling in the fingertips, toes, hands, and feet
• Personality changes
• Pounding in the ears
• Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• Redness of the skin
• Redness, pain, swelling or irritation of the eye, eyelid, or inner lining of the eyelid
• Seeing double
• Seeing, hearing, or feeling things that are not there
• Seizures
• Severe numbness, especially on one side of the face or body
• Severe or sudden headache
• Severe tiredness
• Skin irritation or rash, including rash that looks like psoriasis
• Slurred speech
• Sore throat
• Stopping of heart
• Sweating
• Swelling of the face, fingers, feet, lower legs, and ankles
• Swollen glands
• Temporary blindness
• Tingling or pain in the fingers or toes when exposed to cold
• Tunnel vision
• Unconsciousness
• Unusual tiredness or weakness
• Weakness in arm and/or leg on one side of the body, sudden and severe
• Weight gain

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 the medicine. Also, your health care professional may 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 or are bothersome or if you have any questions about them:

Less common

• Acid or sour stomach
• Belching
• Body aches or pain
• Diarrhea
• Dry mouth
• Ear congestion
• Hearing loss
• Heartburn
• Indigestion
• Lack or loss of strength
• Loss of appetite
• Loss of voice
• Nightmares
• Runny nose
• Sleepiness or unusual drowsiness
• Sneezing
• Stomach discomfort, upset, or pain
• Stuffy nose
• Trouble sleeping
• Weight loss

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.

• Betimol
• Istalol
• Timoptic Ocudose
• Timoptic Ocumeter
• Timoptic Ocumeter Plus
• Timoptic-XE Ocumeter
• Timoptic-XE Ocumeter Plus

Available Dosage Forms:

• Solution
• Gel Forming Solution

Therapeutic Class: Antiglaucoma

Pharmacologic Class: Beta-Adrenergic Blocker, Nonselective

Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Shake the regular eye drops well just before each use. If you are using the gel-forming eye drops, turn the bottle upside down and shake it once. You do not need to shake the gel-forming eye drops more than once.

To use the eye drops (solution and gel):

• First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
• Immediately after using the medicine, wash your hands to remove any medicine that may be on them.
• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed. Serious damage to the eye and possible loss of vision may result from using contaminated eye medicines.

If your doctor ordered two different eye medicines to be used together, wait at least 10 minutes after the regular eye drops before using the second medicine. This will help prevent the second medicine from “washing out” the first one. The gel-forming eye drops should always be the last medicine used if two medicines are ordered. Wait 10 minutes before using the gel-forming eye drops.

You should not use the regular eye drops if you have contact lenses in your eyes. Remove your contact lenses before you use this medicine. Wait at least 15 minutes after you use the medicine before putting the contact lenses back in.

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 glaucoma or ocular hypertension: For ophthalmic gel-forming solution dosage form (eye drops): Adults—Use 1 drop in the affected eye once a day. Children—Use and dose must be determined by your doctor.. For ophthalmic solution dosage form (eye drops): Adults and children 2 years of age and older—Use 1 drop in the affected eye two times a day. Your doctor may need to adjust your dose as needed. Children younger than 2 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, apply 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.

Storage

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.

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

If you are using Timoptic®, use the medicine immediately after opening and throw away any unused medicine after use.