Timolol
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Timolol
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Systematic (IUPAC) name | |
(S)-1-(tert-butylamino)- 3-(4-morpholino-1,2,5-thiadiazol-3-yloxy)propan-2-ol |
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Identifiers | |
CAS number | |
ATC code | C07 |
PubChem | |
DrugBank | |
Chemical data | |
Formula | C13H24N4O3S |
Mol. mass | 316.421 g/mol |
Pharmacokinetic data | |
Bioavailability | 60% |
Metabolism | Hepatic: 80% |
Half life | 2.5-5 hours |
Excretion | Renal |
Therapeutic considerations | |
Pregnancy cat. | |
Legal status |
℞ Prescription only |
Routes | oral, Ophthalmic |
Timolol maleate is a non-selective beta-adrenergic receptor blocker. In its oral form (Blocadren®), it is used to treat high blood pressure and prevent heart attacks, and occasionally to prevent migraine headaches. In its ophthalmic form (brand names Timoptol® in Italy; Timoptic®), it is used to treat open-angle and occasionally secondary glaucoma by reducing aqueous humour production through blockade of the beta receptors on the ciliary epithelium.
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[edit] Side effects
The most serious possible side effects include cardiac arrhythmias and severe bronchospasms. Timolol can also lead to fainting, stroke, congestive heart failure, depression, confusion, and impotence. It is a non-selective beta blocker.
[edit] Usual Dosage
- Children and Adults: Ophthalmic: Initial: 0.25% solution, instill 1 drop twice daily; increase to 0.5% solution if response not adequate; decrease to 1 drop/day if *controlled; do not exceed 1 drop twice daily of 0.5% solution Adults: Oral:
- Hypertension: Initial: 10 mg twice daily, increase gradually every 7 days, usual dosage: 20-40 mg/day in 2 divided doses; maximum: 60 mg/day
- Prevention of myocardial infarction: 10 mg twice daily initiated within 1-4 weeks after infarction
- Migraine headache: Initial: 10 mg twice daily, increase to maximum of 30 mg/day
[edit] Formulations
- Gel-forming solution, ophthalmic, as maleate (Timoptic-XE®): 0.25% (2.5 mL, 5 mL); 0.5% (2.5 mL, 5 mL)
- Solution, ophthalmic, as hemihydrate (Betimol®): 0.25% (5 mL, 10 mL, 15 mL); 0.5% (5 mL, 10 mL, 15 mL) [contains benzalkonium chloride]
- Solution, ophthalmic, as maleate: 0.25% (5 mL, 10 mL, 15 mL); 0.5% (5 mL, 10 mL, 15 mL) [contains benzalkonium chloride]
- Timoptic®: 0.25% (5 mL, 10 mL); 0.5% (5 mL, 10 mL) [contains benzalkonium chloride]
- Solution, ophthalmic, as maleate [preservative free] (Timoptic® OcuDose®): 0.25% (0.2 mL);0.5% (0.2 mL) [single use]
- Tablet, as maleate (Blocadren®): 5 mg, 10 mg, 20 mg
[edit] Brand Names
In Canada Apo®-Timol, Apo®-Timop, Gen-Timolol®, Nu-Timolol®, Phoxal-timolol®, PMS-Timolol®, Tim-AK®. In United States Betimol®, Blocadren®, Istalol®, Timoptic® OcuDose®. In both Canada and US: Timoptic® and Timoptic-XE®.
Beta blockers (C07) | |
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Non-selective β antagonists (C07AA) | Metipranolol, Nadolol, Oxprenolol, Penbutolol, Pindolol, Propranolol, Timolol, Sotalol |
β1 antagonists (cardioselective) (C07AB) | Atenolol, Acebutolol, Betaxolol, Bisoprolol, Esmolol, Metoprolol, Nebivolol |
Mixed α1/β antagonists (C07AG) | Carvedilol, Labetalol |
Antiglaucoma preparations and miotics (S01E) | |
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Sympathomimetics | Apraclonidine, Brimonidine, Clonidine, Dipivefrine, Epinephrine |
Parasympathomimetics | Aceclidine, Acetylcholine, Carbachol, Demecarium, Echothiophate, Fluostigmine, Neostigmine, Paraoxon, Physostigmine, Pilocarpine |
Carbonic anhydrase inhibitors | Acetazolamide, Brinzolamide, Diclofenamide, Dorzolamide, Methazolamide |
Beta blocking agents | Befunolol, Betaxolol, Carteolol, Levobunolol, Metipranolol, Timolol |
Prostaglandin analogues | Bimatoprost, Latanoprost, Travoprost, Unoprostone |
Other agents | Dapiprazole, Guanethidine |