Timoptic, a brand name for timolol maleate, is an ophthalmic solution used to treat wide-angle glaucoma and ocular hypertension. These diseases raise the intraocular pressure in the eye, which can damage the optic nerve. Timoptic, a beta blocker, lowers intraocular pressure. Even though timolol is installed in the eye, small amounts are absorbed systematically and can cause side effects typical of beta blockers.
Ocular Side Effects
Timolol can cause many localized ocular symptoms. Burning and stinging after installation is a common side effect of timolol, experienced by about 8 percent of patients. Blurry vision is also common, as are dry eyes or increased tear production, or a feeling that something is in the eye. Patients may also develop blepharitis, inflammation of the lids; ptosis, droopy eyelids; double vision; or cystoid macular edema.
Respiratory Side Effects
Timolol can cause breathing problems in patients with reactive airway disease like asthma. Timolol may worsen asthma irreversibly. Pulmonary edema, bronchospasm, respiratory failure, difficulty breathing, upper respiratory disease and nasal congestion are other possible side effects. According to a study reported by the Glaucoma Clinic of Melbourne in 2007, patients with respiratory illnesses should be carefully watched when taking timolol, because the link between respiratory illness and timolol isn't always recognized.
Cardiovascular Side Effects
Serious cardiovascular side effects have been linked to timolol. Cases of death due to cardiac failure related to timolol have been reported. Bradycardia. or slow heart beat;, heart arrhythmias; hyper and hypotension, or high and low blood pressure; heart block; chest pain and palpitations have all been reported after timolol use. Timolol side effects also include a raise in cholesterol and trigycerides. Patients with any cardiovascular disease should be watched carefully when using timolol. Timolol is a serious medication with potential cardiovascular side effects, according to an article published in FDA Consumer Magazine in 1995.
Nervous System and Psychiatric Side Effects
Timolol can cause headaches, dizziness, tingling in arms and legs, insomnia, nightmares and memory loss. Cerebral vascular accidents and ischemia have also been reported. Psychiatric side effects are rare and usually reverse after discontinuation of the drug. Timolol can worsen myasthenia gravis.
Dermatologic Side Effects
Patients have reported contact dermatitis; alopecia, or hair loss; worsening of psoriasis; or psoriasiform rash. Hives, generalized rashes and angioedema have occurred as part of an allergic reaction.
Other Side Effects
Diabetic patients may have decreased awareness of developing acute hypoglycemia, or low blood sugar. Patients with hyperthyroid disease may also have masked symptoms of thyrotoxicosis, which can lead to thyroid storm. Gastrointestinal symptoms such as diarrhea, nausea, dry mouth and upset stomach can occur. There have been rare reports of patients developing systemic lupus erythematosus while using timolol. Impotence and loss of libido have also been reported. Patients taking timolol may have a decreased therapeutic response to normal doses of epinephrine. Timolol's safety use in pregnancy and for nursing mothers, and for pediatric patients, has not been established.
References
- Timoptal-Three Years On: A Study of Timolol Maleate Drops Over a Longer Period; WE Gillies; 2007
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