Istalol

Generic Name: timolol (Ophthalmic route)

TIM-oh-lol

Commonly used brand name(s)

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

Uses For Istalol

Timolol is used alone or together with other medicines to treat increased pressure in the eye that is caused by open-angle glaucoma or a condition called ocular (eye) hypertension. This medicine is a beta-blocker .

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

Before Using Istalol

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. 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 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 in the elderly .

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines 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 taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of 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 required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Albuterol


• Amiodarone


• Arformoterol


• Bambuterol


• Bitolterol


• Broxaterol


• Clenbuterol


• Clonidine


• Colterol


• Diltiazem


• Dronedarone


• Epinephrine


• Fenoldopam


• Fenoterol


• Formoterol


• Hexoprenaline


• Indacaterol


• Isoetharine


• Levalbuterol


• Metaproterenol


• Pirbuterol


• Procaterol


• Reproterol


• Rimiterol


• Ritodrine


• Salmeterol


• Terbutaline


• Timolol


• Tretoquinol


• Tulobuterol


• Verapamil

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

• Acarbose


• Aceclofenac


• Acemetacin


• Acetohexamide


• Alclofenac


• Alfuzosin


• Amlodipine


• Apazone


• Arbutamine


• Benfluorex


• Benoxaprofen


• Bromfenac


• Bufexamac


• Bunazosin


• Carprofen


• Chlorpropamide


• Cimetidine


• Clometacin


• Clonixin


• Dexketoprofen


• Diclofenac


• Diflunisal


• Digoxin


• Dipyrone


• Doxazosin


• Droxicam


• Etodolac


• Etofenamate


• Felbinac


• Felodipine


• Fenbufen


• Fenoprofen


• Fentiazac


• Floctafenine


• Flufenamic Acid


• Flurbiprofen


• Gliclazide


• Glimepiride


• Glipizide


• Gliquidone


• Glyburide


• Guar Gum


• Ibuprofen


• Indomethacin


• Indoprofen


• Insulin


• Insulin Aspart, Recombinant


• Insulin Glulisine


• Insulin Lispro, Recombinant


• Isoxicam


• Ketoprofen


• Ketorolac


• Lacidipine


• Lercanidipine


• Lornoxicam


• Manidipine


• Meclofenamate


• Mefenamic Acid


• Meloxicam


• Metformin


• Methyldopa


• Mibefradil


• Miglitol


• Moxisylyte


• Nabumetone


• Naproxen


• Nicardipine


• Nifedipine


• Niflumic Acid


• Nilvadipine


• Nimesulide


• Nimodipine


• Nisoldipine


• Nitrendipine


• Oxaprozin


• Oxyphenbutazone


• Phenoxybenzamine


• Phentolamine


• Phenylbutazone


• Pirazolac


• Piroxicam


• Pirprofen


• Pranidipine


• Prazosin


• Propyphenazone


• Proquazone


• Quinidine


• Repaglinide


• St John's Wort


• Sulindac


• Suprofen


• Tamsulosin


• Tenidap


• Tenoxicam


• Terazosin


• Tiaprofenic Acid


• Tolazamide


• Tolbutamide


• Tolmetin


• Trimazosin


• Troglitazone


• Urapidil


• Zomepirac

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 also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma or


• Bradycardia (slow heartbeat) or


• Chronic obstructive pulmonary disease (COPD), severe or


• Heart block or


• Heart failure—Should not use in patients with these conditions .

• Blood vessel disease (especially blood vessels of the brain) or


• Stroke, history of—Use with caution. This medicine may worsen these conditions .

• 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 .

• Lung disease—Use with caution. May cause difficulty with breathing in patients with this condition .

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

Proper Use of timolol

This section provides information on the proper use of a number of products that contain timolol. It may not be specific to Istalol. Please read with care.

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—One drop in the affected eye(s) once a day.
    
    
    • Children—Use and dose must be determined by your doctor .
    
    
  
  
  • For ophthalmic solution dosage form (eye drops):
    
    • Adults—One drop in the affected eye(s) two times a day.
    
    
    • Children—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

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.

Precautions While Using Istalol

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 .

If itching, redness, swelling, or other signs of eye or eyelid irritation occur, stop using this medicine and check with your doctor. These signs may mean that you are allergic to this medicine .

Timolol 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 .

The gel-forming eye drops may cause blurred vision or other vision problems that last about 30 seconds to 5 minutes after you put them in your eye. If any of these occur, do not drive, use machines, or do anything else that could be dangerous if you are not able to see well. If these eye changes are bothersome, check with your doctor .

Istalol Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they 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 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, sometimes with wheezing


• difficulty in chewing, swallowing, or talking


• dilated neck veins


• discharge, excessive tearing


• disturbed color perception


• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly


• 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, 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


• headaches


• inability to speak


• increased sweating


• irregular, fast or slow, or shallow breathing


• large, hive-like swelling on 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 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 skin


• redness, pain, swelling or irritation of eye, eyelid, or inner lining of 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


• shortness of breath or troubled breathing


• skin irritation or rash, including rash that looks like psoriasis


• slurred speech


• sore throat


• stopping of heart


• sweating


• swelling of face, fingers, feet, lower legs, and ankles


• swollen glands


• temporary blindness


• tingling or pain in 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


• wheezing

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


• sleeplessness


• sneezing


• stomach discomfort, upset, or pain


• stuffy nose


• trouble sleeping


• unable to sleep


• 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.

See also: Istalol side effects (in more detail)

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More Istalol resources

• Istalol Side Effects (in more detail)
• Istalol Use in Pregnancy & Breastfeeding
• Istalol Drug Interactions
• Istalol Support Group
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