Share to: share facebook share twitter share wa share telegram print page

 

Timolol

Timolol
Clinical data
Trade namesTimoptic, others[1]
AHFS/Drugs.comMaleate Monograph
eent Monograph
MedlinePlusa684029
License data
Pregnancy
category
  • AU: C
Routes of
administration		By mouth, topical (eye drop)
Drug classBeta blocker
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability60%
MetabolismLiver (80%, mainly CYP2D6[4])
Onset of action15–30 min[3]
Elimination half-life2.5–5 hours
Duration of action24 hours[3]
ExcretionKidney
Identifiers
  • (S)-1-(tert-Butylamino)-3-[(4-morpholin-4-yl-1,2,5-thiadiazol-3-yl)oxy]propan-2-ol
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.043.651 Edit this at Wikidata
Chemical and physical data
FormulaC13H24N4O3S
Molar mass316.42 g·mol−1
3D model (JSmol)
  • CC(C)(C)NCC(O)COc1nsnc1N1CCOCC1
  • InChI=1S/C13H24N4O3S/c1-13(2,3)14-8-10(18)9-20-12-11(15-21-16-12)17-4-6-19-7-5-17/h10,14,18H,4-9H2,1-3H3/t10-/m0/s1 checkY
  • Key:BLJRIMJGRPQVNF-JTQLQIEISA-N checkY
  (verify)

Timolol is a beta blocker medication used either by mouth or as eye drops.[3][5] As eye drops it is used to treat increased pressure inside the eye such as in ocular hypertension and glaucoma.[3] By mouth it is used for high blood pressure, chest pain due to insufficient blood flow to the heart, to prevent further complications after a heart attack, and to prevent migraines.[5]

Common side effects with the drops is irritation of the eye.[3] Common side effects by mouth include tiredness, slow heart beat, itchiness, and shortness of breath.[5] Other side effects include masking the symptoms of low blood sugar in those with diabetes.[3] Use is not recommended in those with asthma, uncompensated heart failure, or chronic obstructive pulmonary disease (COPD).[3] It is unclear if use during pregnancy is safe for the fetus.[6] Timolol is a non-selective beta blocker.[3]

Timolol was patented in 1968, and came into medical use in 1978.[7] It is on the World Health Organization's List of Essential Medicines.[8] Timolol is available as a generic medication.[3][9] In 2022, it was the 155th most commonly prescribed medication in the United States, with more than 3 million prescriptions.[10][11]

Medical uses

By mouth

In its by mouth or oral form, it is used:

The combination of timolol and the alpha-1 blocker prazosin has sedative effects.[13]

Eye drops

In its eye drop form it is used to treat open-angle and, occasionally, secondary glaucoma.[3][14] The mechanism of action of timolol is probably the reduction of the formation of aqueous humor[3] in the ciliary body in the eye. It was the first beta blocker approved for topical use in treatment of glaucoma in the United States (1978).[15] When used by itself, it depresses intraocular pressure (IOP) 18–34% below baseline within first few treatments. However, there are short-term escape and long-term drift effects in some people. That is, tolerance develops. It may reduce the extent of the daytime IOP curve up to 50%. The IOP is higher during sleep. Efficacy of timolol in lowering IOP during the sleep period may be limited.[16][17][18] It is a 5–10× more potent beta blocker than propranolol. Timolol is light-sensitive; it is usually preserved with 0.01% benzalkonium chloride (BAC), but also comes BAC-free. It can also be used in combination with pilocarpine, carbonic anhydrase inhibitors[19] or prostaglandin analogs.[20]

A Cochrane review compared the effect of timolol versus brimonidine in slowing the progression of open angle glaucoma in adults but found insufficient evidence to come to conclusions.[21]

On the skin

In its gel form it is used on the skin to treat infantile hemangiomas.[22]

Contraindications

The medication should not be taken by individuals with:[23]

Side effects

The most serious possible side effects include cardiac arrhythmias and severe bronchospasms.[23] Timolol can also lead to fainting, congestive heart failure, depression, confusion, worsening of Raynaud's syndrome and impotence.[23]

Side effects when given in the eye include: burning sensation, eye redness, superficial punctate keratopathy, corneal numbness.[25][14]

Formulations

It is available in tablet and liquid formulations.[23][25]

For ophthalmic use, timolol is also available combined:

Brand names

Timolol is sold under many brand names worldwide.[1] Timolol eye drops are sold under the brand names Timoptic and Istalol among others.[26][27]

References

  1. ^ a b "Timolol". Drugs.com. Archived from the original on 7 March 2016. Retrieved 28 December 2016.
  2. ^ "Product monograph brand safety updates". Health Canada. February 2024. Retrieved 24 March 2024.
  3. ^ a b c d e f g h i j k "Timolol eent". The American Society of Health-System Pharmacists. Archived from the original on 28 December 2016. Retrieved 8 December 2016.
  4. ^ Volotinen M, Turpeinen M, Tolonen A, Uusitalo J, Mäenpää J, Pelkonen O (July 2007). "Timolol metabolism in human liver microsomes is mediated principally by CYP2D6". Drug Metabolism and Disposition. 35 (7): 1135–1141. doi:10.1124/dmd.106.012906. PMID 17431033. S2CID 794764.
  5. ^ a b c "Timolol Maleate". The American Society of Health-System Pharmacists. Archived from the original on 28 December 2016. Retrieved 8 December 2016.
  6. ^ "Timolol ophthalmic Use During Pregnancy". The American Society of Health-System Pharmacists. Archived from the original on 28 December 2016. Retrieved 28 December 2016.
  7. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 460. ISBN 9783527607495. Archived from the original on 28 December 2016.
  8. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  9. ^ "Competitive Generic Therapy Approvals". U.S. Food and Drug Administration (FDA). 29 June 2023. Archived from the original on 29 June 2023. Retrieved 29 June 2023.
  10. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  11. ^ "Timolol Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
  12. ^ Marcus DA, Bain PA (27 February 2009). Effective Migraine Treatment in Pregnant and Lactating Women: A Practical Guide. シュプリンガー・ジャパン株式会社. pp. 141–. ISBN 978-1-60327-438-8. Archived from the original on 5 November 2017. Retrieved 14 November 2010.
  13. ^ Atkin T, Comai S, Gobbi G (April 2018). "Drugs for Insomnia beyond Benzodiazepines: Pharmacology, Clinical Applications, and Discovery". Pharmacol Rev. 70 (2): 197–245. doi:10.1124/pr.117.014381. PMID 29487083. S2CID 3578916.
  14. ^ a b "Timolol Ophthalmic". MedlinePlus. 15 April 2017. Retrieved 31 December 2019.
  15. ^ Sambhara D, Aref AA (January 2014). "Glaucoma management: relative value and place in therapy of available drug treatments". Therapeutic Advances in Chronic Disease. 5 (1): 30–43. doi:10.1177/2040622313511286. PMC 3871276. PMID 24381726.
  16. ^ Liu JH, Kripke DF, Weinreb RN (September 2004). "Comparison of the nighttime effects of once-daily timolol and latanoprost on intraocular pressure". American Journal of Ophthalmology. 138 (3): 389–95. doi:10.1016/j.ajo.2004.04.022. PMID 15364220.
  17. ^ Liu JH, Medeiros FA, Slight JR, Weinreb RN (March 2009). "Comparing diurnal and nocturnal effects of brinzolamide and timolol on intraocular pressure in patients receiving latanoprost monotherapy". Ophthalmology. 116 (3): 449–54. doi:10.1016/j.ophtha.2008.09.054. PMID 19157559.
  18. ^ Liu JH, Slight JR, Vittitow JL, Scassellati Sforzolini B, Weinreb RN (September 2016). "Efficacy of Latanoprostene Bunod 0.024% Compared With Timolol 0.5% in Lowering Intraocular Pressure Over 24 Hours". American Journal of Ophthalmology. 169: 249–257. doi:10.1016/j.ajo.2016.04.019. PMID 27457257.
  19. ^ Strohmaier K, Snyder E, Adamsons I (July 1998). "A multicenter study comparing dorzolamide and pilocarpine as adjunctive therapy to timolol: patient preference and impact on daily life". Journal of the American Optometric Association. 69 (7): 441–51. PMID 9697378.
  20. ^ "Ganfort 0.3 mg/ml + 5 mg/ml eye drops, solution - Summary of Product Characteristics (SmPC)". (emc). 20 February 2020. Retrieved 1 March 2020.
  21. ^ Sena DF, Lindsley K (January 2017). "Neuroprotection for treatment of glaucoma in adults". The Cochrane Database of Systematic Reviews. 1 (1): CD006539. doi:10.1002/14651858.CD006539.pub4. PMC 5370094. PMID 28122126.
  22. ^ Novoa M, Baselga E, Beltran S, Giraldo L, Shahbaz A, Pardo-Hernandez H, et al. (April 2018). "Interventions for infantile haemangiomas of the skin". The Cochrane Database of Systematic Reviews. 2018 (4): CD006545. doi:10.1002/14651858.CD006545.pub3. PMC 6513200. PMID 29667726.
  23. ^ a b c d "Timolol Maleate tablet". DailyMed. 17 August 2006. Retrieved 1 December 2019.
  24. ^ "Package leaflet: Information for the user Timolol" (PDF). hpra.ie.
  25. ^ a b "Betimol- timolol solution". DailyMed. 18 March 2010. Retrieved 1 December 2019.
  26. ^ "Generic Istalol Availability". Drugs.com. Retrieved 20 June 2019.
  27. ^ "Istalol". Drugs.com. 1 August 2018. Retrieved 19 July 2019.
Kembali kehalaman sebelumnya


Index: pl ar de en es fr it arz nl ja pt ceb sv uk vi war zh ru af ast az bg zh-min-nan bn be ca cs cy da et el eo eu fa gl ko hi hr id he ka la lv lt hu mk ms min no nn ce uz kk ro simple sk sl sr sh fi ta tt th tg azb tr ur zh-yue hy my ace als am an hyw ban bjn map-bms ba be-tarask bcl bpy bar bs br cv nv eml hif fo fy ga gd gu hak ha hsb io ig ilo ia ie os is jv kn ht ku ckb ky mrj lb lij li lmo mai mg ml zh-classical mr xmf mzn cdo mn nap new ne frr oc mhr or as pa pnb ps pms nds crh qu sa sah sco sq scn si sd szl su sw tl shn te bug vec vo wa wuu yi yo diq bat-smg zu lad kbd ang smn ab roa-rup frp arc gn av ay bh bi bo bxr cbk-zam co za dag ary se pdc dv dsb myv ext fur gv gag inh ki glk gan guw xal haw rw kbp pam csb kw km kv koi kg gom ks gcr lo lbe ltg lez nia ln jbo lg mt mi tw mwl mdf mnw nqo fj nah na nds-nl nrm nov om pi pag pap pfl pcd krc kaa ksh rm rue sm sat sc trv stq nso sn cu so srn kab roa-tara tet tpi to chr tum tk tyv udm ug vep fiu-vro vls wo xh zea ty ak bm ch ny ee ff got iu ik kl mad cr pih ami pwn pnt dz rmy rn sg st tn ss ti din chy ts kcg ve 
Prefix: a b c d e f g h i j k l m n o p q r s t u v w x y z 0 1 2 3 4 5 6 7 8 9 

Portal di Ensiklopedia Dunia

Portal : Agama
Agama
Portal : Bahasa
Bahasa
Portal : Biografi
Biografi
Portal : Budaya
Budaya
Portal : Ekonomi
Ekonomi
Portal : Elektronika
Elektronika
Portal : Film
Film
Portal : Filsafat
Filsafat
Portal : Geografi
Geografi
Portal : Indonesia
Indonesia
Portal : Ilmu
Ilmu
Portal : Lingkungan
Lingkungan
Portal : Masyarakat
Masyarakat
Portal : Matematika
Matematika
Portal : Militer
Militer
Portal : Mitologi
Mitologi
Portal : Musik
Musik
Portal : Olahraga
Olahraga
Portal : Pendidikan
Pendidikan
Portal : Politik
Politik
Portal : Sastra
Sastra
Portal : Sejarah
Sejarah
Portal : Seni
Seni
Portal : Teknologi
Teknologi