Timolol Eye Drops (timolol maleate (ophthalmic))
Also sold as: Timolast, Ocupress, Timopt, Glaucomol, Timoptol XE (gel-forming)
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Eye drops 0.25% solution (5 mL) +2
Indications
- Open-angle glaucoma
- Ocular hypertension
- Secondary glaucoma
- Adjunct to prostaglandin analogs or other IOP-lowering agents
Adult Dosing
Glaucoma / ocular hypertension (solution)
1 drop of 0.25% or 0.5% solution in affected eye(s)
Twice daily (BD); reassess after 4 weeks
If IOP controlled on 0.25% BD, continue at that concentration. Switch to 0.5% if inadequate. Can try once daily gel-forming solution (Timoptol XE 0.5%) for better compliance.
Glaucoma (gel-forming solution)
1 drop of 0.5% gel-forming solution in affected eye(s)
Once daily (OD), morning preferred
Gel causes transient blurring — administer in morning; wait 5 minutes before other eye drops.
Pregnancy & Lactation
Pregnancy: Category C
Systemic absorption occurs; neonatal bradycardia, hypoglycemia, and respiratory distress reported with systemic beta-blockers. Use only if benefit outweighs risk.
Lactation: Caution
Timolol is excreted in breast milk. Systemic absorption from eye drops is low but non-negligible. Apply nasolacrimal occlusion to minimize. Monitor infant for bradycardia.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Systemic beta-blockers (atenolol, metoprolol, propranolol) | Additive systemic beta-blockade — risk of bradycardia, AV block, hypotension, and bronchospasm | Major |
| Calcium channel blockers (verapamil, diltiazem) | Additive effect on AV conduction — risk of AV block and bradycardia | Major |
| Catecholamine-depleting drugs (reserpine) | Additive hypotensive and bradycardic effect | Moderate |
| Epinephrine (systemic) | Unopposed alpha-adrenergic stimulation may cause hypertensive crisis and reflex bradycardia | Moderate |
| Oral antidiabetic agents / insulin | Beta-blockade masks tachycardia (sign of hypoglycemia); may prolong hypoglycemia | Moderate |
| Quinidine, amiodarone | Additive risk of bradycardia and AV block | Moderate |
DoctorScribe — AI Medical Scribe
Stop looking up Timolol Eye Drops — just speak the prescription
"Timolol Eye Drops as per dose, BD for 5 days." DoctorScribe writes the full prescription with brand, strength, frequency, and route — auto-applies pediatric weight-based dosing and renal adjustments. Try the live demo.
Side Effects
Common
- Transient burning/stinging on instillation
- Blurred vision (especially gel formulation)
- Dry eyes
- Eye irritation
- Corneal anesthesia (with long-term use)
- Systemic: fatigue, dizziness, bradycardia, cold extremities
Serious / Discontinue If
- Bronchospasm / bronchoconstriction (even from ophthalmic use — potentially life-threatening in asthmatics)
- Heart failure exacerbation
- AV block / severe bradycardia
- Hypotension
- Masking of hypoglycemia in diabetics
- Depression, impotence (rare, systemic effect)
- Corneal epithelial toxicity (with preservative — benzalkonium chloride)
Contraindications
- Bronchial asthma or severe COPD (absolute — even eye drops carry risk)
- Sinus bradycardia or second/third-degree AV block
- Overt cardiac failure or cardiogenic shock
- Hypersensitivity to timolol or any beta-blocker
- Reactive airway disease
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Timolast 0.5% Eye Drops | Cipla | ₹85/5 mL |
| Ocupress 0.5% Eye Drops | Allergan India | ₹95/5 mL |
| Glaucomol 0.5% Eye Drops | Sun Pharma | ₹75/5 mL |
Monitoring Required
- Intraocular pressure — baseline, then at 4 weeks, then every 3 months
- Heart rate and blood pressure — baseline and periodic (systemic absorption)
- Respiratory function — enquire about dyspnea, wheeze at each visit
- Blood glucose in diabetics — monitor for masked hypoglycemia
- Corneal health — slit-lamp for punctate keratopathy with long-term use
- Visual fields and optic disc — every 6–12 months
Patient Counseling Points
- Apply firm pressure to the inner corner of the eye (nasolacrimal duct) for at least 1 minute after instillation — this significantly reduces systemic absorption and side effects.
- Even though this is an eye drop, it can affect the heart and lungs — inform all doctors (especially cardiologists and pulmonologists) that you use timolol eye drops.
- If you have asthma, COPD, or any breathing problem, tell your ophthalmologist immediately — this medication may not be safe for you.
- Do not stop using without consulting your doctor — sudden discontinuation can worsen glaucoma.
- Gel formulation causes temporary blurring — apply in the morning and wait before driving.
- Remove contact lenses before instillation; wait 15 minutes before reinserting (preservative may damage lenses).
- Report any shortness of breath, wheezing, unusually slow heartbeat, or dizziness immediately.
- Store at room temperature, away from light; discard 4 weeks after opening.
Stop Googling drug references mid-consultation
EasyClinic auto-flags Timolol Eye Drops interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Ananya Pillai, MS (Ophthalmology), Glaucoma Specialist
Last reviewed: 2026-04-01
References
- Pfeiffer N. Timolol in the treatment of glaucoma. Ophthalmologica. 1997;211(Suppl 1):10–14.
- American Academy of Ophthalmology. Primary Open-Angle Glaucoma PPP. 2020.
- British National Formulary. Timolol (ophthalmic). 2025.
- DRUGS.com. Timolol ophthalmic interactions and precautions. 2024.