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Overview
| Generic Names: | Timolol maleate; Timololum [INN-Latin] |
|---|---|
| Trade Names: | Apo-Timol; Apo-Timop; Aquanil; Betim; Betimol; Blocadren; Istalol; Novo-Timol; Nu-Timolol; Phoxal-timolol; Proflax; Temserin; Tenopt; Tim-AK; Timacar; Timacor; Timopic; Timoptic; Timoptic OcuDose; Timoptic in Ocudose; Timoptic-XE; Timoptol |
| Brand Mixtures: | Combigan (Brimonidine Tartrate + Timolol Maleate); Cosopt (Dorzolamide Hydrochloride + Timolol Maleate); Timolide Tab (Hydrochlorothiazide + Timolol Maleate); Timpilo 2 (Pilocarpine Hydrochloride + Timolol Maleate); Timpilo 4 (Pilocarpine Hydrochloride + Timolol Maleate); Xalacom (Latanoprost + Timolol Maleate) |
| PharmGKB Accession Id: | PA451690 |
Description
A beta-adrenergic antagonist similar in action to propranolol. The levo-isomer is the more active. Timolol has been proposed as an antihypertensive, antiarrhythmic, antiangina, and antiglaucoma agent. It is also used in the treatment of migraine disorders and tremor. PubChem (source: Drug Bank)
Indication
In its oral form it is used to treat high blood pressure and prevent heart attacks, and occasionally to prevent migraine headaches. In its opthalmic form it is used to treat open-angle and occasionally secondary glaucoma. (source: Drug Bank)
ATC Therapeutic Categories
- C07AA:Beta blocking agents, non-selective
- S01ED:Beta blocking agents1)
Pharmacology, Interactions, and Contraindications
Mechanism Of Action
Like propranolol and nadolol, timolol competes with adrenergic neurotransmitters such as catecholamines for binding at beta(1)-adrenergic receptors in the heart and vascular smooth muscle and beta(2)-receptors in the bronchial and vascular smooth muscle. Beta(1)-receptor blockade results in a decrease in resting and exercise heart rate and cardiac output, a decrease in both systolic and diastolic blood pressure, and, possibly, a reduction in reflex orthostatic hypotension. Beta(2)-blockade results in an increase in peripheral vascular resistance. The exact mechanism whereby timolol reduces ocular pressure is still not known. The most likely action is by decreasing the secretion of aqueous humor. (source: Drug Bank)
Pharmacology
Similar to propranolol and nadolol, timolol is a non-selective, beta-adrenergic receptor antagonist. Timolol does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anesthetic (membrane-stabilizing) activity, but does possess a relatively high degree of lipid solubility. Timolol, when applied topically to the eye, has the action of reducing elevated, as well as normal, intraocular pressure, whether or not accompanied by glaucoma. Elevated intraocular pressure is a major risk factor in the pathogenesis of glaucomatous visual field loss and optic nerve damage. (source: Drug Bank)
Absorption, Distribution, Metabolism, Elimination & Toxicity
Biotransformation
Primarily hepatic (80%) via the cytochrome P450 2D6 isoenzyme. (source: Drug Bank)
Protein Binding
~10% (source: Drug Bank)
Absorption
Bioavailability is about 60% (source: Drug Bank)
Toxicity
LD<sub>50</sub>=1190 mg/kg (oral, mice), LD<sub>50</sub>=900 mg/kg (oral, rat). Symptoms of overdose include drowsiness, vertigo, headache, and atriventricular block. (source: Drug Bank)
Isomeric SMILES Code:
CC(C)(C)NC[C@@H](COc1c(nsn1)N2CCOCC2)O (source: Drug Bank)
The following genes are in curated knowledge about this drug.
| Gene | Relationship | Evidence | |
|---|---|---|---|
|
|
CYP2D6 |
|
Publications |
A list of non-curated publications that mention this drug along with other genes is available.
Drug Targets
| Gene | Description | |
|---|---|---|
| ADRB1 |
|
(source: Drug Bank) |
| ADRB2 |
|
(source: Drug Bank) |
PharmGKB Curated Pathways
A list of non-curated publications that mention this drug along with other drugs is available.
Drug Interactions
| Drug | Description | |
|---|---|---|
| Methyldopa |
|
Possible hypertensive crisis (source: Drug Bank) |
| acetohexamide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| aminophylline |
|
Antagonism of action and increased effect of theophylline (source: Drug Bank) |
| celecoxib |
|
The NSAID, Celecoxib, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| chlorpropamide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| cimetidine |
|
Cimetidine increases the effect of the beta-blocker (source: Drug Bank) |
| clonidine |
|
Increased hypertension when clonidine stopped (source: Drug Bank) |
| diclofenac |
|
The NSAID, Diclofenac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| diflunisal |
|
The NSAID, Diflunisal, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| dihydroergotamine |
|
Ischemia with risk of gangrene (source: Drug Bank) |
| dihydroergotoxine |
|
Ischemia with risk of gangrene (source: Drug Bank) |
| diltiazem |
|
Additive effects of decreased heart rate and contractility may occur. Increased risk of heart block. (source: Drug Bank) |
| disopyramide |
|
The beta-blocker increases toxicity of disopyramide (source: Drug Bank) |
| dyphylline |
|
Antagonism of action and increased effect of theophylline (source: Drug Bank) |
| epinephrine |
|
Hypertension, then bradycardia (source: Drug Bank) |
| ergonovine |
|
Ischemia with risk of gangrene (source: Drug Bank) |
| ergotamine |
|
Ischemia with risk of gangrene (source: Drug Bank) |
| etodolac |
|
The NSAID, Etodolac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| fenoprofen |
|
The NSAID, Fenoprofen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| fenoterol |
|
Antagonism (source: Drug Bank) |
| flurbiprofen |
|
The NSAID, Flurbiprofen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| formoterol |
|
Antagonism (source: Drug Bank) |
| glibenclamide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| gliclazide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| glipizide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| glisoxepide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| glycodiazine |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| ibuprofen |
|
Risk of inhibition of renal prostaglandins. The NSAID, Ibuprofen, may also antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| indomethacin |
|
Risk of inhibition of renal prostaglandins. The NSAID, Indomethacine, may also antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| isoproterenol |
|
Antagonism (source: Drug Bank) |
| ketoprofen |
|
The NSAID, Ketoprofen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| ketorolac |
|
The NSAID, Ketorolac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| l-methyldopa |
|
Possible hypertensive crisis (source: Drug Bank) |
| lidocaine |
|
The beta-blocker increases the effect and toxicity of lidocaine (source: Drug Bank) |
| lumiracoxib |
|
The NSAID, Lumiracoxib, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| meloxicam |
|
The NSAID, Meloxicam, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| methysergide |
|
Ischemia with risk of gangrene (source: Drug Bank) |
| nabumetone |
|
The NSAID, Nabumetone, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| naproxen |
|
The NSAID, Naproxen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| orciprenaline |
|
Antagonism (source: Drug Bank) |
| oxaprozin |
|
The NSAID, Oxaprozin, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| oxtriphylline |
|
Antagonism of action and increased effect of theophylline (source: Drug Bank) |
| pirbuterol |
|
Antagonism (source: Drug Bank) |
| piroxicam |
|
Risk of inhibition of renal prostaglandins. The NSAID, Piroxicam, may also antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| prazosin |
|
Risk of hypotension at the beginning of therapy (source: Drug Bank) |
| procaterol |
|
Antagonism (source: Drug Bank) |
| repaglinide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| salbutamol |
|
Antagonism (source: Drug Bank) |
| salmeterol |
|
Antagonism (source: Drug Bank) |
| sulindac |
|
The NSAID, Sulindac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| terbutaline |
|
Antagonism (source: Drug Bank) |
| theophylline |
|
Antagonism of action and increased effect of theophylline (source: Drug Bank) |
| tolazamide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| tolbutamide |
|
The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank) |
| tolmetin |
|
The NSAID, Tolmetin, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank) |
| verapamil |
|
Additive effects of decreased heart rate and contractility may occur. Increased risk of heart block. (source: Drug Bank) |
Curated Information
The following diseases are in curated knowledge about this drug.
| Disease | Relationship | Evidence | |
|---|---|---|---|
|
|
normal tension glaucoma |
|
Publications |
Non-Curated Information
A list of non-curated publications that mention this drug along with other diseases is available.
Additional Datasets
These datasets are minimally curated and are sorted alphabetically by title.
LinkOuts
Common Searches
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Non-Curated Publications
A list of non-curated publications that mention this drug is available.
