Drug/Small Molecule:
timolol

2D structure

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
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2D6
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Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
ADRB1 Uncurated Annotation (source: Drug Bank)
ADRB2 Uncurated Annotation (source: Drug Bank)

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
Methyldopa Uncurated Annotation Possible hypertensive crisis (source: Drug Bank)
acetohexamide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
aminophylline Uncurated Annotation Antagonism of action and increased effect of theophylline (source: Drug Bank)
celecoxib Uncurated Annotation The NSAID, Celecoxib, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
chlorpropamide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
cimetidine Uncurated Annotation Cimetidine increases the effect of the beta-blocker (source: Drug Bank)
clonidine Uncurated Annotation Increased hypertension when clonidine stopped (source: Drug Bank)
diclofenac Uncurated Annotation The NSAID, Diclofenac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
diflunisal Uncurated Annotation The NSAID, Diflunisal, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
dihydroergotamine Uncurated Annotation Ischemia with risk of gangrene (source: Drug Bank)
dihydroergotoxine Uncurated Annotation Ischemia with risk of gangrene (source: Drug Bank)
diltiazem Uncurated Annotation Additive effects of decreased heart rate and contractility may occur. Increased risk of heart block. (source: Drug Bank)
disopyramide Uncurated Annotation The beta-blocker increases toxicity of disopyramide (source: Drug Bank)
dyphylline Uncurated Annotation Antagonism of action and increased effect of theophylline (source: Drug Bank)
epinephrine Uncurated Annotation Hypertension, then bradycardia (source: Drug Bank)
ergonovine Uncurated Annotation Ischemia with risk of gangrene (source: Drug Bank)
ergotamine Uncurated Annotation Ischemia with risk of gangrene (source: Drug Bank)
etodolac Uncurated Annotation The NSAID, Etodolac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
fenoprofen Uncurated Annotation The NSAID, Fenoprofen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
fenoterol Uncurated Annotation Antagonism (source: Drug Bank)
flurbiprofen Uncurated Annotation The NSAID, Flurbiprofen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
formoterol Uncurated Annotation Antagonism (source: Drug Bank)
glibenclamide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
gliclazide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
glipizide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
glisoxepide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
glycodiazine Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
ibuprofen Uncurated Annotation Risk of inhibition of renal prostaglandins. The NSAID, Ibuprofen, may also antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
indomethacin Uncurated Annotation Risk of inhibition of renal prostaglandins. The NSAID, Indomethacine, may also antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
isoproterenol Uncurated Annotation Antagonism (source: Drug Bank)
ketoprofen Uncurated Annotation The NSAID, Ketoprofen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
ketorolac Uncurated Annotation The NSAID, Ketorolac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
l-methyldopa Uncurated Annotation Possible hypertensive crisis (source: Drug Bank)
lidocaine Uncurated Annotation The beta-blocker increases the effect and toxicity of lidocaine (source: Drug Bank)
lumiracoxib Uncurated Annotation The NSAID, Lumiracoxib, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
meloxicam Uncurated Annotation The NSAID, Meloxicam, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
methysergide Uncurated Annotation Ischemia with risk of gangrene (source: Drug Bank)
nabumetone Uncurated Annotation The NSAID, Nabumetone, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
naproxen Uncurated Annotation The NSAID, Naproxen, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
orciprenaline Uncurated Annotation Antagonism (source: Drug Bank)
oxaprozin Uncurated Annotation The NSAID, Oxaprozin, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
oxtriphylline Uncurated Annotation Antagonism of action and increased effect of theophylline (source: Drug Bank)
pirbuterol Uncurated Annotation Antagonism (source: Drug Bank)
piroxicam Uncurated Annotation Risk of inhibition of renal prostaglandins. The NSAID, Piroxicam, may also antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
prazosin Uncurated Annotation Risk of hypotension at the beginning of therapy (source: Drug Bank)
procaterol Uncurated Annotation Antagonism (source: Drug Bank)
repaglinide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
salbutamol Uncurated Annotation Antagonism (source: Drug Bank)
salmeterol Uncurated Annotation Antagonism (source: Drug Bank)
sulindac Uncurated Annotation The NSAID, Sulindac, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
terbutaline Uncurated Annotation Antagonism (source: Drug Bank)
theophylline Uncurated Annotation Antagonism of action and increased effect of theophylline (source: Drug Bank)
tolazamide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
tolbutamide Uncurated Annotation The beta-blocker decreases the symptoms of hypoglycemia (source: Drug Bank)
tolmetin Uncurated Annotation The NSAID, Tolmetin, may antagonize the antihypertensive effect of Timolol. (source: Drug Bank)
verapamil Uncurated Annotation 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
No phenotype data No genotype data Literature annotations available Not annotated
normal tension glaucoma
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Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00373
KEGG Compound ID:
C07141
PubChem Compound ID:
33624
PubChem Substance ID:
175467
IUPHAR Ligand ID:
565

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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