Timolol

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Also indexed as: Apo-Timol, Apo-Timop, Betim, Blocadren, Gen-Timolol, Glau-opt, Novo-Timol, Nu-Timolol, PMS-Timolol, Tim-Ak, Timoptic, Timoptol

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Combination drugs: Cosopt, Moducren, Prestim, Timolide

Timolol is a beta-blocker drug used to lower blood pressure in people with hypertension, treat people after heart attacks, and prevent migraine headaches. Timolol is available alone and in a combination product used to lower blood pressure. Timolol is also available in eye drop and eye gel preparations used to lower high internal eye pressure due to glaucoma and other conditions.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

May Be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.	Co-Enzyme Q10
Depletion or interference	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	None known
Adverse interaction	None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Co-Enzyme Q10
In a group of 16 glaucoma patients treated with a timolol eye preparation, six weeks of oral co-Enzyme Q10 (90 mg per day) was reported to reduce timolol-induced cardiovascular side effects without affecting intra-ocular pressure treatment.¹

Potassium
Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,² leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.³ People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Interactions with Herbs

Pleurisy root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as beta-blockers.⁴

Interactions with Foods and Other Compounds

Food
Timolol may be taken with or without food.⁵

Alcohol
Timolol may cause drowsiness, dizziness, lightheadedness, or blurred vision.⁶ Alcohol may intensify these effects and increase the risk of accidental injury. To prevent problems, people taking timolol should avoid alcohol.

References

1. Takahashi N, Iwasaka T, Sugiura T, et al. Effect of coenzyme Q10 on hemodynamic response to ocular timolol. J Cardiovasc Pharmacol 1989;14:462–8.

2. Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal potassium disposal. N Engl J Med 1980;302:431–4.

3. Lundborg P. The effect of adrenergic blockade on potassium concentrations in different conditions. Acta Med Scand Suppl 1983;672:121–6 [review].

4. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213–4.

5. Mantyla R, Mannisto P, Nykanen S, et al. Pharmacokinetic interactions of timolol with vasodilating drugs, food and phenobarbitone in healthy human volunteers. Eur J Clin Pharmacol 1983;24:227–30.

6. Threlkeld DS, ed. Diuretics and Cardiovasculars, Beta-Adrenergic Blocking Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1993, 158q.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires August 2007.