Timolol ophthalmic Disease Interactions

There are 9 disease interactions with timolol ophthalmic:

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Asthma/Copd

Severe Potential Hazard, High plausibility

Applies to: Asthma, Chronic Obstructive Pulmonary Disease

Ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with a current or past history of bronchial asthma or chronic obstructive pulmonary disease. Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In the respiratory tract, beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. Although agents with beta-1 selectivity (e.g., betaxolol) are considered safer in patients with bronchospastic diseases, cardioselectivity is not absolute and may be lost with larger doses or higher plasma levels.

References

  1. Raine JM, Palazzo MG, Kerr JH, Sleight P "Near-fatal bronchospasm after oral nadolol in a young asthmatic and response to ventilation with halothane." Br Med J 282 (1981): 548-9
  2. Adam WR, Meagher EJ, Barter CE "Labetalol, beta blockers, and acute deterioration of chronic airway obstruction." Clin Exp Hypertens A A4 (1982): 1419-28
  3. Falliers CJ, Vincent ME, Medakovic M "Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol." J Asthma 23 (1986): 251-60
View all 27 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Bradycardia/Av Block

Severe Potential Hazard, High plausibility

Applies to: Sinus Node Dysfunction, Heart Block

The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In cardiac tissues, beta blockade causes a reduction in inotropic as well as chronotropic activity, which may further depress cardiac function in such patients.

References

  1. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  2. "Product Information. Timoptic (timolol ophthalmic)." Merck & Co, Inc, West Point, PA.
  3. Crean PA, Williams DO "Effect of intravenous and oral acebutolol in patients with bundle branch block." Int J Cardiol 10 (1986): 119-26
View all 13 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Cardiogenic Shock

Severe Potential Hazard, High plausibility

Applies to: Cardiogenic Shock

The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with cardiogenic shock. Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In cardiac tissues, beta blockade causes a reduction in inotropic as well as chronotropic activity, which may further depress cardiac output and blood pressure in such patients.

References

  1. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  2. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
  3. "Product Information. Timoptic (timolol ophthalmic)." Merck & Co, Inc, West Point, PA.
View all 12 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Chf

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure

The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with overt congestive heart failure (CHF). Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. Since sympathetic stimulation may be important in maintaining the hemodynamic function in patients with CHF, beta blockade can worsen the heart failure. However, therapy with ophthalmic beta-blockers can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Beta-blockers should be discontinued if cardiac failure develops or worsens during therapy.

References

  1. Mashford ML, Coventry D, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  2. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  3. "Product Information. Timoptic (timolol ophthalmic)." Merck & Co, Inc, West Point, PA.
View all 12 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Diabetes

Severe Potential Hazard, High plausibility

Applies to: Diabetes Mellitus

Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., timolol, carteolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.

References

  1. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
  2. "Product Information. Betaxon (levobetaxolol ophthalmic)" Alza, Palo Alto, CA.
  3. Velde TM, Kaiser FE "Ophthalmic timolol treatment causing altered hypoglycemic response in a diabetic patient." Arch Intern Med 143 (1983): 1627
View all 12 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Hypersensitivity

Severe Potential Hazard, High plausibility

Applies to: Allergies

Topically applied beta-adrenergic receptor blocking agents (aka beta-blockers) are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. The use of beta-blockers in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.

References

  1. "Product Information. Betaxon (levobetaxolol ophthalmic)" Alza, Palo Alto, CA.
  2. "Product Information. Ocupress (carteolol ophthalmic)" Ciba Vision Ophthalmics, Duluth, GA.
  3. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
View all 6 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Hyperthyroidism

Severe Potential Hazard, High plausibility

Applies to: Hyperthyroidism

Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask some symptoms of hyperthyroidism such as tachycardia, anxiety, tremor, and heat intolerance. Abrupt withdrawal of beta-blocker therapy in thyrotoxic patients may exacerbate symptoms of hyperthyroidism or precipitate a thyroid storm. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with or suspected of having hyperthyroidism. Cessation of beta-blocker therapy, when necessary, should occur gradually over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.

References

  1. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
  2. "Product Information. Betaxon (levobetaxolol ophthalmic)" Alza, Palo Alto, CA.
  3. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
View all 6 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Pvd

Severe Potential Hazard, Moderate plausibility

Applies to: Cerebrovascular Insufficiency, Peripheral Arterial Disease

Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., timolol, carteolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.

References

  1. Eliasson K, Danielson M, Hylander B, Lindblad LE "Raynaud's phenomenon caused by beta-receptor blocking drugs." Acta Med Scand 215 (1984): 333-9
  2. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  3. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
View all 18 references

Ophthalmic Beta-Blockers (Includes Timolol ophthalmic) ↔ Myasthenia Gravis

Moderate Potential Hazard, Low plausibility

Applies to: Myoneural Disorder

Topically applied beta-adrenergic receptor blocking agents (aka beta-blockers) are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In the nervous and musculoskeletal systems, beta blockade may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms.

References

  1. Coppeto JR "Timolol-associated myasthenia gravis." Am J Ophthalmol 98 (1984): 244-5
  2. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  3. "Product Information. Timoptic (timolol ophthalmic)." Merck & Co, Inc, West Point, PA.
View all 13 references

You should also know about...

timolol ophthalmic drug Interactions

There are 529 drug interactions with timolol ophthalmic

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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