Brimonidine / Timolol Ophthalmic Side Effects

Medically reviewed by Drugs.com. Last updated on Jan 19, 2025.

Applies to brimonidine/timolol ophthalmic: ophthalmic solution.

Precautions

It is very important that your doctor check your the progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

If itching, redness, swelling, or other signs of eye or eyelid irritation occur, stop using this medicine and check with your doctor. These signs may mean that you are allergic to this medicine.

This medicine may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, shortness of breath, swelling of the face, fingers, feet, or lower legs, weight gain, or wheezing.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery.

This medicine may cause blurred vision or other vision problems that may last for several minutes after you put them in your eye. If any of these occur, do not drive, use machines, or do anything else that could be dangerous if you are not able to see well. If these eye changes are bothersome, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects

Along with its needed effects, brimonidine / timolol ophthalmic may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking brimonidine / timolol ophthalmic:

Get emergency help immediately if any of the following symptoms of overdose occur while taking brimonidine / timolol ophthalmic:

Symptoms of overdose

• chest pain or discomfort
• cough
• difficulty breathing
• lightheadedness, dizziness or fainting
• no blood pressure or pulse
• noisy breathing
• stopping of heart
• tightness in the chest
• unconsciousness

Other side effects

Some side effects of brimonidine / timolol ophthalmic may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to brimonidine / timolol ophthalmic: ophthalmic solution.

General adverse events

The commonly reported side effects were allergic conjunctivitis, conjunctival folliculosis, conjunctival hyperemia, eye pruritus, ocular burning, and stinging.^[Ref]

Cardiovascular

• Common (1% to 10%): Hypertension
• Uncommon (0.1% to 1%): Congestive heart failure, palpitations
• Postmarketing reports: Arrhythmia, bradycardia, tachycardia, hypotension, pallor

Brimonidine:

• Frequency not reported: Vasodilation

Timolol:

• Frequency not reported: Chest pain, atrioventricular block, cardiac arrest, cardiac failure, Raynaud's phenomenon, cold hands and feet, claudication, worsening of angina pectoris^[Ref]

Gastrointestinal

• Common (1% to 10%): Oral dryness
• Uncommon (0.1% to 1%): Nausea, diarrhea

Brimonidine:

• Frequency not reported: Gastrointestinal symptoms

Timolol:

• Frequency not reported: Dyspepsia, abdominal pain, vomiting^[Ref]

Immunologic

Brimonidine:

• Frequency not reported: Systemic allergic reactions, systemic lupus erythematosus, flu syndrome

Timolol:

• Frequency not reported: Systemic allergic reactions including angioedema, urticaria, localized and generalized rash, pruritus, anaphylactic reaction^[Ref]

Nervous system

• Common (1% to 10%): Somnolence, headache
• Uncommon (0.1% to 1%): Dizziness, syncope, taste perversion
• Postmarketing reports: Coma, lethargy

Timolol:

• Frequency not reported: Cerebrovascular accident, cerebral ischemia, increases in signs and symptoms of myasthenia gravis, paresthesia, disorientation, memory loss, tinnitus^[Ref]

Psychiatric

• Common (1% to 10%): Depression

Brimonidine:

• Frequency not reported: Insomnia

Timolol:

• Frequency not reported: Insomnia, nightmare, behavioral changes and psychic disturbances including confusion, hallucination^[Ref]

Respiratory

• Uncommon (0.1% to 1%): Rhinitis, nasal dryness
• Postmarketing reports: Respiratory depression

Brimonidine:

• Frequency not reported: Upper respiratory symptoms, dyspnea, apnea

Timolol:

• Frequency not reported: Bronchospasm (predominantly in patients with pre-existing bronchospastic disease), dyspnea, cough, upper respiratory infection, nasal congestion^[Ref]

Genitourinary

Timolol:

• Frequency not reported: Sexual dysfunction, decreased libido, Peyronie's disease, retroperitoneal fibrosis^[Ref]

Ocular

• Very common (10% or more): Conjunctival hyperemia, burning sensation
• Common (1% to 10%): Stinging sensation in the eye, allergic conjunctivitis, corneal erosion, superficial punctuate keratitis, eye pruritus, conjunctival folliculosis, visual disturbance, blepharitis, epiphora, eye dryness, eye discharge, eye pain, eye irritation, foreign body sensation, eyelid edema, eyelid pruritus, eyelid erythema
• Uncommon (0.1% to 1%): Worsened visual acuity, conjunctival edema, conjunctivitis, vitreous floater, asthenopia, photophobia, papillary hypertrophy, eyelid pain, conjunctival blanching, corneal edema, corneal infiltrates, vitreous detachment, allergic contact dermatitis
• Postmarketing reports: Blurred vision, keratoconjunctivitis sicca

Brimonidine:

• Frequency not reported: Iritis, iridocyclitis (anterior uveitis), miosis, cataract, conjunctival blanching, hordeolum, lid crusting, lid disorder

Timolol:

• Rare (less than 0.1%): Corneal calcification (with the use of phosphate containing eye drops in some patients with significantly damaged corneas)
• Frequency not reported: Keratitis, choroidal detachment following filtration surgery, decreased corneal sensitivity, corneal erosion, ptosis, diplopia, cystoid macular edema, pseudopemphigoid, refractive changes, blepharoptosis^[Ref]

Musculoskeletal

• Postmarketing reports: Hypotonia

Timolol:

• Frequency not reported: Myalgia^[Ref]

Other

• Common (1% to 10%): Asthenic conditions
• Postmarketing reports: Facial erythema

Timolol:

• Frequency not reported: Edema, fatigue^[Ref]

Dermatologic

Brimonidine:

• Frequency not reported: Skin reaction including erythema, pruritus, rash

Timolol:

• Frequency not reported: Alopecia, psoriasiform rash or exacerbation of psoriasis, rash^[Ref]

Hepatic

• Common (1% to 10%): Abnormal Liver Function Tests^[Ref]

Metabolic

Brimonidine:

• Frequency not reported: Masked symptoms of hypoglycemia in diabetes patients, hypercholesterolemia

Timolol:

• Frequency not reported: Hypoglycemia^[Ref]

See also:

Further information

Brimonidine/timolol ophthalmic side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer