Betimol (Timolol) – Ophthalmic: Uses, Side Effects, Dosages

What Is Betimol?

Betimol (timolol) is a prescription ophthalmic (eye) medication used to treat open-angle glaucoma or other eye diseases, such as ocular hypertension. Betimol is approved for use in adults 18 and older.

Betimol contains the active ingredient timolol and is classified as a nonselective beta-adrenergic antagonist that can lower eye pressure.

Nonselective beta-adrenergic antagonists, or beta-blockers, are medications used to prevent the stimulation of the adrenergic receptors (receptors on the surface of cells that become activated when they bind to catecholamine, a type of neurotransmitter) responsible for increased heart activity.

Beta-blockers are often used to treat hypertension (high blood pressure), treat angina (chest pain), and control heart rhythm. Specifically, Betimol is thought to work by reducing the amount of aqueous humor, a clear liquid in the space at the front of your eye.

Currently, no therapeutically equivalent, generic alternatives to brand-name Betimol exist.

However, your healthcare provider may prescribe a brand-name alternative to Betimol, such as Istalol, which is administered in the form of liquid eye drops and is used for the treatment of glaucoma and ocular hypertension.

This article will feature Betimol, a prescription medication administered in the form of a liquid eye drop.

What Is Betimol Used For?

The Food and Drug Administration (FDA) has approved Betimol for the treatment of open-angle glaucoma, or other eye diseases, such as ocular hypertension, in adults 18 and older.

Open-angle glaucoma is eye pressure that builds gradually. More specifically, it may appear as an open, healthy-looking anterior chamber angle (part of the eye located between the cornea and iris) but is marked by raised intraocular (eye) pressure (IOP).

Glaucoma affects roughly 3 million people in the United States (U.S.), with open-angle glaucoma being the most common type.

Many people with glaucoma often don’t experience any early symptoms. For this reason, around 50% of people with glaucoma are unaware that they have this eye condition, which is the second-leading cause of blindness in the world.

Unfortunately, there’s currently no cure for glaucoma. However, if it’s caught early, there are ways to prevent vision loss, such as by using Betimol.

Conversely, ocular hypertension refers to any scenario in which the pressure inside the eye is higher than normal. Eye pressure is measured in millimeters of mercury. Typically, healthy eye pressure levels range from 10 to 21 millimeters of mercury.

How to Use Betimol

Since directions may vary for different eye medications, carefully read the directions and packaging label on your container.

In general, however, place one drop of Betimol into the affected eye(s) once to twice daily per your healthcare provider’s directions.

Also, keep the following guidelines in mind for the safe and effective use of Betimol:

• Don’t touch the tip of the Betimol bottle to your eye or any surface: This is to prevent injuring your eye or contaminating (dirtying) the solution. If this occurs, clean the tip of the bottle lightly with water and then dry it using a clean tissue.
• Don’t use Betimol with contact lenses: Remove contact lenses from your eyes before using Betimol. After using Betimol, wait five minutes before wearing contact lenses again.
• Wait between using different eye products: Wait five minutes between applying each eye medication.

The following are some general steps on how to use eye drops:

1. Wash your hands before using your eye drops.
2. Take out your contact lenses. You can usually wear your contact lenses again five minutes after using your eye drops.
3. Tilt your head back to look up.
4. Pull down your lower eyelid to form a small cup or pocket.
5. Place one eye drop into this pocket.
6. Close your eyes and press down on your tear duct, the corner of your eye closest to your nose. Do this for at least one minute.
7. Repeat steps 3–6 for the other eye if recommended by your healthcare provider.
8. Wash your hands after using your eye drops.

How to Store Betimol

Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.

Store between 59 and 77 degrees F. This means room temperature should be OK. Don’t freeze your eye drops, and don’t store your medication in the bathroom. Make sure to also protect your Betimol eye drops from light.

Avoid placing unused and expired drugs down the drain or in the toilet. Visit the FDA’s website to know where and how to discard all unused and expired drugs.

You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you’re planning to travel with Betimol, get familiar with your final destination’s regulations. In general, be sure to make a copy of your Betimol prescription, plus keep your medication in its original container from your pharmacy with your name on the label.

Checking with the U.S. Embassy or Consulate might be a helpful resource. You can also ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

What Are the Side Effects of Betimol?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects associated with the use of Betimol may include but may not be limited to:

• Burning or stinging eyes
• Dry and itchy eyes
• Eye discomfort
• Feeling there is something in your eyes
• Headache

Call your healthcare provider if any symptoms do not go away or worsen.

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Get medical help right away if you develop the following serious side effects:

• Severe allergic reaction: If you have a severe allergic reaction to Betimol, you may experience symptoms of facial swelling, itchiness, rash, or breathing difficulties.
• Breathing problems: Using beta-blockers—like Betimol—may worsen breathing problems in people with certain lung conditions, such as chronic obstructive pulmonary disorder (COPD).
• Eye problems: There’s a chance of serious infection and eye damage with Betimol use—especially if you touch the Betimol bottle tip to your eye or any surface.
• Heart-related effects: Beta-blockers—like Betimol—may lower your blood pressure and heart rate. So, use beta-blockers with caution if you have cerebrovascular insufficiency, which is a group of conditions that affect blood flow to the brain and raise your risk of stroke. Beta-blockers may also increase your risk of heart failure.
• Masked hyperthyroidism (overactive thyroid) symptoms: Hyperthyroidism is a medical condition of too much thyroid hormone. You may experience various symptoms with high thyroid hormone levels, but beta-blockers (e.g., Betimol) may mask certain symptoms—like a fast heart rate. Without treatment, uncontrolled hyperthyroidism might turn into a life-threatening condition called a thyroid storm.
• Masked low blood sugar: When you experience low blood sugar, you may notice a number of symptoms, such as a rapid heart rate. But beta-blockers—like Betimol—may mask many of these symptoms. This can be particularly dangerous in people with diabetes, who are at a higher risk of experiencing low blood sugar from various factors—like insulin use.
• Muscle weakness: Some people may experience muscle weakness with beta-blockers, such as Betimol.

Long-Term Side Effects

Some possible long-term side effects associated with the use of Betimol may include:

• Eye problems: Eye infection and damage are possible with Betimol—especially if you touch the Betimol bottle tip to your eye or any surface. This may become serious, resulting in vision loss.
• Heart-related effects: The potential for the development of heart failure in some people.

Dosage: How Much Betimol Should I Use?

Modifications

The following modifications (changes) for certain groups of people should be kept in mind when using Betimol:

Severe allergic reaction: Avoid using Betimol if you have a known allergy to it or any of its components (ingredients). Ask your healthcare provider for a complete list of the ingredients if you’re unsure.

Pregnancy: In animal studies, oral (by mouth) Betimol at very high doses was found to have negative effects on the fetus. Not enough is known about the safety and effectiveness of Betimol in pregnant people and on the fetus.

Discuss with your healthcare provider if you plan to become pregnant or are pregnant. They’ll help you weigh the benefits and risks of Betimol during your pregnancy.

Breastfeeding: It’s unlikely for Betimol to have negative effects on the nursing infant. But some experts may recommend timolol gel versions over the solution drops.

If you’re going to use timolol eye drops while breastfeeding, there are ways to further prevent Betimol from reaching your breast milk.

Remember to press down on your tear duct (corner of your eye closest to your nose) for at least one minute after placing timolol in your eye. Also, remove any excess eye drop solution with tissue paper.

Talk with your healthcare provider if you plan to breastfeed. They will help you weigh the benefits and risks of epinastine while nursing. They can also discuss the different ways available to feed your baby.

Adults over age 65: In general, older adults with more than one medical condition or who are taking several medications should use caution. Older adults tend to be more sensitive to medication side effects.

Children: There is little safety and effectiveness data for Betimol in children.

Heart-related conditions: Beta-blockers—like Betimol—may lower your blood pressure and heart rate. So, use beta-blockers with caution in people with cerebrovascular insufficiency, which is a group of conditions that affect blood flow to the brain and raise your risk of stroke. Beta-blockers may also raise your risk of heart failure.

If you already have certain heart-related conditions, your healthcare provider may want to closely monitor you, make medication changes, or avoid beta-blockers.

Lung conditions: Betimol may cause tightening of the airways, especially in people with lung conditions. This can become so severe that it’s life-threatening.

If you already have certain lung conditions, your health healthcare provider may want to closely monitor you, make medication changes, or avoid beta-blockers.

Surgery: Betimol may increase the risk of anesthesia problems during surgery. For example, you may experience blood pressure and heart rate problems. For these reasons, your healthcare provider may want to slowly decrease and stop your beta-blocker before your procedure.

Diabetes: Betimol may mask low blood sugar symptoms, such as a rapid heart rate. Some people with diabetes may have a higher risk of low blood sugar problems from various factors, such as insulin use.

So, if you have diabetes, your healthcare provider may want to closely monitor you. And if necessary, they’ll adjust your medications.

Hyperthyroidism: People with hyperthyroidism have high levels of thyroid hormone. From this excess hormone, they may experience a number of symptoms, such as a rapid heart rate. But beta-blockers—like Betimol—may mask some hyperthyroidism symptoms. Be aware that uncontrolled hyperthyroidism may turn into a life-threatening condition called thyroid storm.

If you have thyroid problems, your healthcare provider may want to closely monitor you to make any necessary changes to your medications.

Angle-closure glaucoma: Similar to open-angle glaucoma, people with angle-closure (narrow-angle) glaucoma also have high eye pressure. But in narrow-angle glaucoma, you’re having trouble draining the natural fluid from your eye because your iris (colored part of your eye) is blocking the drainage angle that allows the fluid to drain (leave) your eyes.

Betimol is used for open-angle glaucoma. It shouldn’t be used alone for narrow-angle glaucoma. If you’re using Betimol for narrow-angle glaucoma, it should be used with a miotic eye medication, such as pilocarpine. Miotics—like pilocarpine—make your pupil (part of the eye that lets light in) smaller to open up the drainage angle.

Certain muscle conditions: Betimol may be linked to muscle weakness. If you already have muscle weakness issues, beta-blockers may make this worse. For this reason, your healthcare provider may want to closely monitor you to make any necessary medication adjustments.

Missed Dose

If you accidentally forgot your Betimol dose, use your Betimol eye drops as soon as you remember. If it’s already close to your next scheduled dose, then skip the missed dose and use Betimol at your next scheduled dosing time. Don’t try to double up to make up for the missed dose.

Try to find ways to help yourself remember to routinely keep your appointments and take your medication. If you miss too many doses, Betimol might be less effective at treating your condition.

Overdose: What Happens If I Use Too Much Betimol?

There is limited information available about Betimol overdoses. But symptoms of a suspected overdose may include:

• Heart failure
• Hypotension (low blood pressure)
• Bradycardia (slow heart rate)
• Bronchospasms (constricted airways causing difficulty breathing)

If you think that you’re experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

Precautions

What Are Reasons I Shouldn’t Use Betimol?

Before using Betimol, talk with your healthcare provider if any of the following applies to you:

Severe allergic reaction: If you have a severe allergic reaction to Betimol or its components (ingredients), this medication isn’t a viable option for you.

Pregnancy: There is limited information about the effects and safety of Betimol on the fetus. Discuss with your healthcare provider to discuss the benefits and risks of Betimol while pregnant.

Breastfeeding: The chances of Betimol reaching your nursing baby are very low. But some experts may prescribe timolol gel versions over the solution drops for people who are breastfeeding. Talk with your healthcare provider about the benefits and harms of Betimol while breastfeeding.

Children: There is little information about the effects and safety of Betimol in children.

Older adults over 65 years of age: Older adults tend to be more sensitive to medication side effects. For this reason, use caution with Betimol.

Certain heart-related conditions: Betimol shouldn’t be used in people with certain heart-related conditions, such as severe heart failure and slow heart rate.

Another condition also includes cardiogenic shock, which can be life-threatening. In cardiogenic shock, your heart isn’t pumping enough blood and oxygen to the rest of your body.

Examples of other conditions also include second-degree or third-degree atrioventricular (AV) block.

In general, people with a heart block have an electrical system that isn’t working properly in the heart. And this can affect how fast or regular your heart beats.

Certain lung conditions: Betimol should be avoided in people with certain lung conditions, such as asthma or severe COPD.

What Other Medications Interact With Betimol?

Use caution when using Betimol with the following medications:

• Anesthesia: Betimol may raise the risk of complications with anesthesia during major surgery. For example, you may experience blood pressure and heart rate issues.
• Beta-blockers: Since Betimol is a beta-blocker, taking other beta-blockers (e.g., Betagan [levobunolol] eye drops) may increase the risk of side effects.
• Calcium channel blockers (CCB): While CCB and beta-blockers can be used together in certain cases, the combination should be avoided in other conditions. For example, if you have a heart block condition, the combination may make things worse. Cardizem (diltiazem) is an example of a CCB.
• Diabetes medications: Some diabetes medications—like insulin—may increase your chances of experiencing low blood sugar. And beta-blockers may mask the warning signs of low blood sugar—like a rapid heart rate.
• Digoxin: Taking Lanoxin (digoxin) with beta-blockers may affect how your heart’s electrical system works.
• Eye medications: You may use other eye medications with Betimol, but don’t use of them at the same time. Instead, try to separate them from each other by five minutes.

For more detailed information about medication interactions with Betimol, talk with your healthcare provider.

And be sure to inform your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC), nonprescription products, vitamins, herbs, or plant-based medicines.

What Medications Are Similar?

Betimol is a beta-blocker.

Other beta-blockers that are also used to treat glaucoma, or other eye conditions, may include:

• Betagan (levobunolol)
• Betoptic (betaxolol)
• Ocupress (carteolol)

In general, beta-blockers are commonly used eye medications for glaucoma.

However, most beta-blockers are nonselective. This means that they attach to both beta-1 and beta-2 receptors (binding sites). The heart has a high number of beta-1 receptors, and the lungs have more beta-2 receptors.

The only selective beta-blocker eye medication is betaxolol, which attaches to the beta-1 receptors. Since it doesn’t attach to the beta-2 receptors, there are typically fewer lung-related side effects. So, betaxolol might be a better option for people with lung conditions.

How Can I Stay Healthy While Using Betimol?

If you’re using Betimol eye drops, chances are the consequences of glaucoma or ocular hypertension have negatively affected your quality of life. You may have tried different approaches or treatments.

Generally, while living with one or multiple eye diseases does have its challenges, there are ways to prevent vision loss and help improve your quality of life. Refer below for some general tips:

• In addition to using your eye medications, learn more about various types of glaucoma and keep your appointments to monitor your eye pressure.
• During your office visits, let your healthcare provider know if you’re taking steroid medications—even steroid eye drops. Plus, let them know if you’re experiencing low blood pressure at night. Steroid medications and low blood pressure at night may worsen your glaucoma condition.
• At these appointments, you may also have a discussion with your healthcare provider about other ways to prevent worsening eye pressure. For example, they may recommend sleeping with your eyes against the pillow.
• Exercise can benefit your health, but some types of exercise may increase your eye pressure. Talk with your healthcare provider about your exercise routine.
• Aside from regular visits to your healthcare provider, you may also wish to work with a mental health professional or participate in support groups.