What is Istalol (Timolol Ophthalmic)?

Timolol is a beta-blocker that also reduces pressure inside the eye.
Timolol ophthalmic (for the eyes) is used to treat open-angle glaucoma and other causes of high pressure inside the eye.
Timolol ophthalmic may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Istalol (Timolol Ophthalmic)?

Do not allow the dropper to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.
Do not use any other eye medication unless your doctor has prescribed it for you. If you use another eye medication, use it at least 10 minutes before or after using timolol ophthalmic. Do not use the medications at the same time.
Timolol ophthalmic can cause blurred vision. Be careful if you drive or do anything that requires you to be able to see clearly.

What should I discuss with my healthcare provider before taking Istalol (Timolol Ophthalmic)?

Do not use this medication if you are allergic to timolol, or if you have:

• asthma or severe chronic obstructive pulmonary disease (COPD)
• certain serious heart conditions, especially “AV block”; or
• severe or uncontrolled congestive heart failure

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

• breathing problems such as bronchitis or emphysema
• a history of heart disease or congestive heart failure
• diabetes
• history of stroke, blood clot, or circulation problems
• a thyroid disorder
• a muscle disorder such as myasthenia gravis
• kidney disease; or
• liver disease

FDA pregnancy category C. It is not known whether timolol ophthalmic is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.
Timolol ophthalmic passes into breast milk and could cause harm to a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Do not use this medicine for a child younger than 2 years old.

Istalol Side Effects

What are the possible side effects of Istalol (Timolol Ophthalmic)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using this medication and call your doctor at once if you have any of these serious side effects:

• swelling or redness of your eyelids
• eye redness, discomfort, or sensitivity to light
• drainage, crusting, or oozing of your eyes or eyelids
• depressed mood, confusion, hallucinations, unusual thoughts or behavior
• wheezing, gasping, or other breathing problems
• swelling, rapid weight gain
• chest pain, slow or uneven heart rate; or
• feeling short of breath, even with mild exertion

Less serious side effects may include:

• blurred vision, double vision, drooping eyelid
• burning or stinging in your eye
• headache, weakness, drowsiness
• numbness, tingling, or cold feeling in your hands or feet
• ringing in your ears
• dry mouth
• nausea, diarrhea, loss of appetite, upset stomach
• skin rash or worsening psoriasis
• sleep problems (insomnia); or
• cough, stuffy nose

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Istalol Interactions

What other drugs affect Istalol (Timolol Ophthalmic)?

Before using timolol ophthalmic, tell your doctor if you are using any of the following drugs:

• clonidine (Catapres)
• quinidine (Cardioquin, Quinadex, Quinaglute)
• reserpine
• digitalis (digoxin, Lanoxin, Lanoxicaps)
• acetazolamide (Diamox), dichlorphenamide (Daranide), or methazolamide (Neptazane)
• oral timolol (Blocadren)
• any other beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), penbutolol (Levatol), pindolol (Visken), propranolol (Inderal, InnoPran), sotalol (Betapace), and others
• a calcium channel blocker such as diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nifedipine (Procardia, Adalat), verapamil (Calan, Covera, Isoptin, Verelan), and others; or
• antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft)

This list is not complete and there may be other drugs that can interact with timolol ophthalmic. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I avoid while taking Istalol (Timolol Ophthalmic)?

Timolol ophthalmic can cause blurred vision. Be careful if you drive or do anything that requires you to be able to see clearly.
Do not use any other eye medication unless your doctor has prescribed it for you. If you use another eye medication, use it at least 10 minutes before or after using timolol ophthalmic. Do not use the medications at the same time.

Istalol Dosage

How should I take Istalol (Timolol Ophthalmic)?

Use timolol ophthalmic exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.
Wash your hands before using the eye drops.
Do not use this medication while you are wearing contact lenses. Timolol ophthalmic may contain a preservative that can be absorbed by soft contact lenses. Wait at least 15 minutes after using timolol before putting your contact lenses in.
To apply the eye drops:

• Tilt your head back slightly and pull down your lower eyelid. Hold the dropper above the eye with the dropper tip down. Look up and away from the dropper as you squeeze out a drop, then close your eye
• Gently press your finger to the inside corner of the eye (near your nose) for about 1 minute to keep the liquid from draining into your tear duct. If you use more than one drop in the same eye, wait about 5 minutes before putting in the next drop
• Do not allow the dropper tip to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye

Do not use the eye drops if the liquid has changed colors or has particles in it. Call your doctor for a new prescription.
If you need to have any type of surgery, especially eye surgery, tell the surgeon ahead of time that you are using timolol ophthalmic. You may need to stop using the medicine for a short time.
Store this medication at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I overdose on Istalol (Timolol Ophthalmic)?

Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include feeling dizzy or short of breath, headache, slow heart beat, chest pain, or fainting.

What happens if I miss a dose of Istalol (Timolol Ophthalmic)?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.
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