$Unique_ID{BRK02157}
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$Title{TIMOLOL (SYSTEMIC)}
$Subject{Blocadren (Merck Sharp & Dohme)}
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Blocadren 10*0215701.scf
Blocadren 20*0215702.scf}

Copyright (C) 1991 Publications International, Ltd.


TIMOLOL (SYSTEMIC)
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BRAND NAME (Manufacturer):
     Blocadren (Merck Sharp & Dohme)
TYPE OF DRUG:
     Beta-adrenergic blocking agent
INGREDIENT:
     timolol
DOSAGE FORM:
     Tablets (5 mg, 10 mg, and 20 mg)
STORAGE:
     Timolol should be stored at room temperature in a tightly closed,
       light-resistant container.

USES:
     Timolol is used to treat high blood pressure and to prevent additional
heart attacks in heart attack patients.  This drug belongs to a group of
medicines known as beta-adrenergic blocking agents or, more commonly, beta
blockers.  These drugs work by controlling nerve impulses along certain nerve
pathways.

TREATMENT

     Timolol tablets can be taken with a glass of water, with meals,
immediately following meals, or on an empty stomach, depending on your
doctor's instructions for taking your medication.  You should try to take your
dose(s) of the medication at the same time(s) each day.
     Try not to miss any doses of this medication.  If you do miss a dose,
take the missed dose as soon as possible.  However, if the next scheduled dose
is within eight hours (if you are taking this medicine only once a day) or
within four hours (if you are taking this medicine more than once a day), do
not take the missed dose at all; just return to your regular dosing schedule.
Do not double the next dose that you take of this medication.
     It is important to remember that timolol does not cure high blood
pressure, but it will help to control the condition as long as you continue to
take it.

SIDE EFFECTS

     Minor.

     Anxiety; constipation; decreased sexual ability; diarrhea; difficulty in
sleeping; drowsiness; dryness of the eyes, mouth, and skin; headache; nausea;
nervousness; stomach discomfort; tiredness; or weakness.  These side effects
should disappear during treatment, as your body adjusts to the medicine.
     If you are extra-sensitive to the cold, be sure to dress warmly during
cold weather.
     To relieve constipation, increase the fiber in your diet (fresh fruits
and vegetables, salads, bran, and whole-grain breads) unless your doctor
directs otherwise.
     Plain, nonmedicated eye drops (artificial tears) may help to relieve eye
dryness.
     Sucking on ice chips or chewing sugarless gum helps to relieve mouth and
throat dryness.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
cold hands or feet (due to decreased blood circulation to skin, fingers, and
toes), confusion, depression, dizziness, fever and sore throat, hair loss,
hallucinations, light-headedness, nightmares, numbness or tingling of the
fingers or toes, rapid weight gain (three to five pounds within a week),
reduced alertness, skin rash, swelling, unusual bleeding or bruising, or
wheezing or difficulty in breathing.

INTERACTIONS

     Timolol interacts with several other types of drugs:
     1. Indomethacin has been shown to decrease the blood-pressure-lowering
effects of the beta blockers.  This may also happen with aspirin or other
salicylates.
     2. Concurrent use of beta blockers and calcium channel blockers
(diltiazem, nifedipine, verapamil) or disopyramide can lead to heart failure
or very low blood pressure.
     3. Cimetidine and oral contraceptives (birth control pills) can increase
the blood concentrations of timolol, which can result in greater side effects.
     4. Side effects may also be increased when beta blockers are taken with
clonidine, digoxin, epinephrine, phenylephrine, phenylpropanolamine,
phenothiazine tranquilizers, prazosin, reserpine, or monoamine oxidase (MAO)
inhibitors.  At least 14 days should separate the use of a beta blocker and
the use of an MAO inhibitor.
     5. Alcohol, barbiturates, and rifampin can decrease the blood
concentrations of beta blockers, which can result in a decrease in
effectiveness.
     6. Beta blockers may antagonize (work against) the effects of
theophylline, aminophylline, albuterol, isoproterenol, metaproterenol, and
terbutaline.
     7. Beta blockers can also interact with insulin or oral antidiabetic
agents, raising or lowering blood sugar levels or masking the symptoms of low
blood sugar.
     8. The action of beta blockers may be increased if they are used with
chlorpromazine, furosemide, or hydralazine.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any listed above.

WARNINGS

     * Before starting to take this medication, it is important to tell your
doctor if you have ever had unusual or allergic reactions to timolol or to any
beta blocker (acebutolol, atenolol, betaxolol, carteolol, esmolol, labetalol,
metoprolol, nadolol, penbutolol, pindolol, propranolol).
     * Tell your doctor if you now have or if you have ever had allergies,
asthma, hay fever, eczema, slow heartbeat, bronchitis, diabetes mellitus,
emphysema, heart or blood vessel disease, kidney disease, liver disease,
thyroid disease, or poor circulation in the fingers or toes.
     * You may want to check your pulse while taking this medication.  If your
pulse is much slower than your usual rate (or if it is less than 50 beats per
minute), check with your doctor.  A pulse rate that is too slow may cause
circulation problems.
     * This medicine may affect your body's response to exercise.  Be sure you
discuss with your doctor how much exercise is safe for you, taking into
account your medical condition.
     * It is important that you do not stop taking this medicine unless you
first check with your doctor.  Some conditions may become worse when the
medicine is stopped suddenly, and the danger of a heart attack is increased in
some patients.  Your doctor may want you to gradually reduce the amount of
medicine you take before stopping completely.  Make sure that you have enough
medicine on hand to last through weekends, vacations, and holidays.
     * Before having surgery or any other medical or dental treatment, tell
your doctor or dentist that you are taking this medication.  Often, this
medication will be discontinued 48 hours prior to major surgery.
     * This medication can cause dizziness, drowsiness, light-headedness, or
decreased alertness.  Exercise caution while driving a car or using any
potentially dangerous machinery.
     * While taking this medicine, do not use any over-the-counter
(nonprescription) allergy, asthma, cough, cold, sinus, or diet preparations
unless you first check with your pharmacist or doctor.  Some of these
medicines can result in high blood pressure when combined with timolol.
     * Be sure to tell your doctor if you are pregnant.  Animal studies have
shown that some beta blockers can cause problems in pregnancy when used at
very high doses.  Adequate studies have not been conducted in humans, but
there has been some association between use of beta blockers during pregnancy
and low birth weight, as well as breathing problems and slow heart rate in
newborn infants.  However, other reports have shown no effects on newborn
infants.  Also, tell your doctor if you are breast-feeding an infant.  Small
amounts of timolol may pass into breast milk.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
