Timololong - instructions for use, dose, side effects, contraindications

Gipromellose 3 mg, sodium hydrogen phosphate dodecahydrate 11.9 mg, potassium dihydrogen phosphate 4.5 mg, sodium chloride 3.0 mg, benzalkonium chloride 0.12 mg, water purified to 1 ml.

Description:

Transparent, colorless, odorless liquid.

Pharmacotherapeutic group:Antiglaucoma means β-blocker

ATX: & nbsp

S.01.E.D. Beta-blockers

S.01.E.D.01 Timolol

Pharmacodynamics:

Timolol is a non-selective beta-adrenergic blocker. Has no internal sympathomimetic and membrane-stabilizing activity.

With topical application in the form of eye drops reduces both normal and increased intraocular pressure due to a decrease in the formation of intraocular fluid. Does not affect the size of the pupil and accommodation. The effect of the drug manifests itself 20 minutes after instillation. The maximum decrease in intraocular pressure occurs in 1-2 hours and persists for 24 hours.

Pharmacokinetics:

With topical application timolol quickly penetrates through the cornea. After instillation of eye drops, the maximum concentration of timolol in the aqueous humor of the anterior chamber of the eye is achieved after 1-2 hours.

In a small amount falls into the systemic bloodstream by absorption through the vessels of the conjunctiva, nasal mucosa and lacrimal tract. Biotransformatsya in the liver. The excretion of timolol metabolites is mainly carried out by the kidneys.

Indications:

- increased intraocular pressure (ophthalmic hypertension)

- open-angle glaucoma;

- secondary glaucoma (uveal, aphakic, post traumatic);

- as an additional means to reduce intraocular pressure in closed-angle glaucoma (in combination with miotics);

- congenital glaucoma (with ineffectiveness of other media).

Contraindications:

bronchial asthma or other severe chronic obstructive airway disease (including history);
sinus bradycardia;
atrioventricular block II or P1 degree;
decompensated chronic heart failure of II-III degree;
cardiogenic shock
corneal dystrophy;
child, age under 18 (due to the lack of data on the efficacy and safety of the drug in children and adolescents under 18 years);
lactation period
hypersensitivity to the components of the drug.

Carefully:

Pulmonary insufficiency, severe cerebrovascular insufficiency, heart failure, atrophic rhinitis, arterial hypotension; sinoatrial blockade, diabetes mellitus, hypoglycemia, thyrotoxicosis, myasthenia gravis, as well as simultaneous administration of other beta-blockers, peripheral circulation disorders (including Raynaud's syndrome), pheochromocytoma, pregnancy.

Pregnancy and lactation:

Possible use of the drug "Timololong®" in pregnancy, if the expected therapeutic effect for the mother justifies the risk to the fetus.

If treatment with Timololong® was carried out immediately before delivery, then newborns should be closely monitored for several days after birth.

Dosing and Administration:

At the beginning of the treatment, the drug "Timololong®" is instilled in the conjunctival sac; 1 drop of 0.25% solution 2 times a day, with insufficient efficiency - 1 drop of 0.5% solution 2 times a day.With the normalization of intraocular pressure, it is necessary to reduce the dose to the 1st drop of 0.25% solution of the drug 1 time per day. The difference in the severity of the action of 2 concentrations is 10 - 15%.

Side effects:

Local reactions:

Irritation of the conjunctiva is conjunctival hyperemia, conjunctival hyperemia, burning of the skin of the eyelids, burning and itching in eyes, lacrimation or a decrease in tearing, photophobia, edema of the corneal epithelium, blepharitis, conjunctivitis, keratitis, with prolonged use, it is possible to develop superficial point-keratopathy (decrease of corneal transparency) and decrease sensitivity of the cornea, it is possible ptosis, rarely - diplopia, short-term impairment of visual acuity.

Systemic reactions:

Paresthesia, rhinitis, nasal congestion, epistaxis, lowering of blood pressure collapse, bradycardia, bradyarrhythmia, atrioventricular blockade, decreased myocardial contractility, worsening of manifestations of chronic heart failure; headache, dizziness, drowsiness, hallucinations, depression, myasthenia gravis; decreased potency; shortness of breath, bronchospasm, pulmonary insufficiency; nausea; vomiting, diarrhea, chest pain, ringing in the ears.Deceleration of the speed of the psychomotor reaction.

Allergic reactions (including urticaria).

In case of side effects, discontinue use of the drug and contact the treating physician (ophthalmologist) as soon as possible.

Overdose:

It is possible to develop systemic effects characteristic of beta-adrenoblockers: dizziness, headache, arrhythmia, bradycardia, bronchospasm; nausea, vomiting.

Treatment: immediately flush eyes with water or 0.9% sodium chloride solution, symptomatic therapy.

Interaction:

Co-administration of Timololong® with eye drops containing epinephrine, can cause a dilated pupil.

Decrease in intraocular pressure is enhanced with simultaneous use of eye drops containing epinephrine and pilocarpine. It is not recommended simultaneous instillation of two different beta-blockers.

Decrease in blood pressure, and bradycardia may increase with the joint application of the drug with blockers of slow calcium channels, reserpine and systemic beta-blockers.

Against the background of drug treatment, intravenous administration of verapamil should be avoided,diltiazem (possibly oppression of atrioventricular conduction, the development of bradycardia and lowering blood pressure).

Simultaneous use with insulin or oral hypoglycemic agents can lead to hypoglycemia.

Inhibitors of CYP2D6 (incl. quinidine, cimetidine) can increase the concentration of timolol in the plasma.

Timolol enhances the action of peripheral muscle relaxants and general anesthetics. In the case of an impending surgery with general anesthesia, it is necessary to cancel the drug 48 hours before the operation.

Special instructions:

Control of effectiveness is recommended to be performed approximately 3-4 weeks after the start of therapy (not earlier than in 1-2 weeks). With prolonged use of timolol, the effect may be weakened. When used, it is necessary to monitor the function of tearing, the integrity of the cornea and assess the magnitude of the visual fields at least once every 6 months. At least once a month, measure intraocular pressure.

If the patient wears soft contact lenses, then Timololong® eyedrops should not be used with 0.25% and 0.5%, since the preservative can be absorbed by soft contact lenses and adversely affect the eye tissue.

Strong contact lenses should be removed before instillation of the drug and reapply them only 15 minutes after it.

When transferring patients to treatment with timolol, correction of refraction after effects caused by previously used miotics may be necessary.

"Timololong®", like other beta-blockers, can conceal possible symptoms of hypoglycemia in patients with diabetes mellitus taking insulin or oral hypoglycemic drugs.

Within 30 minutes after instillation of the drug, visual acuity and slowing of mental reactions may decrease, which can affect the ability to drive vehicles and engage in other potentially dangerous activities that require increased concentration of attention, speed of psychomotor reactions and good vision.

In the case of an upcoming surgical intervention with the use of general anesthesia, it is necessary to cancel the drug 48 hours before the beginning of the operation, because timolol strengthens the action of muscle relaxants and general anesthetics.

Effect on the ability to drive transp. cf. and fur:Within 30 minutes after instillation of the drug, a decrease in visual clarity and a decrease in mentalreactions, which may affect the ability to manage motor vehicles and other potentially hazardous activities that require increased concentration of attention, speed of psychomotor reactions and good vision.

Form release / dosage:

Eye drops 0.25% and 0.5% solution.

Packaging:

Eye drops 0.25% and 0.5% solution. For 5 and 10 ml in plastic bottles with a dispenser - a dropper.

One bottle, along with instructions for medical use, is placed in a pack of cardboard.

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:

3 years. The opened vial should not be stored for more than 30 days.

Do not use after the expiry date printed on the package.

Terms of leave from pharmacies:On prescription

Registration number:PL-000917

Date of registration:18.10.2011 / 13.08.2013

Expiration Date:18.10.2016

Date of cancellation:2016-11-30

The owner of the registration certificate:FIRN M, ZAO FIRN M, ZAO Russia

Manufacturer: & nbsp

FIRN M, ZAO Russia

Information update date: & nbsp07.12.2016

Illustrated instructions

Instructions

Timololong® (Timolollong®)