Timolol contraindications

The P-blockers propranolol and timolol are FDA-approved for migraine prophylaxis, but other drugs in the class are also as effective.46 Cautious dosage titration is advised for those patients who do not have other indications for P-blocker use. Rizatriptan interacts with propranolol and thus dosages must be titrated downward, or another triptan chosen for abortive therapy.36 Comorbid reactive airway disease is a relative contraindication to P-blocker prophylaxis, and patients with cardiac conduction disturbances should be closely monitored. Calcium channel antagonists are often used when patients cannot tolerate P-blockers. They are purported to beneficially... 

Contraindications Bronchial asthma or chronic obstructive pulomonary disease, cardiogenic shock, overt cardiac failure, second and third degree AV block, severe sinus bradycardia, hypersensitivity to dorzolamide, timolol, or any other component of the formulation... 

Drug therapy is the most common initial treatment and is initiated in a stepwise manner, starting with a single well tolerated topical agent (Table 66-2). Historically, )3-blockers (e.g., timolol) were the treatment of choice and continue to be used if there are no contraindications to potential P-blockade caused by systemic absorption. Blockers have the advantage of low cost owing to generic formulations. 

Other Medical Conditions. Other systemic disorders can be affected by or contraindicate the use of topically applied medications. Examples include myasthenia gravis, which can be worsened with topical timolol, and erythema multiforme (Stevens-Johnson syndrome), which can be caused or exacerbated by topical ocular sulfonamides and related antiglaucoma drugs such as carbonic anhydrase inhibitors. 

Timolol is contraindicated in patients with bronchial asthma, a history of bronchial asthma, or severe COPD. 

The contraindications for levobunolol are the same as those for timolol. Levobunolol is contraindicated in... 

Quick relief can be obtained with a p-adrenoceptor blocking drug (judge dose by heart rate) though these do not block all the metabolic effects of the hormone, e.g. on the myocardium, and the basal metabolic rate is unchanged. For this reason they should not be used as sole therapy except in mild thyrotoxicosis in preparation for radioiodine treatment, and should be continued in these patients until the radioiodine has taken effect. They do not alter the course of the disease, nor biochemical tests of thyroid function. Any effect on thyroid hormonal action on peripheral tissues is clinically unimportant. It is desirable to choose a drug that is nonselective for pj and p2 receptors and lacks partial agonist effect (e.g. propranolol 20-80 mg 6-8-hourly, or timolol 5 mg once daily). Usual contraindications to P-blockade (see p. 478) should be observed, especially asthma. 

Timolol is contraindicated in patients with nnstabilized cardiac failure or bronchial obstruction, AV condnction disturbances of the second and third grade, nnstable insnlin-dependent diabetes, and severe peripheral arterial obstruction. The most common side effects are mnscnlar fatigne, cold hands and feet, symptomatic hypotension, and bradycardia. 

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