Adrenaline
Adverse Effect: Hypertension, bradycardia, resistance to Adrenaline in anaphylaxis Clinical Management: Concurrent use should be avoided if possible. However, if used concurrently, monitor blood pressure carefully. If Timolol causes resistance to Adrenaline in anaphylactic shock, glucagon may be effective in a dose of 1 mg or more intravenously every five minutes.
Amiodarone
Adverse Effect: hypotension, bradycardia, or cardiac arrest Clinical Management: Monitor cardiac function carefully. Amiodarone should be used with caution in patients onTimolol particularly if there is suspicion of underlying dysfunction of the sinus node, such as bradycardia or sick sinus syndrome, or if there is partial AV block.
Amlodipine
Adverse Effect: hypotension and/or bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure.
Benidipine
Adverse Effect: hypotension and/or bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure.
Celecoxib
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Cimetidine
Adverse Effect: enhanced beta-blockade (hypotension, bradycardia) Clinical Management: Clinicians should be aware that ophthalmic administration of timolol may result in systemic side effects and enhanced beta-blockade during coadministration with cimetidine. If coadministration of these two agents is necessary, monitor patients closely for signs of timolol toxicity (hypotension,
Clonidine
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: When clonidine is to be withdrawn from concomitant therapy with Timolol , discontinue Timolol first, and monitor blood pressure carefully. Labetalol (alph/beta blocker) or alpha blockers (eg, prazosin, doxazosin) may prevent rebound hypertension.
Digoxin
Adverse Effect: AV block and possible digoxin toxicity Clinical Management: When Timolol and digoxin is to be given concomitantly, carefully monitor ECG and digoxin serum concentrations. Adjust doses accordingly.
Diltiazem
Adverse Effect: hypotension, bradycardia, AV conduction disturbances Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure. A dosage adjustment for hepatically metabolized beta blockers may be required.
Ergotamine
Adverse Effect: Peripheral ischemia Clinical Management: If used together, monitor for peripheral ischemic effects (eg, cold extremities), and choose a selective beta blocker (eg, atenolol) if ischemia occurs.
Felodipine
Adverse Effect: hypotension and/or bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure.
Flunarizine
Adverse Effect: Hypotension, bradycardia, and AV conduction disturbances Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure or bradyarrhythmias.
Flurbiprofen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ibuprofen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ibuprofen Comb.
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Indomethacin
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ketoprofen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ketorolac
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Lacidipine
Adverse Effect: hypotension and/or bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure.
Lidoflazine
Adverse Effect: Hypotension, bradycardia, and AV conduction disturbances Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure or bradyarrhythmias.
Mefenamic Acid
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Meloxicam
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Methyldopa
Adverse Effect: Exaggerated hypertensive response, tachycardia, or arrhythmias during physiologic stress or exposure to exogenous catecholamines Clinical Management: Monitor blood pressure carefully during concurrent therapy, especially during excessive physiologic stress or use of exogenous catecholamines such as phenylpropanolamine.
Nabumetone
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Naproxen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Nifedipine
Adverse Effect: hypotension and/or bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure.
Nimesulide
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Nitrendipine
Adverse Effect: hypotension and/or bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure.
Oxyphenbutazone
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Paracetamol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Paracetamol Comb.
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Phenacetin
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Phenylbutazone
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Piroxicam
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Prazosin - BPH
Adverse Effect: an exaggerated hypotensive response to the first dose of Prazosin - BPH Clinical Management: When concurrent therapy with Prazosin - BPH and Timolol is required, initiate Prazosin - BPH with a smaller than usual dose, preferably at bedtime. Monitor the patient closely for hypotension.
Quinidine
Adverse Effect: Enhanced beta-blockade (hypotension, bradycardia) Clinical Management: Clinicians should be aware that ophthalmic administration of timolol may result in systemic side effects and enhanced beta-blockade during coadministration with quinidine. If coadministration of these two agents is necessary, monitor patients closely for signs of timolol toxicity (hypotension, bradycardia).
Ritodrine
Adverse Effect: Potential interference with tocolytic action of ritodrine Clinical Management: It is possible to successfully treat a patient with both a beta blocker and a beta mimetic if an appropriate dosage is found and the clinical response is monitored.
Tenoxicam
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Terazosin - BPH
Adverse Effect: an exaggerated hypotensive response to the first dose of Terazosin - BPH Clinical Management: When concurrent therapy with Terazosin - BPH and Timolol is required, initiate Terazosin - BPH with a smaller than usual dose, preferably at bedtime. Monitor the patient closely for hypotension.
Verapamil
Adverse Effect: Hypotension, bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure |