The endpoints evaluated were each subject's response to survey questions about their current timolol treatment. Patient survey shows the survey questionnaire. A 5 point scoring 0 to 4 was done for each of the questions. All questions were analyzed between timolol hemihydrate vs timolol maleate with potassium sorbate with a Student's t-test except question 9 which was evaluated with a Chi-square test. The study included patients from seven centers. The demographic and baseline data is elucidated in Table 1.
The mean age was The results for all patients for the survey questions are shown in Table 2. Also, there was little effect on activities of daily living. The same statistical results as with the complete patient population also held with subanalyses of timolol hemihydrate once daily or twice daily vs timolol maleate with potassium sorbate, or mono- or adjunctive treatment with timolol hemihydrate vs timolol maleate with potassium sorbate.
Table 7: Survey question results monotherapy timolol hemihydrate vs timolol maleate in sorbate. Timolol maleate formulation combined with sorbate has the advantage of better penetration due to enhanced lipophilicity, but maleate is a salt of an organic acid that has several types of cellular effects. It reduces glutathione, a free radical scavenger, in both epithelial and endothelial cells and in corneal endothelial cells specifically. Timolol maleate too has a pH of 6.
Despite similar pH and osmolaity, stinging is more marked with the latter. Table 4: Survey question results timolol hemihydrate BID vs timolol maleate in sorbate. Table 5: Survey question results timolol hemihydrate QD vs timolol maleate in sorbate. The reason for the differences between these medications in comfort were not clear by the results of this survey.
Past research has also not been able to elucidate if the irritation from timolol maleate results from the active ingredient or the maleate. Sonty S et al compared the symptoms and tolerability of once daily timolol hemihydrate 0. Table 6: Survey question results adjunctive therapy timolol hemihydrate vs timolol maleate in sorbate. Our survey did not evaluate symptoms or signs after instillation or adherence in a randomized prospective clinical trial. Further research is needed to analyze anterior segment safety between these two beta-blockers as well as to describe the mechanism of stinging associated with timolol maleate with potassium sorbate.
National Center for Biotechnology Information , U. J Curr Glaucoma Pract. Published online Jan Author information Article notes Copyright and License information Disclaimer.
Corresponding author. Received Jun 17; Accepted Sep 4. This work is licensed under a Creative Commons Attribution 3. This article has been cited by other articles in PMC. Subjects who met any of the following criteria were not qualified to be enrolled in the trial: Inability to understand the trial procedures and thus inability to give informed consent.
Inability to understand, read or write English. Current moderate to severe dry eye syndrome. Current chronic use of ocular corticosteroids. Ocular surgery or intraocular laser surgery to either eye in the prior 3 months. Treated with three or more glaucoma medicines in both eyes. Patient survey 1. Does your beta-blocker drops burn or sting when you put them in your eyes? In order to administer the drop, the patient needed to use the bottle cap to poke a hole in the tip of the bottle.
A patient did not realize this and instead took a pair of scissors to cut open the tip, resulting in a large amount of drop wastage and running out of the medication early. Finally, some of my patients bring in drops from other countries, where glaucoma medications may be a lot less expensive. Unfortunately, it is difficult to know how strictly the generic drug adheres to the brand name formulation, and if there are differences in the inactive ingredients, for example.
Another potential concern with generic eye drops is that your pharmacy may dispense the same glaucoma drop made by different manufacturers from month to month. This is because the pharmacy will tend to purchase the medication from whichever generic manufacturer is offering the lowest bid. Finally, for those who are sensitive to the preservatives used in eye drops, the preservative-free formulations of glaucoma drops for example, ZioptanPF or CosoptPF are not yet made by generic manufacturers.
You should ask your ophthalmologist whether there are coupons or programs to assist in the cost of preservative-free medications. So, how do you determine whether you should use a brand name or a generic? This is a conversation you should have with your eye doctor. It helps if you bring your eye drop bottles to every visit, and let your doctor know if the bottle for a particular medication changes in any given month.
There are instances where brand name medications may be preferred and this may include issues with tolerability often this is due to the preservative used in the generics vs. In my practice, it is uncommon to have a patient whose eye pressure control is lost after a switch to generic, but it does happen. If you cannot tolerate the generic or it is ineffective your eye doctor should be able to help you file paperwork with your insurance company to have them cover the brand name medication.
You are your own best advocate, and in partnership with your eye doctor, you can determine whether generic or brand name glaucoma medications are best for you. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Inclusion Criteria: Patients, male or female of any race or ethnicity, 18 years of age or older, diagnosed with ocular hypertension or open-angle glaucoma with or without pseudoexfoliative or pigmentary dispersion component.
Stable use of Latanoprost 0. Exclusion Criteria: Females of childbearing potential those who are not surgically sterile, postmenopausal or using a reliable birth control method will be excluded from the study. Any allergic component or contraindication to the study medications Pachymetry of microns or greater Systemic corticosteroids not on a stable regimen within 30 days of screening visit.
Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials. Petaluma, California, United States, More Information.
Layout table for additonal information Responsible Party: Dr. National Library of Medicine U. These drugs are taken by mouth. They may monitor you more often than usual to see if you have side effects such as dizziness or feeling tired.
Or your doctor may recommend a different medication to treat your increased eye pressure. Using Timoptic with calcium channel blockers may increase your risk for serious heart conditions, such as heart failure or a drop in blood pressure.
This is because Timoptic and calcium channel blockers can both affect your heart. This is due to the risk of serious side effects. They may recommend a different medication to treat your increased eye pressure. Using Timoptic along with digoxin Lanoxin and a calcium channel blocker may increase your risk for developing a heart condition called prolonged atrioventricular conduction time.
With this condition, part of your heartbeat becomes too long. This can lead to serious symptoms, such as chest pain, fainting, or trouble breathing.
Stopping clonidine treatment can cause you to have a condition called rebound hypertension. This means that when you stop taking clonidine, you may develop an increase in your blood pressure. Timoptic is a type of drug called a beta-blocker. Taking oral beta-blockers may increase the severity of rebound hypertension that occurs after stopping clonidine treatment. However, Timoptic comes in eyedrop form. But your doctor should monitor your blood pressure closely if you stop using clonidine while taking Timoptic.
Timoptic is broken down in your liver by a protein called CYP2D6. Medications that block this protein from working are called CYP2D6 inhibitors. As a result, you may have too much Timoptic in your body. They can help determine if any of them are CYP2D6 inhibitors. Injectable epinephrine is used in cases of serious allergic reactions. However, taking Timoptic may cause your usual epinephrine dose to not treat an allergic reaction.
They may recommend a medication other than Timoptic to treat your increased eye pressure. However, you should still check with your doctor or pharmacist before using any of these products while taking Timoptic.
If you have any questions about eating certain foods with Timoptic, talk with your doctor. Both Timoptic and alcohol can lower your blood pressure and make it harder to breathe. This can increase your risk for side effects, such as feeling dizzy or fainting.
Sometimes, even after your doctor has prescribed the maximum dosage of Timoptic, your eye pressure may not be well controlled. If this happens, they may recommend adding another medication to treat the high eye pressure.
Be sure to wash your hands before you use Timoptic. If you do, bacteria may grow on the tip of the bottle. This can lead you to develop an eye infection.
In some cases, the infection can be serious. In addition, avoid touching your eye with the bottle of Timoptic. This helps prevent bacteria from reaching the bottle tip. See the package instructions for Timoptic or Timoptic-XE to get step-by-step directions for each of these products. You can also talk with your doctor or pharmacist.
In addition, they can give you directions on how to use Timoptic in Ocudose. As a result, you could develop an eye infection if you use Timoptic in Ocudose more often than once. After each dose, be sure to dispose of the vial and any medication remaining in it. This is important to make sure that your eye absorbs both drugs. If you use the medications within 10 minutes of each other, one drug may wash out the other one. This means that one of your medications may not work properly.
The inside of your eye contains fluid, and when the fluid builds up, the pressure in your eye increases. The higher the pressure in your eye is, the greater your risk for developing vision loss and damage to your optic nerve. The optic nerve helps your eyes and brain communicate with each other.
In rare cases, the harm can be permanent. Open-angle glaucoma may be genetic or the result of trauma to the eye. However, the drug is believed to decrease the level of liquid in your eye called aqueous humor. As a result, the pressure in your eye may lower. Timoptic may also cause your eye to drain more liquid than usual. This decrease in liquid may also decrease the pressure in your eye. No studies have been done on the drug during pregnancy. In animal studies , there was no risk of birth defects when the mother was given Timoptic by mouth.
However, bones were slower to form in the fetus. In very high doses between 14, and , times the maximum dose approved in humans , Timoptic caused an increased risk of fetal death in animal studies. They may monitor you more often than usual or recommend a different medication to treat your increased eye pressure. The drug passes into breast milk. They may be able to recommend a medication other than Timoptic to treat your increased eye pressure. Timoptic eye drops belong to a group of medications called beta-blockers.
But beta-blockers may also be taken by mouth to treat other conditions, such as hypertension high blood pressure and heart failure. In some cases, using Timoptic may cause your heart failure to worsen. This is because the drug can decrease your heart rate , which may cause your heart to pump less blood. This is because beta-blockers can work in your airways. If you have lung disease, beta-blockers may cause you to develop serious side effects, such as trouble breathing.
If you have a heart or lung condition, talk with your doctor before using Timoptic. Your doctor may also monitor you more often than normal during your treatment.
This helps prevent you from develop serious side effects from the Timoptic. However, the drug can treat your condition by lowering the pressure in your eye or eyes.
Timoptic can also help prevent vision loss or worsening disease from occurring. There are currently no cures for increased eye pressure or open-angle glaucoma. However, these conditions can be controlled using medications, such as Timoptic, or eye surgery.
You can talk with your doctor about the best treatment for your increased eye pressure. In some people, Timoptic can cause eye burning or stinging.
This may cause your vision to be strained. It may also be hard for your eyes to focus for the first few minutes after using Timoptic. If your eyes burn or sting after a dose of Timoptic, you should wait until they feel better before driving. They may recommend that you wait until your vision clears up before you drive. This drug comes with several precautions. Before taking Timoptic, talk with your doctor about your health history.
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