Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No	Ailment	Route	Dose Min	Dose Max	Unit	Dosage Form	Frequency	Additional Info
1	Raised intra-ocular pressure in open-angle glaucoma and ocular hypertension	ophthalmic	0.25	0.5	%	Eye Drop	b.d.
2	hypertension	Oral	10		mg	Tablet		Dose: Given daily daily, increased according to response at intervals of 7 or more days. Usual maintenance doses are 10 to 40 mg daily, but doses up to 60 mg daily may be required in some patients; doses above 30 mg daily should be given in 2 equally divided doses.
3	Angina pectoris	Oral	5		mg	Tablet	b.d.	Dose increased at intervals of 3 or more days by 10 mg daily. Most patients respond to 35 to 45 mg daily in divided doses, but some patients may require up to 60 mg daily.
4	Myocardial infarction	Oral	5		mg	Tablet	b.d.	Dose: Given daily for 2 days, starting 7 to 28 days after infarction, and increased subsequently in the absence of any contra- indicating adverse effects, to 10 mg twice daily.
5	Prophylaxis of migraine	Oral	10	20	mg	Tablet		Dose:Given daily.

Adult Dose

S.No	Ailment	Route	Dose Min	Dose Max	Unit	Dosage Form	Frequency	Additional Info
1	Raised intra-ocular pressure in open-angle glaucoma and ocular hypertension	ophthalmic	0.25	0.5	%	Eye Drop	b.d.
2	hypertension	Oral	10		mg	Tablet		Dose: Given daily daily, increased according to response at intervals of 7 or more days. Usual maintenance doses are 10 to 40 mg daily, but doses up to 60 mg daily may be required in some patients; doses above 30 mg daily should be given in 2 equally divided doses.
3	Angina pectoris	Oral	5		mg	Tablet	b.d.	Dose increased at intervals of 3 or more days by 10 mg daily. Most patients respond to 35 to 45 mg daily in divided doses, but some patients may require up to 60 mg daily.
4	Myocardial infarction	Oral	5		mg	Tablet	b.d.	Dose: Given daily for 2 days, starting 7 to 28 days after infarction, and increased subsequently in the absence of any contra- indicating adverse effects, to 10 mg twice daily.
5	Prophylaxis of migraine	Oral	10	20	mg	Tablet		Dose:Given daily.

Ref :-  Book : Martindale    Page : 1550   Edition : 37  

Pediatric Dose

Ref :- Book :    Page :    Edition :   

►  Side Effect : Heart failure, heart block, Bronchospasm, Fatigue, Coldness of the extremities, Bradycardia, Hypotension, Shortness of breath, Dyspnoea, Pneumonitis, Pleurisy, Headache, Depression, Dizziness, Hallucinations, Confusion, Amnesia, Sleep disturbances, Nightmares, Coma, Convulsion, Paresthesia, Arthralgia, Myopathies, Muscle cramp, Raynaud’s syndrome, Nausea, Vomiting, Diarrhoea, Constipation, Abdominal cramping, Hypoglycaemia, Hyperglycaemia, Changes in blood concentrations of triglycerides and cholesterol, Rashes, Pruritus, Exacerbation of psoriasis, Excess sweating, Reversible alopecia, Blurred Vision, Conjunctivitis, Soreness, Nonthrombocytopenic purpura, Thrombocytopenia, Transient eosinophilia, Systemic lupus erythematous (SLE), Dry mouth, Raised liver enzymes, Male impotence, Sclerosing peritonitis, Retroperitoneal fibrosis
Ref :-   Book : Martindale    Page : 1349,1550   Edition : 37.  
►  Drug Interaction : Drug interaction of Timolol is with Angiotensin conveting enzyme inhibitors , Calcium Channel Blockers , General anaesthetics , NSAIDS, Antiarrhythmics, Sympathomimetic Drugs , Oral Hypoglycemic Drugs, Barbiturates , ,  Nadolol, Atenolol , Propranolol , Labetalol , Hydralazine , Fluvoxamine, Erythromycin , Cimetidine , Rifampicin , Cholestyramine , Insulin , Epinephrine (adrenaline) , Verapamil , Aldesleukin , Clonidine
Ref :-   Book : Martindale    Page : 1352,1550   Edition : 37.  

Drug interaction

Drug Interaction : Drug interaction of Timolol is with Angiotensin conveting enzyme inhibitors , Calcium Channel Blockers , General anaesthetics , NSAIDS, Antiarrhythmics, Sympathomimetic Drugs , Oral Hypoglycemic Drugs, Barbiturates , ,  Nadolol, Atenolol , Propranolol , Labetalol , Hydralazine , Fluvoxamine, Erythromycin , Cimetidine , Rifampicin , Cholestyramine , Insulin , Epinephrine (adrenaline) , Verapamil , Aldesleukin , Clonidine

Book : Martindale    Page : 1352,1550   Edition : 37.  

  ►    Mechanism of Drug Drug Interaction :  Drugs that enhance the antihypertensive effects of beta blockers, such as ACE inhibitors, calcium-channel blockers, and clonidine may be useful in controlling hypertension. Drugs that cause hypotension such as aldesleukin and general anaesthetics also enhance the antihypertensive effects of beta blockers while other drugs, for example NSAIDs, antagonise the antihypertensive effects. Use of beta blockers with other cardiac depressants such as antiarrhythmics and rate-limiting calciumchannel blockers can precipitate bradycardia and heart block; the combination of intravenous verapamil and beta blockers should especially be avoided. Patients taking beta blockers may have an exaggerated hypertensive response to adrenaline, caused by unopposed alpha-mediated vasoconstriction, while the bronchodilator effects are inhibited; the response to adrenaline given for anaphylaxis may also be reduced in patients on long-term treatment with beta blockers. In diabetic patients beta blockers can reduce the response to insulin and oral hypoglycaemics through their effects on pancreatic beta receptors. Drugs that reduce absorption include aluminium salts and bile-acid binding resins such as colestyramine. Metabolism of some beta blockers can be increased by drugs such as barbiturates and rifampicin and decreased with drugs such as cimetidine, erythromycin, fluvoxamine, and hydralazine. Drugs that alter hepatic blood flow also affect metabolism of some beta blockers. For example, cimetidine and hydralazine decrease hepatic blood flow and this contributes to the decreased hepatic clearance seen with these drugs. Drugs that influence hepatic metabolism affect beta blockers that are extensively metabolised, such as labetalol, propranolol, and timolol, while beta blockers that are excreted largely unchanged, for example atenolol and nadolol, are unaffected.
Ref :-   Book : Martindale    Page : 1352,1550   Edition : 37.  

Mechanism of Drug

Mechanism of Drug Drug Interaction : Drugs that enhance the antihypertensive effects of beta blockers, such as ACE inhibitors, calcium-channel blockers, and clonidine may be useful in controlling hypertension. Drugs that cause hypotension such as aldesleukin and general anaesthetics also enhance the antihypertensive effects of beta blockers while other drugs, for example NSAIDs, antagonise the antihypertensive effects. Use of beta blockers with other cardiac depressants such as antiarrhythmics and rate-limiting calciumchannel blockers can precipitate bradycardia and heart block; the combination of intravenous verapamil and beta blockers should especially be avoided. Patients taking beta blockers may have an exaggerated hypertensive response to adrenaline, caused by unopposed alpha-mediated vasoconstriction, while the bronchodilator effects are inhibited; the response to adrenaline given for anaphylaxis may also be reduced in patients on long-term treatment with beta blockers. In diabetic patients beta blockers can reduce the response to insulin and oral hypoglycaemics through their effects on pancreatic beta receptors. Drugs that reduce absorption include aluminium salts and bile-acid binding resins such as colestyramine. Metabolism of some beta blockers can be increased by drugs such as barbiturates and rifampicin and decreased with drugs such as cimetidine, erythromycin, fluvoxamine, and hydralazine. Drugs that alter hepatic blood flow also affect metabolism of some beta blockers. For example, cimetidine and hydralazine decrease hepatic blood flow and this contributes to the decreased hepatic clearance seen with these drugs. Drugs that influence hepatic metabolism affect beta blockers that are extensively metabolised, such as labetalol, propranolol, and timolol, while beta blockers that are excreted largely unchanged, for example atenolol and nadolol, are unaffected.

Book : Martindale    Page : 1352,1550   Edition : 37.  

►  Contraindication : Bronchospasm, Asthma, Metabolic acidosis, Cardiogenic shock, Hypotension, Severe peripheral arterial disease, Sinus bradycardia, Second or third degree AV block, Uncontrolled heart failure, Hyperthyroidism, Hypoglycaemia, Prinzmetal angina, Severity of anaphylactoid reactions, Pregnancy, Phaeochromocytoma should not be given beta blockers without alpha-adrenoceptor blocking therapy as well
Ref :-   Book : Martindale    Page : 1351,1550   Edition : 37.  

  ►  Mechanism of Action :   Timolol is a non-cardioselective beta blocker. It is reported to lack intrinsic sympathomimetic and membrane-stabilising activity
Ref :-   Book : Martindale    Page : 1550   Edition : 37.  

►   Route of Elimination :   Renal
Ref :-   Book : Martindale    Page : 1550   Edition : 37.  
►    Plasma Half-life :   Min value :-   4 hours,    Max value :-   NA
Ref :-   Book : Martindale    Page : 1550   Edition : 37.  
►    Peak Plasma Concentration :   Min value :-   1 hour,    Max value :-   2 hours.  
Ref :-   Book : Martindale    Page : 1550   Edition : 37.