Hypersensitivity to timolol maleate & benzalkonium Cl. Heart failure, 2nd or 3rd degree cardiac arrhythmias w/ AV blockade, bradycardia, cardiogenic shock, bronchial asthma, chronic airway obstruction w/ a predisposition to or history of bronchial spasm.
Administer 5 min apart if >1 topical ophth drug is being used. May cause punctate &/or toxic ulcerative keratopathy. Closely monitor frequent or prolonged use in dry eye patients, or in conditions where the cornea is compromised. Advise patient not to wear contact lenses if the eye is red. Not to be used to treat contact lenses-related irritation. Benzalkonium Cl may be absorbed by contact lenses. Patients who wear contact lenses & whose eyes are not red should wait at least 10 min after instilling the drug prior to insertion of their contact lenses. Inform patients of possible eye color changes prior to treatment; observe eye color changes; aphakia or pseudophakia w/ tear in the posterior lens cap or anterior lens space; risk factors for cystoid macular edema; severe or recurrent asthma. Not to be used w/in 5 min after using prep containing thyomersal. Potential for heterochromia in patients receiving a single treatment. May mask the signs & symptoms of hypoglycemia. Pregnancy. Not to be used in women who are breastfeeding. Childn & adolescents.
Potentiated effects when given to patients already receiving an oral β-adrenergic blocking agent, & the use of ≥2 topical β-adrenergic blocking agent. Paradoxical elevations in IOP following the concomitant ophth administration of 2 prostaglandin analogs. May cause mydriasis when timolol is given w/ epinephrine. Potential for additive effects resulting in hypotension &/or marked bradycardia w/ oral Ca channel blockers, guanethidine or β-blockers, antiarrhythmics, digitalis glycosides or parasympathomimetics. Potentiated hypertensive reaction to sudden w/drawal of clonidine. May increase the hypoglycemic effect of antidiabetic agents.
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