Last update: Jan. 3, 2021

Timolol Maleate

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

It is a non-cardioselective beta blocker
It is used in the treatment of glaucoma and ocular hypertension, hypertension, angina and myocardial infarction, in the prophylactic treatment of migraine and as a topical treatment for infantile hemangiomas.
Administration in eye drops or oral once or twice a day.

After oral or ophthalmic administration it is excreted in breast milk in clinically insignificant amounts (Madadi 2008, Lustgarten 1983, Fidler 1983) and no problems have been observed in infants whose mothers have taken it (Johnson 2001, Lustgarten 1983).

Absorption should be minimized by closing the eye after instillation, applying pressure for 1 to 5 minutes with your finger on the tear duct at the inner corner of the eye and administering the dose immediately after nursing (Blumen 2020, Belkin 2020, Johnson 2001).

The manufacturer considers ophthalmic use compatible with breastfeeding (Novartis 2020).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

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Other names

Timolol Maleate in other languages or writings:

Groups

Timolol Maleate belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Timolol Maleate in its composition:

List of 30 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 - 75 %
Molecular weight 433 daltons
Protein Binding 10 %
VD 1,8 - 3,5 l/Kg
pKa 9,2 -
Tmax 0,4 - 3 hours
T1/2 4 (3 - 5) hours
M/P ratio 0,8 -
Theoretical Dose 0,0024 mg/Kg/d
Relative Dose 0,9 (0,01 - 1,1) %

References

  1. Blumen-Ohana E, Sellem E. Grossesse & glaucome : recommandations SFO—SFG. [Pregnancy & glaucoma: SFO-SFG recommendations]. J Fr Ophtalmol. 2020 Jan;43(1):63-66. Abstract
  2. Belkin A, Chen T, DeOliveria AR, Johnson SM, Ramulu PY, Buys YM; American Glaucoma Society and the Canadian Glaucoma Society.. A Practical Guide to the Pregnant and Breastfeeding Patient with Glaucoma. Ophthalmol Glaucoma. 2020 Mar - Apr;3(2):79-89. Abstract
  3. Novartis. Timolol (oftálmico) Ficha técnica. 2020 Full text (in our servers)
  4. AA Pharma. Timolol maleate tablets. Drug Summary. 2018 Full text (in our servers)
  5. Méndez-Hernández C. Uso de fármacos antiglaucomatosos durante el embarazo y lactancia. [Use of glaucoma medications during pregnancy and breastfeeding]. Arch Soc Esp Oftalmol. 2012 Dec;87(12):389-91. Abstract
  6. Tamargo Menéndez J, Delpón Mosquera E. Farmacología de los bloqueantes de los receptores β-adrenérgicos. Curso βeta 2011 de Actualización en Betabloqueantes. 2011 Full text (in our servers)
  7. Madadi P, Koren G, Freeman DJ, Oertel R, Campbell RJ, Trope GE. Timolol concentrations in breast milk of a woman treated for glaucoma: calculation of neonatal exposure. J Glaucoma. 2008 Jun-Jul;17(4):329-31. Abstract
  8. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  9. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  10. Johnson SM, Martinez M, Freedman S. Management of glaucoma in pregnancy and lactation. Surv Ophthalmol. 2001 Mar-Apr;45(5):449-54. Abstract
  11. Riant P, Urien S, Albengres E, Duche JC, Tillement JP. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986 Abstract
  12. Lustgarten JS, Podos SM. Topical timolol and the nursing mother. Arch Ophthalmol. 1983 Sep;101(9):1381-2. Abstract
  13. Fidler J, Smith V, De Swiet M. Excretion of oxprenolol and timolol in breast milk. Br J Obstet Gynaecol. 1983 Oct;90(10):961-5. Abstract

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