Timolol and Hydrochlorothiazide (Oral)

Timolol and hydrochlorothiazide is a combination medication that is prescribed for hypertension in adults to lower blood pressure, resulting in healthy blood flow to the heart, arteries, and kidneys.

Overview

The combination of timolol and hydrochlorothiazide treats adults for hypertension (high blood pressure). When the body has high blood pressure, the arteries and heart can become overworked. The arteries and heart may begin to have problems functioning if hypertension continues for a prolonged time period. If blood pressure remains high, the blood vessels of the heart, brain, and kidneys can be compromised which could result in kidney failure, heart failure, or a stroke. There is also a higher possibility of heart attack for patients with hypertension. When blood pressure is measured and monitored closely, these issues can be less likely to take place.

Timolol impacts the reaction to nerve impulses within particular body parts, such as the heart; it happens to be a beta-blocker. After the body is exposed to timolol, blood pressure begins to drop and the heart can begin beating at a normal and slower rate again. After the blood pressure has returned to a normal level, the total amount of oxygen and blood to the heart is elevated.

Hydrochlorothiazide is a water pill (diuretic). It lowers the total quantity of water within the body by maximizing the urine output, which directly aids in reducing blood pressure.

This medication is only available with a prescription from your doctor and is manufactured under the US brand name Timolide. The timolol and hydrochlorothiazide combination currently can only be obtained in tablet form.

Condition Treated

  • Hypertension (high blood pressure)

Type of Medicine

  • style="font-weight: 400;">Combination blood pressure medication
  • Timolol is a beta-blocker
  • Hydrochlorothiazide is a diuretic

Side Effects

Medications can occasionally cause undesired side effects along with the benefits that it provides. Not every one of the following side effects will likely take place, however, if they do take place they could require medical care.

Consult with your physician right away if any of these side effects take place.

Less Common Side Effects Medical Care Required

  • Wheezing
  • Weakness or tiredness (atypical)
  • Vision blurred
  • Sweating
  • Heartbeat irregularity or slowness
  • Faintness, lightheadedness, or dizziness when quickly standing or getting up from a sitting or lying state
  • Cough
  • Confusion
  • Chest tightness
  • Chest discomfort or pain
  • Breathing hoarseness (noisy breathing or shortness or breath)
  • Breathing difficulty

Rare Side Effects Medical Care Required

  • Weight gain
  • Urine cloudy or bloody
  • Swelling (lower leg, feet, fingers, or face)
  • Neck veins dilated
  • Lung rattling, bubbling, or clicking (slightly when heard with a stethoscope)
  • Lower back or side pain
  • Heartbeat (fast)
  • Fatigue (extreme)
  • Breathing irregularity

Side Effects (Incidence unknown) Medical Care Required

  • Joint pain (knee, ankle, or big toe)
  • Eye position fixed
  • Muscle cramps
  • Seizures
  • Joint swelling or stiffness
  • Speaking inability
  • Numbness (focused more on one side of the body or face)
  • Headache (sudden, severe)
  • Speech slurring
  • Blindness (temporary)
  • Arm/leg weakness (one side of body only, severe and sudden)

Occasionally, side effects also take place but these do not typically require medical care. The following lists of side effects can diminish on their own throughout the course of treatment as the body becomes more accustomed to taking the medication. Your physician can inform you of ways to decrease or prevent certain side effects.

If any of the subsequent side effects are prolonged or if they become irritating, feel free to consult your medical care professional. Your physician can also answer general questions regarding side effects of timolol and hydrochlorothiazide.

Less Common Side Effects Medical Care Not Required

  • Strength loss (or lack of)

Rare Side Effects Medical Care Not Required

  • Skin color darkening
  • Stomach (sour feelings or intense acidity)
  • Belching
  • Lack of interest in sexual intercourse (loss of drive, performance, or ability)
  • Diarrhea
  • Bowel movement (stool) difficulty
  • Moving difficulty
  • Focus difficulty (completing everyday tasks)
  • Heartburn
  • Erection inability (to keep or have)
  • Indigestion
  • Joint pain
  • Muscle stiffness, pains, or aches
  • Nausea
  • Nervousness
  • Rash
  • Drowsiness (unusual/sleepiness)
  • Sleeplessness
  • Stomach pain, upset, or discomfort
  • Joints swelling
  • Sleeping difficulties (inability)

Side Effects (Occurrence not determined) Medical Care Not Required

  • Earache

Certain patients may experience additional side effects. If you become aware of any additional side effects, be sure to consult your physician.

Contact your medical professional for advice regarding side effects. The FDA also accepts side effect reports. They can be reached at 1-800-FDA-1088.

Dosage

Prior to taking this medication, patients should be aware that treatment plans for high blood pressure can also be comprised of dietary changes in regards to the kinds of foods people eat, specifically in regards to foods with excess sodium. Your physician will be able to let you know which foods should be avoided. Consult with your physician prior to changing your diet.

Typically, patients with hypertension will not observe any symptoms or signs of the issue. Actually, many patients will feel normal. It is imperative that this medication is taken precisely as recommended by your doctor. Patients must meet regularly with their doctor even if they feel fine to ensure the progress of the patient can be monitored.

It is important for the patient to remember that this medication will not completely heal hypertension, however, it does help regulate it. Patients must remember to take timolol and hydrochlorothiazide, and they must take it according to physician instructions. In order to keep blood pressure low, this medication must be taken consistently. Patients may need to take hypertension medication for the remainder of their life to keep pressure off of the heart, kidneys, and arteries. Individuals who have hypertension and do not treat the problem may develop blood vessel disease, kidney disease, stroke, or heart failure.

When looking to stop taking this medication, patients must discuss with their physician how to do so in a way that will result in minimal side effects. Ask your physician how they recommend reducing the dosage, as it is typically not recommended to stop altogether. Certain medical conditions can be agitated and get worse when medication is abruptly stopped. This is unsafe and should be avoided.

Different patients will receive different dosage instructions from their doctors that are tailored specifically to their situation. Always follow the instructions by your physician or the instructions on the container. Typical doses of timolol and hydrochlorothiazide are listed below for informational purposes only. If you have been given a dose that differs from this information, do not adjust your doses unless given instructions by your physician to change your dose.

The potency of the medication determines how much of that medication you should take. In addition, how many doses taken per day, how much time allotted between each dose, and the total amount of time the medication is taken is all contingent on the medical issue the patient has for which they need timolol and hydrochlorothiazide.

Oral Dose (Tablet form)

For hypertension (high blood pressure):

Adults

Take one capsule twice daily. Alternatively, take two capsules once daily. Your physician can change the dosage whenever needed.

Children

Physician must establish dosage information.

Missed Dose

This medication must be taken immediately if a dose of it is missed. Alternatively, if it is closer to the scheduled next dose, the patient should return to the original dosing schedule and forgo the skipped dose. Never take double doses of timolol and hydrochlorothiazide.

Interactions

When considering whether or not one should take a medication, they should compare the risks the medication has against the benefits that it offers. The patient and physician must determine whether timolol and hydrochlorothiazide is right for them together. There are many considerations when deliberating if a drug is right for a certain individual.

Allergies

Inform your physician if any allergic or atypical reactions occur to timolol and hydrochlorothiazide or other medications. Also ensure your physician is aware of any additional kinds of allergies you may have, including animals, dyes, preservatives, and/or foods. When considering products that are non-prescription (over the counter), be sure to read the ingredients on the package cautiously.

Drug Interactions

Some medications should never be used simultaneously. In other circumstances, two various medications can be used at the same time despite the possibility that an interaction may take place. In these circumstances, the physician may be inclined to shift the dosage or take other precautions to protect the patient from unwanted interactions or side effects.

Be sure to let your doctor know if you are currently prescribed any of the following medications while taking timolol and hydrochlorothiazide. The list below is not entirely all-inclusive, but it includes medications that would have a significant interaction with timolol and hydrochlorothiazide.

It is not suggested to take timolol and hydrochlorothiazide with any of the following prescription drugs. Your physician may choose not to prescribe this medicine or they may adjust dosages for other medications you may be taking.

  • Dofetilide

It is not recommended for patients to take timolol and hydrochlorothiazide with any medication on the following list. Some circumstances, however, may require the combination. If the physician prescribes both medications, the dose may be adjusted or the frequency of the dose may be shifted for one or both of the medications.

  • Valdecoxib
  • Tolmetin
  • Tolfenamic Acid
  • Tiaprofenic Acid
  • Tenoxicam
  • Sulindac
  • Sotalol
  • Sodium Salicylate
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Rivastigmine
  • Proscillaridin
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Piroxicam
  • Piketoprofen
  • Phenylbutazone
  • Parecoxib
  • Oxyphenbutazone
  • Oxymetazoline
  • Oxaprozin
  • Ouabain
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Metildigoxin
  • Methotrexate
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lithium
  • Levomethadyl
  • Lacosamide
  • Ketorolac
  • Ketoprofen
  • Ketanserin
  • Indomethacin
  • Ibuprofen
  • Flurbiprofen
  • Flufenamic Acid
  • Floctafenine
  • Flecainide
  • Fingolimod
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Fenoldopam
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Droxicam
  • Droperidol
  • Dronedarone
  • Dipyrone
  • Digoxin
  • Digitoxin
  • Digitalis
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Deslanoside
  • Cyclophosphamide
  • Crizotinib
  • Clonixin
  • Choline Salicylate
  • Celecoxib
  • Bufexamac
  • Bromfenac
  • Aspirin
  • Arsenic Trioxide
  • Amtolmetin Guacil
  • Amphetamine
  • Acetyldigoxin
  • Acemetacin
  • Aceclofenac

It is not typically recommended to take the following medications with timolol and hydrochlorothiazide, however, it may end up being the best form of treatment for certain patients. Combining the following medications with timolol and hydrochlorothiazide can raise the possibility of side effects taking place. Your physician may adjust the frequency or dosage amount of one or both medications if prescribed at the same time.

  • Valdecoxib
  • Topiramate
  • Tolmetin
  • Tolfenamic Acid
  • Tiaprofenic Acid
  • Tenoxicam
  • Sulindac
  • St John's Wort
  • Sodium Salicylate
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Pranoprofen
  • Piroxicam
  • Piketoprofen
  • Phenylbutazone
  • Parecoxib
  • Oxyphenbutazone
  • Oxaprozin
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Licorice
  • Ketorolac
  • Ketoprofen
  • Indomethacin
  • Ibuprofen
  • Gossypol
  • Ginkgo
  • Flurbiprofen
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Droxicam
  • Dipyrone
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Clonixin
  • Choline Salicylate
  • Cholestyramine
  • Celecoxib
  • Carbamazepine
  • Bufexamac
  • Bromfenac
  • Bepridil
  • Aspirin
  • Amtolmetin Guacil
  • Acemetacin
  • Aceclofenac

Other Interactions

Some medications should not be taken while eating or near mealtimes as it increases the possibility of interactions taking place. The use of tobacco or alcohol with particular medications can also trigger certain interactions. Consult with your physician regarding how timolol and hydrochlorothiazide interacts with tobacco, alcohol, or food.

Other Medical Issues

Patients who have other medical issues must inform their doctor as the occurrence of other medical issues can impact the effectiveness of timolol and hydrochlorothiazide.

Inform your physician of other medical issues you may have, including:

  • Angina (intense chest pain) - can trigger chest pains if medication is quit too suddenly
  • Anuria (inability to urinate)
  • Asthma
  • Bradycardia (slowed heartbeat)
  • Chronic obstructive pulmonary disease (COPD) (severe)
  • Heart block
  • Heart failure (patients with this condition should not use)
  • Gout
  • Blood vessel disease (specifically in brain blood vessels)
  • High cholesterol
  • High uric acid in blood (hyperuricemia)
  • Hypochloremia (low chloride levels in blood)
  • Hypokalemia (low potassium blood levels)
  • Hypomagnesemia (low blood magnesium)
  • Hyponatremia (low sodium levels in blood)
  • Parathyroid disease
  • Stroke (history of)
  • Systemic lupus erythematosus:  Take caution; this medication can impact conditions and make them worse
  • Diabetes
  • Hyperthyroidism (highly active thyroid)
  • Hypoglycemia (blood sugar that is too low) - Take caution; this medication can mask symptoms of hypoglycemia, including a quick heartbeat
  • Kidney disease (severe)
  • Liver disease:  Take caution; side effects can be heightened due to slower extraction of this medication from the body
  • Lung disease (emphysema, bronchitis): Can cause breathing trouble for patients
  • Myasthenia gravis: Symptoms of the condition (including weakness of the muscles) can be intensified
  • Sympathectomy: Take caution; side effects of medication can be heightened

Warnings

Your physician must monitor your progress while taking timolol and hydrochlorothiazide regularly. They must check to see if the medication is working as it should, and they should be sure there are not any undesirable side effects.

Heart failure can occur for certain individuals when they are taking timolol and hydrochlorothiazide. Consult with your physician immediately if you are experiencing chest discomfort or pain, weight gain, shortness of breath, heartbeat irregularity, dilated neck veins, breathing irregularities, wheezing, extreme fatigue, or swelling of the lower legs, feet, fingers, or face.

This medication can cause levels of blood sugar to change. Timolol and hydrochlorothiazide can also mask symptoms of low blood sugar (like a fast pulse). Consult with your physician if any of these issues take place, or a variation in the results of your urine sugar or blood sugar tests take place.

Ensure any dentist who is treating you is aware that you are being prescribed timolol and hydrochlorothiazide. Patients who are having medical tests or surgery may need to stop taking this medication for a few days both before and afterward.

Specific Demographic Use

Pediatric

There have not yet been applicable studies in regards to how timolol and hydrochlorothiazide affects pediatric patients. It is not yet known whether or not it is both effective and safe for children to take timolol and hydrochlorothiazide.

Geriatric

There have not yet been applicable studies in regards to how timolol and hydrochlorothiazide affects geriatric patients. Physicians will likely need to adjust the doses for elderly patients as they typically have some health issues related to aging, including kidney, heart, or even liver problems.

Pregnancy

Either there has not yet been research in regards to how timolol and hydrochlorothiazide affects pregnant women, but similar animal research has shown a negative effect; or there has not yet been research in pregnant women completed, and there has not been any research in regards to animals and timolol and hydrochlorothiazide.

Breastfeeding

  • Hydrochlorothiazide: There has not yet been research conducted to find out if there is any risk to the infant when a woman is breastfeeding while taking this prescription. Women should compare the benefits they may receive from this drug with the possible risks prior to breastfeeding while taking timolol and hydrochlorothiazide.
  • Timolol: Research has shown that there is minimal risk to the baby when the mother takes timolol while breastfeeding.

Storage

  • Make sure this medication is kept in a closed container. It should not be kept near moisture, heat, or direct light. Keep timolol and hydrochlorothiazide at room temperature. Do not allow this medication to be near freezing temperatures.
  • Do not store this medication in a place where children can easily access it.
  • Dispose of medication once it is not required any longer.
  • Consult your doctor to find out how best to dispose of unused medication.

Summary

Timolol and hydrochlorothiazide is a combination medication that is prescribed for high blood pressure (hypertension) in adults to lower blood pressure, which can help improve blood movement to the heart, arteries, and kidneys. Timolol drops the blood pressure and hydrochlorothiazide is a diuretic, which lowers the amount of water within the body.

Resources
Last Reviewed:
January 31, 2018
Last Updated:
April 16, 2018
Content Source: