BETIMOL: Proven. Effective. Comfortable.

As monotherapy, BETIMOL provides proven efficacy for consistent IOP control4 As adjunctive therapy, BETIMOL delivers significant reduction in IOP levels when added to Xalatan (P<0.001)3 Less post-installation blurred vision than timolol gel solution2, 7 Patients reported less stinging and burning compared to Istalol 2 Prescribe Prescribe BETIMOL: Comfortable and effective IOP control for your patients
To see full Prescribing and Safety Information for Betimol please click here.

IMPORTANT SAFETY INFORMATION The most commonly reported ocular side effect was stinging and burning. BETIMOL is contraindicated in patients with overt heart failure, cardiogenic shock, sinus bradycardia, second- or third-degree atrioventricular block, bronchial asthma or history of bronchial asthma, severe chronic obstructive pulmonary disease, or hypersensitivity to any component of this product.
REFERENCES: 1. Mundorf TK.Therapeutic options for glaucoma:beta blockers remain a mainstay therapy for the medical management of glaucoma. Ophthalmol Manage. April 2008; 15:49-52. 2. Sonty S, Mundorf TK, Stewart JA, Stewart WC. Short-term tolerability of once-daily timolol hemihydrate 0.5%, timolol maleate in sorbate 0.5%, and generic timolol maleate gel-forming solution 0.5% in glaucoma and/or ocular hypertension: a prospective, randomized, doublemasked, active-controlled, three-period crossover pilot study. Clinical Therapeutics. 2009;31:2063-2071 3. Stewart WC, Day DG, Sharpe ED, Dubiner HB, Holmes KT, Stewart JA. Efficacy and safety of timolol solution once daily vs timolol gel added to latanoprost. Am J Ophthalmol. 1999;128:692-696. 4. Stewart WC, Leland TM, Cate EA, Stewart JA. Efficacy and safety of timolol solution once daily versus timolol gel in treating elevated intraocular pressure. J Glaucoma. 1998;7:402-407. 5. DuBiner HB, Hill R, Kaufman H, et al. Timolol hemihydrate vs timolol maleate to treat ocular hypertension and open-angle glaucoma. Am J Ophthalmol.1996;121:522-528. 6. Beckers HJ, Schouton JS, Webers CA, van de Valk R, Hendrikse F. Side effects of commonly used glaucoma medication: comparison of tolerability, chance of discontinuation, and patient satisfaction. Graefes Arch Clin Exp Oph 2008: 246:1485-1490. 7. Stewart WC, Leland TM, Cate EA, Stewart JA. Efficacy and safety of timolol solution once daily vs. timolol gel in treating elevated IOP. J Glaucoma 1998;7:402-447. 8. Stewart WC, Stewart JA, Holmes KT, Leech JN. Differences in ocular surface irritation between timolol hemihydrate and timolol maleate. Am J Ophthalmol. 2000;130:712-716.

BETIMOL (timolol) Ophthalmic Solution

Betimol

Patient Information: Details with Side Effects

SHARE THIS ARTICLE:

FACEBOOKTWITTEREMAILPRINT AA

DRUG DESCRIPTION
Betimol (timolol ophthalmic solution), 0.25% and 0.5%, is a non-selective beta-adrenergic antagonist for ophthalmic use. The chemical name of the active ingredient is (S)-1-[(1,1dimethylethyl)amino]-3-[[4-(4-morpholinyl)-1,2,5-thiadiazol-3-yl]oxy]-2-propanol. Timolol hemihydrate is the levo isomer. Specific rotation is []25 405nm=-16 (C=10% as the hemihydrate form in 1N HCI). The molecular formula of timolol is Formula C13H24N4O3S and its structural formula is:

Timolol (as the hemihydrate) is a white, odorless, crystalline powder which is slightly soluble in water and freely soluble in ethanol. Timolol hemihy-drate is stable at room temperature. Betimol (timolol ophthalmic solution) is a clear, colorless, isotonic, sterile, microbiologically preserved phosphate buffered aqueous solution. It is supplied in two dosage strengths, 0.25% and 0.5%. Each mL of Betimol 0.25% contains 2.56 mg of timolol hemihydrate equivalent to 2.5 mg timolol. Each mL of Betimol 0.5% contains 5.12 mg of timolol hemihydrate equivalent to 5.0 mg timolol. Inactive ingredients: monosodium and disodium phosphate dihydrate to adjust pH (6.5 - 7.5) and water for injection, benzalkonium chloride 0.01% added as preservative. The osmolality of Betimol (timolol ophthalmic solution) is 260 to 320 mOsmol/kg.

http://www.rxlist.com/betimol-drug.htm

Am J Ophthalmol. 1996 May;121(5):522-8.

Timolol hemihydrate vs timolol maleate to treat ocular hypertension and open-angle glaucoma.
DuBiner HB1, Hill R, Kaufman H, Keates EU, Zimmerman TJ, Mandell AI, Mundorf TK, Bahr RL, Schwartz LW, Towey AW, Hurvitz LM, Starita RJ, Sassani JW,Ropo A, Gunn R, Stewart WC.
Author information

Clayton Eye Center, Morrow, Georgia, USA.

Abstract
PURPOSE: We compared the therapeutic efficacy and safety of timolol hemihydrate to timolol maleate in patients with ocular hypertension and chronic open-angle glaucoma. METHODS: We conducted this three-month study as a multicentered, masked, parallel group comparison. Both the 0.25% and 0.5% concentrations were evaluated against similar concentrations of timolol maleate. Dosing was twice daily. An open-label, nine-month study followed the masked portion of the protocol, in which all patients received either 0.25% or 0.5% timolol hemihydrate. A total of 371 patients were included in both the 0.25% and 0.5% studies. RESULTS: We found statistically similar intraocular pressures with both the 0.25% (18.3 and 18.6 mm Hg for the hemihydrate and maleate groups, respectively) and 0.5% (19.9 and 19.5 mm Hg for the hemihydrate and maleate groups, respectively) concentrations of timolol hemihydrate and timolol maleate after three months of masked treatment. Likewise, peak intraocular effect at two hours after taking the medication was statistically similar between medicines at both concentrations. Likewise, both ocular and systemic safety were similar between the maleate and hemihydrate preparations at both concentrations. In the nine-month open-label protocol, therapeutic efficacy (19.9 and 19.1 mm Hg for the 0.25% and 0.5% concentrations, respectively) and safety of timolol hemihydrate were similar to effect and safety of the three-month protocol. CONCLUSIONS: This study suggests that timolol hemihydrate had an ocular hypotensive efficacy and safety profile statistically equivalent to that of timolol maleate for up to three months of therapy. Timolol hemihydrate showed efficacy and safety similar to that observed within the first three months, for up to one year of therapy. Am J Ophthalmol. 2000 Dec;130(6):712-6.

Differences in ocular surface irritation between timolol hemihydrate and timolol maleate.
Stewart WC1, Stewart JA, Holmes KT, Leech JN.
Author information

Abstract
PURPOSE: We evaluated the anterior segment surface reaction findings between timolol hemihydrate and timolol maleate. The only known difference between these preparations is the maleate salt. METHODS: After a baseline examination, we randomized 28 healthy subjects (26 completed) to timolol hemihydrate or timolol maleate given in both eyes twice daily, in a double masked fashion, for 1 week. Subjects then were evaluated at the morning trough (hour 0 examination), dosed, and re-evaluated in 1 hour (hour 1 examination). Subjects were left untreated for 1 week and then switched to the opposite medication for the second study period.

RESULTS: Corneal staining (graded 0 to 4) for timolol maleate was worse between baseline (0.9) and hour 0 (1.4; P =.009) and baseline and hour 1 (1.4; P =.011). Also, mean punctate corneal staining for timolol maleate was increased from baseline (22.6) to hour 0 (31.7; P =.033) and showed borderline significance to hour 1 (33.4; P =.058), and for timolol hemihydrate there was a borderline significant elevation from baseline (24.2) to hour 1 (29.8; P =.060). When treatment groups were compared, there was a greater change in corneal staining with timolol maleate than timolol hemihydrate from baseline to hour 0 (P =.020) and greater staining with timolol maleate than timolol hemihydrate at hour 0 (P =.032). Nasal conjunctiva showed increased mean staining with timolol maleate from baseline (23.6, P =.035) to hour 0 (29.5, P =.035) and to hour 1 (31.9 P =.038) but not with timolol hemihydrate. There were increased symptoms of ocular dryness from baseline to hour 0 with timolol maleate (P =.012) but not with timolol hemihydrate. CONCLUSIONS: The study suggests that timolol maleate potentially may have more of an irritant effect than timolol hemihydrate on the corneal and nasal conjunctival epithelium.

Compound Summary for: CID 62933

Timolol
Also known as: Timolol hemihydrate, 2-Propanol, 1-((1,1-dimethylethyl)amino)-3-((4-(4-morpholinyl)-1,2,5thiadiazol-3-yl)oxy)-, hemihydrate, (S)Molecular Formula: C26H50N8O7S2 Molecular Weight: 650.8546 InChIKey: TWBNMYSKRDRHATRCWTXCDDSA-N

A beta-adrenergic antagonist similar in action to PROPRANOLOL. The levo-isomer is the more active. Timolol has been proposed as an antihypertensive, antiarrhythmic, antiangina, and antiglaucoma agent. It is also used in the treatment of MIGRAINE DISORDERS and tremor. From: MeSH
Show subcontent titlesTable of Contents
Identification

2D Structu

Related Records Use and Manufacturing Pharmacology Biomedical Effects and Toxicity Literature Classification Chemical and Physical Properties

re 3D Confor mer

Expand all sub-sections

Chemical and Physical Properties

Helptop of page Synonyms: (CID 62933) Total: 16 Display: Timolol hemihydrate 2-Propanol, 1-((1,1-dimethylethyl)amino)-3-((4-(4-morpholinyl)-1,2,5-thiadiazol-3-yl)oxy)-, hemihydrate, (S)91524-16-2 UNII-817W3C6175 timolol.0.5H2O SureCN345440 AC1L1Y2J AC1Q59QN Timolol [USAN:BAN:INN] CHEBI:60787 2C13H24N4O3S.H2O LS-178152 D00378 (2S)-1-(tert-butylamino)-3-[(4-morpholin-4-yl-1,2,5-thiadiazol-3-yl)oxy]propan-2-ol hydrate (2S)-1-(tert-butylamino)-3-[(4-morpholin-4-yl-1,2,5-thiadiazol-3-yl)oxy]propan-2-ol--water (2/1) (S)-1-(tert-Butylamino)-3-((4-morpholino-1,2,5-thiadiazol-3-yl)oxy)-2-propanol hemihydrate
Filtered, sorted by w eight

Computed Properties Molecular Weight Molecular Formula H-Bond Donor H-Bond Acceptor Rotatable Bond Count Exact Mass MonoIsotopic Mass Topological Polar Surface Area Heavy Atom Count Formal Charge Complexity Isotope Atom Count Defined Atom Stereocenter Count Undefined Atom Stereocenter Count Defined Bond Stereocenter Count Undefined Bond Stereocenter Count Covalently-Bonded Unit Count 650.8546 [g/mol] C26H50N8O7S2 5 17 14 650.324388 650.324388 217 43 0 310 0 2 0 0 0 3

http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=62933#itabs-3d