Timolol and hydrochlorothiazide (Oral route)

Pronunciation:

hye-droe-klor-oh-THYE-a-zide, TIM-oh-lol MAL-ee-ate

Brand Names:

Timolide

Classifications:

Pharmacologic—

Diuretic

Chemical—

Thiazide

Uses of This Medicine:

Timolol and hydrochlorothiazide combination is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled .

Timolol is a beta-blocker. It works by affecting the response to some nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart .

Hydrochlorothiazide is a diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps lower the blood pressure .

This medicine is available only with your doctor's prescription .

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of timolol and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established .

Older adults—

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of timolol and hydrochlorothiazide combination in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment of dosage in patients receiving timolol and hydrochlorothiazide combination .

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Dofetilide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abiraterone Acetate
Acarbose
Aceclofenac
Acemetacin
Acetyldigoxin
Albiglutide
Albuterol
Alogliptin
Amphetamine
Amtolmetin Guacil
Arsenic Trioxide
Aspirin
Benzphetamine
Bromfenac
Bromocriptine
Bufexamac
Buprenorphine
Bupropion
Canagliflozin
Celecoxib
Ceritinib
Chlorpropamide
Choline Salicylate
Clonixin
Cobicistat
Codeine
Crizotinib
Dapagliflozin
Darunavir
Deslanoside
Desmopressin
Desvenlafaxine
Dexibuprofen
Dexketoprofen
Dextroamphetamine
Diclofenac
Diflunisal
Digitalis
Digitoxin
Digoxin
Diltiazem
Dipyrone
Dronedarone
Droperidol
Droxicam
Dulaglutide
Duloxetine
Empagliflozin
Escitalopram
Etodolac
Etofenamate
Etoricoxib
Exenatide
Fedratinib
Felbinac
Fenoldopam
Fenoprofen
Fepradinol
Feprazone
Fingolimod
Flecainide
Floctafenine
Flufenamic Acid
Fluoxetine
Flurbiprofen
Formoterol
Glimepiride
Glipizide
Glyburide
Ibuprofen
Indacaterol
Indomethacin
Insulin
Insulin Aspart, Recombinant
Insulin Bovine
Insulin Degludec
Insulin Detemir
Insulin Glulisine
Iobenguane I 131
Iohexol
Ketanserin
Ketoprofen
Ketorolac
Lacosamide
Levalbuterol
Levomethadyl
Linagliptin
Liraglutide
Lisdexamfetamine
Lithium
Lixisenatide
Lornoxicam
Loxoprofen
Lumiracoxib
Meclofenamate
Mefenamic Acid
Meloxicam
Methamphetamine
Methotrexate
Metildigoxin
Miglitol
Morniflumate
Nabumetone
Naproxen
Nateglinide
Nepafenac
Niflumic Acid
Nimesulide
Nimesulide Beta Cyclodextrin
Olodaterol
Ouabain
Oxaprozin
Oxymetazoline
Oxyphenbutazone
Parecoxib
Paroxetine
Phenylbutazone
Piketoprofen
Pioglitazone
Piroxicam
Ponesimod
Porfimer
Pramlintide
Proglumetacin
Propyphenazone
Proquazone
Proscillaridin
Repaglinide
Rivastigmine
Rofecoxib
Rosiglitazone
Salicylic Acid
Salmeterol
Salsalate
Saxagliptin
Sitagliptin
Sodium Salicylate
Sotalol
Sulindac
Tapentadol
Tenoxicam
Terbutaline
Tiaprofenic Acid
Tolazamide
Tolbutamide
Tolfenamic Acid
Tolmetin
Topiramate
Valdecoxib
Venlafaxine
Verapamil
Vilanterol
Vildagliptin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Angina (severe chest pain)—May provoke chest pain if stopped too quickly .

Anuria (not able to form urine) or
Asthma or
Bradycardia (slow heartbeat) or
Chronic obstructive pulmonary disease (COPD), severe or
Heart block or
Heart failure—Should not use in patients with these conditions .

Blood vessel disease (especially blood vessels in the brain) or
Gout or
High cholesterol or
Hyperuricemia (high uric acid in the blood) or
Hypochloremia (low chloride in the blood) or
Hypokalemia (low potassium in the blood) or
Hypomagnesemia (low magnesium in the blood) or
Hyponatremia (low sodium in the blood) or
Parathyroid disease or
Stroke, history of or
Systemic lupus erythematosus—Use with caution. This medicine may make these conditions worse .

Diabetes or
Hyperthyroidism (overactive thyroid) or
Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat .

Kidney disease, severe or
Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body .

Lung disease (e.g. bronchitis, emphysema)—May cause difficulty with breathing in patients with this condition .

Myasthenia gravis—May worsen symptoms of this condition, such as muscle weakness .

Sympathectomy—Use with caution. The effects of this medicine may be increased .

Proper Use of This Medicine:

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet .

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well .

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease .

Do not interrupt or stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous .

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For high blood pressure:
  - Adults—One tablet two times a day, or two tablets once a day. Your doctor may adjust your dose if needed.
  - Children—Use and dose must be determined by your doctor .

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects .

This medicine may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing .

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests .

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests .

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common: Blurred vision; chest pain or discomfort; confusion; cough; difficult or labored breathing; dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly; lightheadedness, dizziness, or fainting; noisy breathing; shortness of breath; slow or irregular heartbeat; sweating; tightness in chest; unusual tiredness or weakness; wheezing

Rare: Bloody or cloudy urine; dilated neck veins; extreme fatigue; fast heartbeat; irregular breathing; pain in lower back or side; small clicking, bubbling, or rattling sounds in the lung when listening with a stethoscope; swelling of face, fingers, feet, or lower legs; weight gain

Incidence not determined: Ankle, knee, or great toe joint pain; fixed position of eye; headache; inability to speak; joint stiffness or swelling; muscle cramps; seizures; severe numbness, especially on one side of the face or body; severe or sudden headache; slurred speech; temporary blindness; weakness in arm and/or leg on one side of the body, sudden and severe

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common: Lack or loss of strength

Rare: Acid or sour stomach; belching; darkening of skin color; decreased interest in sexual intercourse; diarrhea; difficulty having a bowel movement (stool); difficulty in moving; having a hard time focusing or doing everyday activities; heartburn; inability to have or keep an erection; indigestion; joint pain; loss in sexual ability, desire, drive, or performance; muscle aching, pains, or stiffness; nausea; nervousness; rash; sleepiness or unusual drowsiness; sleeplessness; stomach discomfort, upset, or pain; swollen joints; trouble sleeping; unable to sleep

Incidence not determined: Earache

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Last Updated: 11/16/2023

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