Arutimol drops 0.5%, 5 ml

• Increased intraocular pressure (ocular hypertension);

• open-angle glaucoma;

• aphakic glaucoma and other types of secondary glaucoma;

• as an additional agent for reducing intraocular pressure in angle-closure glaucoma (in combination with miotics);

• congenital glaucoma (with insufficient effectiveness of other therapeutic measures).

At the beginning of therapy, 1 drop of 0.25% or 0.5% of Arutimol eye drops is instilled into the conjunctival sac 2 times / day.

When the intraocular pressure is normalized, the maintenance dose is 1 drop of 0.25% eye drops 1 time / day. Treatment with Arutimol is usually carried out for a long time. A break or dose change is carried out only as directed by the attending physician.

Eye drops in the form of a clear solution, colorless or with a yellowish tinge, odorless.

1 ml

timolol

Excipients: benzalkonium chloride solution (50%) corresponds to benzalkonium chloride, povidone K30, sodium dihydrogen phosphate dihydrate, sodium monohydrogen phosphate dodecahydrate, disodium edetate dihydrate, water d / i.

• Bronchial asthma or other severe chronic obstructive airways disease;

• sinus bradycardia;

• cardiogenic shock;

• AV block II or III degree;

• heart failure;

• dystrophic processes in the cornea;

• severe atrophic rhinitis;

• pregnancy;

• lactation period;

• children under 18 years of age;

• allergic reactions to the components of the drug.

• With caution: in patients with pulmonary insufficiency, severe cerebrovascular insufficiency, chronic heart failure, diabetes mellitus, hypoglycemia, thyrotoxicosis, myasthenia gravis, Raynaud's syndrome, pheochromocytoma, as well as simultaneously with other beta-blockers. In diabetic patients taking insulin or oral hypoglycemic agents, timolol can lead to hypoglycemia.

pharmachologic effect

Timolol is a non-selective blocker of ? 1 and ? 2 adrenergic receptors. It has no internal sympathomimetic and membrane stabilizing activity. When applied topically in the form of eye drops, it reduces both normal and increased intraocular pressure by reducing the formation of intraocular fluid. Does not affect pupil size and accommodation. The effect of the drug is manifested 20 minutes after instillation into the conjunctival sac. The maximum decrease in intraocular pressure occurs after 1-2 hours and lasts for 24 hours.

Pharmacokinetics

When applied topically, timolol quickly penetrates the cornea. After instillation of eye drops, Cmax of timolol in the aqueous humor of the anterior chamber of the eye is achieved after 1-2 hours. 80% of timolol, used in the form of eye drops, enters the systemic circulation by absorption through the vessels of the conjunctiva, nasal mucosa and lacrimal tract. Excretion of timolol metabolites is carried out mainly by the kidneys. In newborns and young children, the Cmax of timolol in blood plasma exceeds that in the blood plasma of adults.

Side effect

Local reactions

From the side of the organ of vision: irritation and hyperemia of the conjunctiva, skin of the eyelids, burning and itching in the eyes, lacrimation, photophobia, edema of the corneal epithelium, punctate superficial keratopathy, corneal hypesthesia, diplopia, ptosis. When carrying out fistulizing antiglaucoma operations, retinal detachment may develop in the postoperative period.

Systemic reactions

From the side of the cardiovascular system: heart failure, bradycardia, bradyarrhythmia, decreased blood pressure, collapse, AV blockade, cardiac arrest, palpitations, cerebral hypoperfusion, transient cerebrovascular accident. From the respiratory system: rhinitis, shortness of breath, bronchospasm, pulmonary insufficiency. From the nervous system: headache, dizziness, weakness, depression, paresthesia. From the digestive system: nausea, diarrhea. Allergic reactions: urticaria, eczema. On the part of the skin: alopecia. Others: sexual dysfunction. If side effects occur, the patient should stop using the drug and consult a doctor (ophthalmologist) as soon as possible.

Application during pregnancy and lactation

The use of the drug during pregnancy and lactation (breastfeeding) is contraindicated.

Application in children

The use of the drug under the age of 18 is contraindicated.

special instructions

The patient should be warned about the need to regularly visit a doctor to measure intraocular pressure and examination of the cornea, as well as in the event of adverse reactions. If the patient uses soft contact lenses, then he should not use the drug Arutimol, because the preservative can be absorbed by soft contact lenses and have an adverse effect on the tissues of the eye. Immediately after instillation, a short-term decrease in vision clarity is possible. You should take out hard contact lenses before instilling the drug and install them again 15 minutes after instillation. When transferring patients to treatment with Arutimol, it may be necessary to correct refraction after the effects caused by previously used miotics. In the event of an upcoming surgical intervention using general anesthesia,it is necessary to cancel the drug within 48 hours.

Influence on the ability to drive vehicles and use mechanisms

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention, speed of psychomotor reactions and good vision (within 30 minutes after instillation into the eye), because the drug can help lower blood pressure, the appearance of a feeling of fatigue and dizziness. This is even more the case when the drug interacts with ethanol.

Overdose

Symptoms: the development of systemic effects characteristic of beta-blockers is possible: dizziness, headache, arrhythmia, bradycardia, decreased blood pressure, heart failure, bronchospasm, nausea, vomiting. Treatment: immediately flush eyes with water or 0.9% sodium chloride solution; symptomatic therapy.

Drug interactions

—овместное применение тимолола с глазными капл¤ми, содержащими эпинефрин, может вызвать расширение зрачка. —пецифическое действие препарата - снижение внутриглазного давлени¤ усиливаетс¤ при одновременном применении глазных капель, содержащих эпинефрин и пилокарпин; закапывать в глаза два бета-адреноблокатора не следует. —нижение ј? и замедление сердечного ритма могут потенцироватьс¤ при совместном применении препарата с блокаторами кальциевых каналов, резерпином и бета-адреноблокаторами. ќдновременное применение с инсулином или пероральными гипогликемическими средствами может привести к гипогликемии. “имолол усиливает действие миорелаксантов, поэтому необходима отмена препарата за 48 ч до планируемого хирургического вмешательства с применением общей анестезии. Ёти данные могут относитьс¤ и к лекарственным препаратам, которые были применены незадолго до этого.