Tonemide
Generic Name
Timolol Maleate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tonemide 20 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Tonemide is an ophthalmic solution containing Timolol Maleate, used to reduce elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma.
Uses & Indications
Dosage
Adults
Initially one drop of 0.5% solution in the affected eye(s) twice daily. Reduce to once daily if satisfactory response is maintained.
Elderly
Same as adults, but caution is advised due to potential for systemic side effects.
Renal_impairment
No specific dosage adjustment is required for ophthalmic use, but systemic absorption should be considered in severe renal impairment.
How to Take
Instill one drop into the conjunctival sac of the affected eye(s). Gently close the eye for 1-2 minutes to allow absorption and reduce systemic absorption.
Mechanism of Action
Timolol Maleate is a non-selective beta-adrenergic receptor blocking agent. It reduces elevated and normal intraocular pressure by decreasing the production of aqueous humor.
Pharmacokinetics
Onset
Approximately 20 minutes
Excretion
Excreted predominantly by the kidneys, both as unchanged drug and metabolites.
Half life
2-4 hours (systemic after ophthalmic use)
Absorption
Systemic absorption occurs following ocular administration. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Primarily metabolized in the liver via CYP2D6.
Side Effects
Contraindications
- Bronchial asthma or a history of bronchial asthma, severe chronic obstructive pulmonary disease (COPD).
- Sinus bradycardia, second or third-degree atrioventricular block, overt cardiac failure, cardiogenic shock.
Drug Interactions
Clonidine
Potentiation of rebound hypertension upon clonidine withdrawal.
Quinidine
Inhibition of timolol metabolism, leading to increased plasma concentrations.
Oral Beta-blockers
Increased risk of systemic beta-blockade.
Calcium Channel Blockers
Increased risk of hypotension and/or bradycardia.
Catecholamine-depleting drugs (e.g., reserpine)
Possible additive effects leading to hypotension and/or marked bradycardia.
Storage
Store at room temperature (below 30°C). Protect from light and moisture. Do not refrigerate or freeze.
Overdose
Symptoms of overdose may include bradycardia, hypotension, bronchospasm, and acute cardiac failure. Treatment is symptomatic and supportive, including general supportive measures and monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Timolol is excreted in breast milk; caution is advised when administered to a nursing mother.
Side Effects
Contraindications
- Bronchial asthma or a history of bronchial asthma, severe chronic obstructive pulmonary disease (COPD).
- Sinus bradycardia, second or third-degree atrioventricular block, overt cardiac failure, cardiogenic shock.
Drug Interactions
Clonidine
Potentiation of rebound hypertension upon clonidine withdrawal.
Quinidine
Inhibition of timolol metabolism, leading to increased plasma concentrations.
Oral Beta-blockers
Increased risk of systemic beta-blockade.
Calcium Channel Blockers
Increased risk of hypotension and/or bradycardia.
Catecholamine-depleting drugs (e.g., reserpine)
Possible additive effects leading to hypotension and/or marked bradycardia.
Storage
Store at room temperature (below 30°C). Protect from light and moisture. Do not refrigerate or freeze.
Overdose
Symptoms of overdose may include bradycardia, hypotension, bronchospasm, and acute cardiac failure. Treatment is symptomatic and supportive, including general supportive measures and monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Timolol is excreted in breast milk; caution is advised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 2-3 years for unopened bottles. Discard any remaining solution 28 days after first opening the bottle.
Availability
Available in pharmacies nationwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available, patent expired
WHO Essential Medicine
YesClinical Trials
Timolol Maleate has undergone extensive clinical trials demonstrating its efficacy and safety in reducing intraocular pressure in various forms of glaucoma and ocular hypertension.
Lab Monitoring
- Regular monitoring of intraocular pressure is necessary. Systemic monitoring (heart rate, blood pressure) may be appropriate in patients with pre-existing cardiovascular or respiratory conditions due to potential systemic absorption.
- No specific laboratory tests are routinely required for ophthalmic use.
Doctor Notes
- Counsel patients on proper administration technique to minimize systemic absorption and local side effects.
- Monitor patients with a history of cardiac or respiratory conditions carefully for systemic beta-blocker effects.
- Advise patients not to abruptly discontinue treatment without consulting a physician.
Patient Guidelines
- Follow the doctor's instructions strictly regarding dosage and administration.
- Do not touch the dropper tip to any surface to avoid contamination.
- Remove contact lenses before administration and wait at least 15 minutes before reinserting.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not double the dose.
Driving Precautions
Timolol Maleate eye drops may cause temporary blurred vision or dizziness, especially after administration. Patients should be cautious when driving or operating machinery.
Lifestyle Advice
- Inform your doctor about all medications, including over-the-counter drugs and herbal supplements.
- Avoid activities requiring mental alertness if blurred vision or dizziness occurs.
- Attend regular eye check-ups as advised by your ophthalmologist.
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Global Brand Names
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