Section 02 · Monograph
Timolol
Reviewed Nov 2026FDA label
Blocadren / genericBeta-blocker
- Forms
- Tab: 5, 10, 20mg
- Dose
- Migraine prevention: 10mg BID (max 30mg/day)
- MOA
- Nonselective β1/β2 blockade
Indications
- Hypertension, myocardial infarction (reduce cardiovascular mortality), and migraine prophylaxisFDA-labeled
Mechanism of Action
- Nonselective beta-adrenergic blocker; migraine prevention mechanism involves reduced central sympathetic and cortical excitability
Full Dosing
Adult / usual
- Migraine prophylaxis: 10mg twice daily; may increase to a maximum of 30mg/day in divided doses; discontinue if no benefit after about 6-8 weeks at maximum
- Do not stop abruptly; taper over 1-2 weeks
Contraindications
- Bronchial asthma or severe COPD
- Sinus bradycardia, greater than first-degree AV block, cardiogenic shock, overt heart failure
- Hypersensitivity
Drug Interactions
- Verapamil/diltiazem: bradycardia and AV block
- Insulin and oral hypoglycemics: masked hypoglycemia
- CYP2D6 inhibitors (fluoxetine, paroxetine) raise levels
Adverse Effects
- Fatigue, bradycardia, dizziness
- Bronchospasm
- Cold extremities, depression, sleep disturbance
Monitoring Parameters
- Heart rate and blood pressure
- Respiratory symptoms
- Mood and fatigue
Pregnancy & Lactation
- Fetal bradycardia and growth restriction possible; use if benefit justifies risk
- Present in milk