Apimol 0.5% Eye Drop 5 ml

Timolol maleate 0.5% Eye drops solutionWhat Timolol maleate is used for:

• Timolol maleate is used for patients with glaucoma (increased pressure in the eye that can lead to loss of vision) to reduce eye pressure.

Do not use Timolol maleate:

• If you are allergic to Timolol maleate or other beta-blockers or any of the ingredients in this medicine.
• Tell your doctor about the allergy and what signs you had.
• If you currently have or have previously had respiratory problems such as asthma or severe chronic obstructive bronchitis (severe lung problem that may cause difficulty in breathing and wheeziness).
• If you have heart problems including abnormal heart rhythms, slow heartbeat, heart failure (inability of your heart muscle to pump blood properly) or cardiogenic shock (a serious heart problem due to very low blood pressure, which may lead to symptoms like white skin, dizziness, fast heart rate, lightheadedness, restlessness, sweating and loss of consciousness).

Warnings and Precautions:

• Stop using this medicine and talk to your doctor if you develop allergic reactions such as shortness of breath, skin rash, swelling of the face or neck, decreased blood pressure and dizziness.
• Stop using this medicine and talk to your doctor immediately if you develop eye allergic reactions such as eye redness, itchiness, rash or swelling.
• Talk to your doctor before starting Timolol if you currently have or have previously had heart failure, abnormal heartbeats, coronary heart disease (heart problem that may cause choking, chest pain or tightness and difficulty breathing) or low blood pressure.
• Talk to your doctor before starting Timolol if you currently have or have previously had breathing problems, chronic obstructive pulmonary disease or asthma.
• Talk to your doctor before starting Timolol if you currently have or have previously had poor blood circulation disease (e.g. Raynaud's disease).
• Talk to your doctor before starting Timolol if you currently have or have previously had diabetes as this medicine may hide signs and symptoms of low blood sugar.
• Talk to your doctor before starting Timolol if you currently have or have previously had overactive thyroid gland as this medicine may hide signs and symptoms.
• Talk to your doctor before starting Timolol if you wear soft contact lenses.
• Talk to your doctor before starting Timolol if you have a planned surgical procedure as this medicine may alter the effects of some medications used during anesthesia.
• Seek your physician advice immediately if you experience eye infection, eye irritation or any new eye problems (e.g. swelling of the eyelids or eye redness).
• Talk to your doctor if you have an eye injury.
• Talk to your doctor if your eye condition is getting worse or if you experience new symptoms.
• This product contains a preservative known as benzalkonium chloride which can affect the color your soft contact lenses and may also cause eye irritation especially if you have cornea problems or eye dryness,
• therefore make sure that you remove your soft contact lens before you apply the eye drop and wait at least 15 minutes before you put your contact lens back.
• Talk to your doctor if you feel abnormal eye sensation (pain or stinging) in your eye after applying the eye drop.
• This product contains phosphates which may very rarely cause calcium accumulation during treatment leading to cloudy patches on the cornea (clear layer at the front of the eye) if you have severe damage to the cornea.

Possible side effects:

• Possible side effects include allergic reactions (like rash and itching), low blood glucose levels, depression, memory loss,
• difficulty sleeping (insomnia), nightmares, hallucination, stroke or reduced blood supply to the brain, fainting,
• headache, dizziness, increases in signs and symptoms of myasthenia gravis (muscle problem),
• abnormal sensations like tingling or pins and needles, ringing sound in the ears, chest pain, slow heart rate or palpitations,
• edema (fluid accumulation), heart problems like heart rhythm or heart rate changes or irregularities,
• congestive heart failure (heart problem that may cause difficulty breathing and swelling of the feet and legs) or heart attack,
• low blood pressure, fainting, raynaud's phenomenon (rare disorder of blood vessels that causes them to constrict in the fingers and toes), cold hands and feet, reduced blood supply to the legs causing limping,
• constriction of the airways in the lungs (especially in patients with respiratory problems), difficulty breathing, cough and wheezing,
• taste disturbances, diarrhea, nausea, indigestion, dry mouth, vomiting, abdominal pain, sexual dysfunction,
• decreased sex drive, Peyronie’s disease (a disorder that causes abnormal curve, pain or hardening of the tissue of your penis),
• skin rash with white silvery appearance, hair loss, worsening of psoriasis, itching, muscle tiredness or weakness,
• muscle pain that is not due to exercise, systemic lupus erythematosus (a disorder that causes your immune system to attack your own body tissues, leading to widespread inflammation and damage in the affected organs like skin, joints, brain, kidneys, lungs, and blood vessels).
• Eye side effects include eye irritation (e.g. itching, burning, stinging, redness, tearing), inflammation of the eyelid or cornea, blurred vision, decreased corneal sensitivity, detachment of the layer under the retina which may lead to visual abnormalities, dry eyes, drooping of the upper eyelid, corneal erosion (damage to the front layer of the eyeball), double vision, sensitivity to light, eye discharge and eye pain.

Other medicines and Timolol maleate:

• Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medications including prescription medicines, over the counter medicines (non-prescription medicines), vitamins, supplements and eye drops. If you are using more than one eye drop solution, make sure to administer each at least five minutes apart to avoid precipitation of the eye drop.
• If you are taking medicines used to treat high blood pressure.
• If you are taking heart medicines.
• If you are taking medicines used to treat diabetes.
• If you are taking a calcium antagonist (e.g. verapamil, nifedipine, diltiazem; used to treat angina, high blood pressure, abnormal heartbeat or Raynaud’s disease).
• If you are taking digoxin (used to treat heart failure or abnormal heartbeat).
• If you are taking catecholamine-depleting agents (e.g. rauwolfia alkaloids or reserpine; used for high blood pressure).
• If you are taking pressor amines (e.g. adrenaline; used to treat severe allergic reactions).
• If you are taking quinidine (used to treat heart problems and some types of malaria).
• If you are taking fluoxetine or paroxetine (antidepressants).
• If you are taking clonidine (used to treat high blood pressure).
• If you are taking other beta-blockers taken orally or as eye drops.

How to apply Timolol maleate:
Adults

• The usual recommended dose is one drop in the affected eye twice daily (one drop in the morning and one drop at night).
• Use as prescribed by your doctor.

Children and Adolescents:

• This medicine should generally be used with caution in young patients. Use as prescribed by your doctor.
• Before you or your child starts to use this medicine, your doctor or your child's doctor should do a thorough medical examination to determine if you can take this medicine or not.
• You or your child should be closely and carefully monitored for one to two hours after applying the first dose until surgery is carried out.

Newborns, infants and younger children:

• This medicine should be used with extreme caution in newborns, infants and younger children.
• Stop giving this medicine to your child or baby and talk to the doctor immediately if wheezing, coughing, abnormal breathing or abnormal pauses in breathing happen.
• Your doctor may recommend a portable apnea (difficulty breathing) monitor.
• Your child or baby should be closely and carefully monitored for one to two hours after applying the first dose until surgery is carried out.

How To Use:

• Use this medicine exactly as prescribed by your doctor. Ask your doctor if you are not sure.
• Your doctor will determine the number of drops that you need to apply, when to apply them and for how long you should use the medicine.
• Wash your hands. When opening the bottle for the first time, tear off the plastic safety strip.
• Uncap the bottle. Tilt your head slightly backward and pull down your lower eyelid making a pocket.
• Keep the bottle above your eye with the tip facing down.
• Look upward and away from the bottle then press on the container to release a drop.
• Let go of the lower eyelid and close your eyes for 2 minutes or as long as possible in babies and children (e.g. 3 – 5 minutes).
• If an eye drop is missed, repeat the steps. Wipe off any excess drops from your cheeks.
• Repeat the same steps after opening the bottle for the other eye if needed.
• Space your eye drops by at least 5 minutes.
• Use at the same time every day.
• Do not stop using your medication without consulting your doctor.
• Do not use the eye drop if the tamper-proof seal on the bottle neck is broken when you are using it for the first time.
• Avoid contact of the eye drop tip with your eye or other surfaces to prevent bacterial contamination which may lead to eye infection and serious eye damage.
• Contact your doctor if you suspect that your eye drop is contaminated.

How to store Timolol maleate:

• Discard the bottle 28 days after its opening even if it is not empty.
• Keep out of the reach of children and pets.
• Do not store above 25°C.
• Do not use beyond the expiry date mentioned on the box.
• Keep away from light.
• Do not dispose in the wastewater or household waste.
• Ask your pharmacist how to properly dispose medicines that you no longer use.