(i) ROUTE OF ADMINISTRATION

Oral

DOSAGE AND ADMINISTRATION

The usual starting dose is 1 drop of 0.25% Health 2000 Timolol maleate 0.5% eye drops in the affected eye(s) twice a day. If the clinical response is not adequate, the dosage may be changed to 1 drop of 0.5% solution in the affected eye(s) twice a day.
Health 2000 Timolol maleate 0.5% eye drops may require a few weeks to stabilize, evaluation should include a determination of intraocular pressure after approximately 4 weeks of treatment with Health 2000 Timolol maleate 0.5% eye drops. If the intraocular pressure is maintained at satisfactory levels, the dosage schedule may be changed to 1 drop once a day in the affected eye(s).

(ii) THERAPEUTIC / DIAGNOSTIC CLAIMS

Treatment of elevated intraocular pressure in patients with ocular hypertension, chronic open angle glaucoma, secondary glaucoma, aphakic glaucoma.


(iii) DESCRIPTION OF DOSAGE FORM

Timolol maleate is a nonselective beta-adrenergic receptor blocking agent that does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anaesthetic (membrane stabilising) activity.Health 2000 Timolol maleate 0.5% eye drops reduce elevated and normal intraocular pressure whether or not associated with glaucoma.

(iv) CONTRAINDICATIONS

Health 2000 Timolol maleate 0.5% eye drops Eye Drops are contraindicated in the following conditions: bronchial asthma; a history of bronchial asthma; severe chronic obstructive pulmonary disease; sinus bradycardia; second or third degree atrioventricular block; overt cardiac failure; cardiogenic shock; hypersensitivity to any component of the product.

WARNING AND PRECAUTIONS
Product may have sulfites, which may cause allergic-type reactions In susceptible patients; may exacerbate or precipitate heart block, asthma, chronic obstructive pulmonary disease, and mental changes (especially in elderly patients)

USE IN PREGNANCY C - Safety for use during pregnancy has not been established. Timolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

NURSING MOTHERS
Timolol maleate has been detected in human milk following oral and ophthalamic drug administration.Because of the potential for serious adverse reactions from Timolol in nursing infants , a decision should be made whether to discontinue nursing or to discontinue the drug , taking into account the importance of the drug to the mother.

PADEIATRIC USE
Safety and effectiveness in pediatric patients have not been established.

INTERACTION
It is not recommended to use two ophthalmic beta-blockers at the same time. Special caution is warranted in people taking antidiabetic drugs, as timolol may mask symptoms of low blood sugar. Consult your doctor for specific advice if you are taking any other prescription or over-the-counter medication.

FOOD INTERACTIONS
No known food interactions

DISEASE INTERACTIONS
Caution is advised when taking timolol. Consult your doctor if you have any of the following: asthma, emphysema or another lung disease, low blood sugar, heart disease, blood vessel disease, or an overactive thyroid. In diabetes, timolol can affect blood sugar levels or mask symptoms of low blood sugar.

(v) SIDE EFFECTS

Serious Side Effects-Palpitations; trouble breathing; dizziness and weakness caused by low blood pressure. Call your doctor right away.
Common Side Effects-Stinging or irritation of the eye when drops are applied; tearing
Less Common Side Effects-Decreased night vision; eyebrow pain; crusted eyelashes; dry eyes; increased sensitivity of eyes to light; redness, stinging, burning, watering, or other irritation of the eye; droopy eyelid; eye inflammation

(vi) TOXIC EFFECTS

TERATOGENICITY
No epidemiological studies of congenital abnormalities among infants born to women treated with timolol during pregnancy have been reported.

MUTAGENICITY
Timolol has not caused birth defects in animals. Human studies have not been completed.

CARCINOGENICITY
In a lifetime study in mice, there were statistically significant increases in the incidence of benign and malignant pulmonary tumors, benign uterine polyps and mammary adenocarcinoma in female mice at 500 mg/kg/day, (approximately 400 times** the maximum recommended daily human dose), but not at 5 or 50 mg/kg/day. In a subsequent study in female mice, in which post-mortem examinations were limited to uterus and lungs, a statistically significant increase in the incidence of pulmonary tumors was again observed at 500 mg/kg/day.

Timolol maleate 0.5% eye drops