Timolol

(Date: March 2020. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Timolol is prescribed in eye drop form to treat glaucoma.

What are the benefits of using timolol in pregnancy?

Use of timolol eye drops can help to prevent sight problems (including blindness) in people with glaucoma.

Are there any risks of using timolol during pregnancy?

Timolol in eyedrop form enters the woman’s bloodstream in small amounts. Only a handful of pregnant women specifically using timolol have been studied, but overall there is no concern that its use causes problems.

Timolol belongs to a family of medicines called beta blockers. Studies have not shown that beta blockers cause birth defects, stillbirth or preterm birth. Women taking beta blockers in tablet form may be more likely to have a small baby. However a small baby can be due to underlying health conditions that beta blockers are commonly used to treat, like high blood pressure. It is therefore difficult to know if a beta blocker has also contributed to the baby being small. 

Occasionally, beta blockers taken in tablet form in late pregnancy can affect the baby for a short while after birth (for example, causing low blood sugar). The baby may require an extra day or two in hospital following birth to look out for any problems. If these occur, they can be easily treated and usually settle quickly.

While it is unlikely that the small amount of timolol reaching the baby from eye drops would have an effect, it is still sensible to try and minimise the amount entering the bloodstream. To do this, apply the drops and close the eyes for one to two minutes, or press the fingertips to the inner corners of the eyes for at least one minute.

Are there any alternatives to using timolol?

Possibly. Other medicines can be used to treat glaucoma. You should let your midwife, GP obstetrician or eye specialist know that you are taking timolol so that it can be reviewed as soon as possible. If you have any questions about a medicine that you are offered in pregnancy you should discuss them with your doctor or midwife.

What if I prefer not to take medicines during pregnancy?

It very important that glaucoma continues to be appropriately treated during pregnancy as stopping treatment can cause irreversible sight damage. Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Will my baby need extra monitoring?

You will be offered a detailed scan at around 20 weeks of pregnancy as part of your routine antenatal care. No further monitoring will usually be necessary following use of timolol eye drops.

Are there any risks to my baby if the father uses timolol?

We would not expect any increased risk to your baby if the father uses timolol.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system offers all pregnant women, and women who have been pregnant in the past, the opportunity to create their own digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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