Common questions about timolol tablets

Timolol tablets are a type of medicine called a beta blocker.

Like other beta blockers, they work by changing the way your body responds to some nerve impulses, including in the heart. They slow down your heart rate and make it easier for your heart to pump blood around your body.

It's not fully understood how timolol prevents migraines.

Timolol tablets usually start to work after about 2 hours. But it usually takes days or weeks to see the full effect.

You may not feel any different when you take timolol tablets for high blood pressure, but this does not mean they're not working. It's important to keep taking them.

For migraines, it can take several weeks for timolol tablets to start making a real difference, so keep taking them.

Timolol tablets are generally safe to take for a long time.

If you're taking them for a heart condition or to prevent migraines, they work best when you take them long term.

You'll need to have your blood pressure checked regularly if you're taking timolol tablets for a long time for migraines.

Talk to your doctor if you want to stop taking timolol tablets. If you're bothered by side effects, your doctor may be able to prescribe a different medicine instead.

Stopping timolol tablets suddenly may make your health condition worse.

If you stop taking your tablets, it'll take about a day for the medicine to be completely out of your body.

There are lots of other medicines which are used to lower your blood pressure.

They work in different ways from beta blockers and include:

• ACE inhibitors – for example, ramipril and lisinopril
• angiotensin receptor blockers – for example, losartan
• calcium channel blockers – for example, amlodipine
• diuretics (medicines that make you pee more) – for example, indapamide

The medicine your doctor prescribes first depends on your age and ethnicity. Beta blockers are not usually the first choice of medicine for high blood pressure (hypertension).

Sometimes you may have to try other blood pressure-lowering tablets if you get side effects.

Many people need to take a combination of different blood pressure-lowering tablets.

There are lots of other medicines which are used to prevent angina attacks.

They include:

• calcium channel blockers – for example, diltiazem and amlodipine
• nitrates – for example isosorbide mononitrate
• medicines such as ranolazine, nicorandil and ivabradine

These medicines work in different ways so it's difficult to say whether one is better than the others.

If timolol tablets do not work for you, or you cannot take them or other beta blockers because of side effects, you may be able to switch to another medicine.

Your doctor will be able to advise you on which medicine is best for you. Some people need to take a combination of medicines to control their angina symptoms.

Other beta blockers which are used to prevent migraines are atenolol, metoprolol, nadolol and propranolol.

There are also other medicines that can be used to prevent migraines. If timolol tablets do not work for you, or you cannot take them or other beta blockers because of side effects, you may be able to switch to another medicine. This

Other medicines that are used to prevent migraines include topiramate and amitriptyline. These medicines work in different ways so it is difficult to say whether one is better than the others. Ask your doctor or pharmacist which medicine is best for you.

Timolol tablets will not stop your contraception working.

But some types of combined hormonal methods of contraception, such as the combined pill and combined contraceptive patch, are not usually recommended if you have high blood pressure. Talk to your doctor if you're taking or using a hormonal contraceptive.

If timolol tablets make you sick (vomit) or have severe diarrhoea for more than 24 hours, however, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Find out more:

• what to do if you're sick or have diarrhoea when taking the combined pill
• what to do if you're sick or have diarrhoea when taking the progestogen-only pill

Timolol tablets may make you feel tired or dizzy. This can happen particularly when you first start taking them, or after taking a bigger dose.

If this happens to you, do not drive a car, ride a bike, or operate machinery until you feel better.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking timolol tablets. GOV.UK has more information on the law on drugs and driving.

Drinking alcohol can increase the blood pressure-lowering effect of timolol tablets, which can make you feel dizzy or light-headed.

During the first few days of taking timolol tablets, or after an increase in your dose, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find timolol tablets make you feel dizzy it's best to stop drinking alcohol.

You can eat and drink normally while taking timolol tablets.

Eating a healthy, balanced diet can help if you have high blood pressure or another heart condition.

If you have heart problems, you can boost the health of your heart by making some key lifestyle changes. These will also help if you have high blood pressure.

• Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke.
• Cut down on alcohol – drinking alcohol while you're taking timolol tablets can make you feel dizzy or light-headed. Drinking too much alcohol also raises blood pressure over time and makes heart failure worse.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic, walking every day will help.
• Eat well – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins. It's a good idea to follow these tips for a lower salt diet too. Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Manage stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life, such as relaxing and resting when possible.

There are steps you can take to help prevent migraines. These include working out what triggers an attack so you can avoid triggers. Keeping a migraine diary can help you do this.