Arutimol

Arutimol (also known as timolol) is a medication commonly used to treat glaucoma and high intraocular pressure. Glaucoma is a serious eye disease characterized by increased intraocular pressure, which can lead to damage to the optic nerve and loss of vision.

Timolol belongs to a class of drugs known as beta blockers. It works by reducing the production of aqueous humor inside the eye, which in turn reduces intraocular pressure. This helps reduce the risk of optic nerve damage and preserve visual function in patients with glaucoma.

Arutimol is usually available in the form of eye drops. It is usually applied 1-2 times daily, depending on the doctor's instructions and the patient's specific needs. As with any medicine, before using Arutimol, it is important to consult your doctor to ensure it is suitable for your specific conditions and will not cause unwanted side effects.

Indications Arutimola

• Open angle glaucoma: This is the most common form of glaucoma, where the pressure inside the eye (intraocular pressure) is increased due to improper drainage of aqueous humor. Arutimol helps reduce this pressure, which can help prevent damage to the optic nerve and preserve vision.
• Narrow-angle glaucoma: This is a less common but more severe form of glaucoma, characterized by impaired drainage of aqueous humor from the eye due to a narrow angle between the iris and cornea. Timolol can be used to reduce intraocular pressure before performing procedures aimed at widening the angle and improving aqueous outflow.
• Focal or diffuse corneal atrophy: Arutimol may sometimes be recommended to treat this condition, which is characterized by a reduction in corneal thickness.
• Elevated intraocular pressure without glaucoma: In some cases, timolol may be used to lower intraocular pressure in patients with elevated intraocular pressure without evidence of glaucoma, to prevent the development of the disease.
• Open angle glaucoma: This is the most common form of glaucoma and is characterized by increased intraocular pressure due to limited or obstructed drainage of aqueous humor from the eye. Timolol helps lower intraocular pressure, which may help prevent further damage to the optic nerve and preserve vision.
• Certain forms of hypertensive eye disease: Timolol may sometimes be used to control intraocular pressure in patients with hypertensive eye disease.

Release form

Arutimol is usually available in the form of eye drops. Eye drops are usually packaged in special containers to ensure sterility and ease of use. Typically, the drops come in vials or plastic bottles with a dispensing device that makes it easy to accurately dispense the drops.

Pharmacodynamics

The pharmacodynamics of timolol, the main active component in Arutimol, is associated with its ability to block beta-adrenergic receptors. Timolol is a direct non-cardioselective beta-adrenergic receptor blocker.

In the eye, timolol reduces intraocular pressure by reducing the production of aqueous humor. This process is carried out by blocking beta-adrenergic receptors in the structures of the eye, such as the root-like epithelium of the ciliary body, which leads to a decrease in the formation of aqueous humor.

Blockade of beta-adrenergic receptors can also reduce the secretion of aqueous humor in the eye by reducing the formation of aqueous humor during the active production of aqueous humor in the ciliary body. This leads to a decrease in intraocular pressure, which is especially important for the treatment of glaucoma and the prevention of damage to the optic nerve.

Timolol is usually applied topically as eye drops and works directly in the eyes, minimizing systemic side effects. However, in rare cases, some of the drug may still be absorbed through the eye and have systemic effects, affecting other organs and tissues associated with beta-adrenergic receptors, which may cause side effects.

Pharmacokinetics

• Absorption: After topical application of timolol eye drops to the eyes, the drug can be absorbed through the conjunctiva and cornea of the eye. However, the absorption of timolol is systematically low, since it mainly remains in the eyes and practically does not penetrate through the ocular barriers into the blood.
• Distribution: Timolol, which is absorbed into the bloodstream, usually has a high volume of distribution, which means it can spread quickly throughout the body.
• Metabolism: Timolol is metabolized mainly in the liver to form inactive metabolites. The main metabolic pathway is oxidation with the participation of the enzyme CYP2D6.
• Excretion: Timolol metabolites and some unchanged drug are excreted from the body primarily through urine. Elimination of timolol from the body occurs mainly in the form of metabolites.

Dosing and administration

• Dosage: The usually recommended dose for adults is one drop of 0.25% or 0.5% timolol solution into the conjunctival sac of the eye, once or twice a day. However, the exact dosage can be adjusted by the doctor depending on the severity of the disease and the individual characteristics of the patient.
• Method of use: Before using the drops, you must wash your hands well to avoid eye infection. Then you need to tilt your head back or lie down, lift your eyes up and gently pull your lower eyelid down to create a pocket for the drops. After this, you should carefully introduce one drop of the solution into the conjunctival sac of the eye, and cover your eyes a little after introducing the drop to prevent leakage.
• Consistency of use: For best results, drops should be used daily at the indicated doses and at the indicated times, even if there are no symptoms. This will help maintain stable intraocular pressure and prevent progression of the disease.

Use Arutimola during pregnancy

The use of Arutimol during pregnancy should be carried out under the supervision of a physician and only in the case of clear medical indications, when the benefits of its use outweigh the potential risks for the mother and fetus.

To date, data on the safety of timolol during pregnancy are limited, and its effects on the fetus are not fully understood. There have not been enough controlled clinical studies in pregnant women to assess the risk to the fetus.

Timolol, like many other drugs, can cross the placental barrier and affect fetal development. Therefore, its use should be done with caution and only after careful discussion with your doctor.

Contraindications

• Hypersensitivity or allergic reaction: People with a known hypersensitivity or allergic reaction to timolol or other components of the drug should avoid its use.
• Bronchial asthma or chronic obstructive pulmonary disease (COPD): Timolol, as a beta blocker, may cause bronchoconstriction and poor respiratory function in patients with asthma or COPD. Therefore, it is contraindicated in such patients without strict medical supervision.
• Cardiovascular disease: Timolol may worsen symptoms of heart failure, worsen cardiac arrhythmias, or cause hypotension in patients with cardiovascular disease. Therefore, it is generally not recommended for people with serious cardiovascular disease.
• Sinus bradycardia syndrome: Timolol may cause bradycardia (slow heart rate) in patients with sinus bradycardia syndrome.
• Hypersensitivity to CYP2D6 enzyme inhibitors: Since timolol is metabolized by the CYP2D6 enzyme, patients with hypersensitivity to CYP2D6 enzyme inhibitors should avoid its use or use with caution.
• Children: The use of timolol in children may be limited due to insufficient safety and effectiveness data in this group of patients.

Side effects Arutimola

• Application site reactions: This may include irritation, burning, redness or itching of the eyes.
• Changes in taste: Some patients may experience a change in taste perception after using timolol eye drops.
• Decreased heart rate (bradycardia): Timolol may decrease the heart rate, which may cause bradycardia in some patients.
• Low blood pressure: Timolol may cause low blood pressure in some people.
• Dry Eyes: Some patients may experience dry, uncomfortable, or gritty eyes.
• Headache: Patients may experience headaches after taking timolol.
• Drowsiness: Some people may feel drowsy or tired after using timolol.
• Digestive problems: This may include diarrhea or nausea.
• Serious side effects such as allergic reactions, bronchospasm (narrowing of the bronchi), worsening asthma, angioedema (Steward-Adams edema), arrhythmias and other cardiovascular problems are rare.

Overdose

• Increased side effects: Such as severe drowsiness, dizziness, blurred vision, severe bradycardia (slow heart rate), headache, nausea, vomiting, etc.
• Serious cardiovascular complications: Including cardiac arrhythmia, cardiac arrest and low blood pressure.
• Respiratory complications: Deterioration of respiratory function, bronchospasm (narrowing of the bronchi), obstructive airway diseases.

Interactions with other drugs

• Medicines that lower blood pressure (antihypertensive drugs): Using timolol in combination with other antihypertensive drugs, such as beta blockers, diuretics or ACE inhibitors, may lead to an additional decrease in blood pressure.
• Medicines for the treatment of cardiovascular diseases: Timolol may increase the effect of antiarrhythmic drugs such as amineoxidine and lead to serious heart rhythm disturbances.
• Central depressants and hypnotics: Timolol may enhance the depressant effects of central depressants and hypnotics, which may lead to increased drowsiness and respiratory depression.
• Antidepressants and antipsychotics: In combination with timolol, antidepressants and antipsychotics can enhance its hypotensive effect and increase the risk of orthostatic hypotension.
• Sympathomimetics: The use of sympathomimetics in combination with timolol may lead to a decrease in its antihypertensive effect.
• Monoamine oxidase inhibitors (MAOIs): Use of timolol in combination with MAOIs may result in enhanced antihypertensive effects and an increased risk of serious side effects.