Short description Antiglaucoma. Blocks beta-adrenergic receptors and reduces the secretion of aqueous humor, reducing intraocular pressure. Children over 1 year old are instilled into the conjunctival sac 1 cap - 0.25% solution 2 r per day, adults 1 drop 0.5% solution 2 p per day. With the normalization of intraocular pressure, the maintenance dose is 1 cap of 0.25% solution 1 r per day. pharmachologic effect Antiglaucoma drug, non-selective blocker of ?1- and ?2-adrenergic receptors. It has no internal sympathomimetic and membrane stabilizing activity. When applied topically in the form of eye drops, it reduces both normal and increased intraocular pressure by reducing the formation of intraocular fluid. Does not affect pupil size and accommodation. The effect of the drug is manifested 20 minutes after instillation into the conjunctival sac. The maximum decrease in intraocular pressure occurs after 1-2 hours and lasts for 24 hours. Indications - increased intraocular pressure (ocular hypertension); - open-angle glaucoma; - secondary glaucoma (including aphakic); - angle-closure glaucoma (in combination with miotics as an additional means to lower IOP); - congenital glaucoma (with insufficient effectiveness of other therapeutic measures). Method of administration and dosage At the beginning of therapy, 1 drop of 0.25% or 0.5% of Arutimol eye drops is instilled into the conjunctival sac 2 times / day. When the intraocular pressure is normalized, the maintenance dose is 1 drop of 0.25% eye drops 1 time / day. Treatment with Arutimol is usually carried out for a long time. A break or dose change is carried out only as directed by the attending physician. Side effects Local reactions On the part of the organ of vision: irritation, hyperemia of the conjunctiva, skin of the eyelids, burning and itching in the eyes, lacrimation, photophobia, edema of the corneal epithelium, punctate superficial keratopathy, corneal hypesthesia, diplopia, ptosis. When carrying out fistulizing antiglaucoma operations, retinal detachment may develop in the postoperative period. Systemic reactions From the side of the cardiovascular system: heart failure, bradycardia, bradyarrhythmia, decreased blood pressure, collapse, AV block, cardiac arrest, heart palpitations, cerebral hypoperfusion, transient cerebrovascular accidents. From the respiratory system: rhinitis, shortness of breath, bronchospasm, pulmonary insufficiency. From the side of the central nervous system and peripheral nervous system: headache, dizziness, weakness, depression, paresthesia. From the digestive system: nausea, diarrhea. Allergic reactions: urticaria. On the part of the skin: eczema, alopecia. Others: sexual dysfunction. Contraindications - bronchial asthma or other severe chronic obstructive respiratory diseases; - sinus bradycardia; - cardiogenic shock; - AV block II or III degree; - heart failure; - dystrophic processes in the cornea; - severe atrophic rhinitis; - pregnancy; - lactation period; - children up to age 18; - allergic reactions to the components of the drug. The drug should be used with caution in patients with pulmonary insufficiency, severe cerebrovascular insufficiency, chronic heart failure, diabetes mellitus, hypoglycemia, thyrotoxicosis, myasthenia gravis, Raynaud's syndrome, pheochromocytoma, as well as simultaneously with other beta-blockers. In diabetic patients taking insulin or oral hypoglycemic agents, timolol can lead to hypoglycemia. Overdose Symptoms: the development of systemic effects characteristic of beta-blockers is possible: dizziness, headache, arrhythmia, bradycardia, decreased blood pressure, heart failure, bronchospasm, nausea, vomiting. Treatment: immediately flush eyes with water or 0.9% sodium chloride solution; if necessary, symptomatic therapy is carried out. special instructions The patient should be warned about the need to regularly visit a doctor to measure intraocular pressure and examination of the cornea, as well as in the event of adverse reactions. If the patient wears soft contact lenses, then he should not use the drug Arutimol, because the preservative can be adsorbed in soft contact lenses and have an adverse effect on the tissues of the eye. Immediately after instillation, a short-term decrease in vision clarity is possible. You should take out hard contact lenses before instilling the drug and install them again after 15 minutes. When transferring patients to treatment with Arutimol, it may be necessary to correct refraction after the effects caused by previously used miotics. In the event of an upcoming surgical intervention with the use of general anesthesia, it is necessary to cancel the drug within 48 hours. Effects on the ability to drive vehicles and control mechanisms During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities, tr those with increased concentration of attention, quickness of psychomotor reactions and good vision (within 30 minutes after instillation in the eye), because the drug can help lower blood pressure, feeling tired and dizzy. This is even more the case when the drug interacts with alcohol. Interaction with other drugs Concurrent use of Arutimol with epinephrine-containing eye drops may cause pupil dilation. The specific effect of the drug - a decrease in intraocular pressure is enhanced with the simultaneous use of eye drops containing epinephrine and pilocarpine; two beta-blockers should not be instilled into the eyes. A decrease in blood pressure and a slowdown in heart rate can be potentiated when Arutimol is used together with calcium channel blockers, reserpine and beta-blockers. Concomitant use with insulin or oral hypoglycemic agents can lead to hypoglycemia. Timolol enhances the effect of muscle relaxants, therefore, it is necessary to discontinue the drug 48 hours before the planned surgical intervention using general anesthesia. These data may also apply to drugs that were used shortly before. Storage conditions List B. The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25 C. Shelf life is 3 years. After opening the bottle, the shelf life of the eye drops is 6 weeks.