Drug interactions
Neostigmine + Timolol
Severity: Moderate
Neostigmine and Timolol: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Neostigmine increases cholinergic tone, which slows heart rate, and timolol also reduces heart rate. Together they can cause bradycardia or AV block, and beta-blockers may also provoke bronchospasm in susceptible patients.
What this interaction means in plain words
Neostigmine and Timolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Neostigmine belongs to Central Nervous System; Timolol belongs to Cardiovascular.
Why it happens
Additive bradycardia from acetylcholinesterase inhibition (vagal stimulation) and beta-adrenergic blockade.
What to do
Monitor heart rate and ECG when neostigmine is given to patients on timolol, for example at reversal of neuromuscular block. Have an anticholinergic such as glycopyrrolate or atropine available.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Neostigmine and Timolol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Timolol
- Acebutolol + Timolol Major
- Albuterol + Timolol Major
- Aldesleukin + Timolol Major
- Amifostine + Timolol Major
- Amiodarone + Timolol Major
- Arformoterol + Timolol Major
Other interactions of Neostigmine
Frequently asked questions
Can I take Neostigmine with Timolol?
MediHelp rates the interaction as moderate. Neostigmine and Timolol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Neostigmine increases cholinergic tone, which slows heart rate, and timolol also reduces heart rate. Together they can cause bradycardia or AV block, and beta-blockers may also provoke bronchospasm in susceptible patients.
How serious is the interaction between Neostigmine and Timolol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate and ECG when neostigmine is given to patients on timolol, for example at reversal of neuromuscular block. Have an anticholinergic such as glycopyrrolate or atropine available.
What other medicines interact with Timolol?
MediHelp also lists interactions of Timolol with, for example, Acebutolol, Albuterol, Aldesleukin. The full list is on the Timolol page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
