Drug interactions
Physostigmine + Timolol
Severity: Moderate
Physostigmine 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
Physostigmine increases cholinergic tone and can cause bradycardia, and timolol also slows heart rate and AV conduction. Together they may produce marked bradycardia or heart block, and physostigmine can also provoke bronchospasm.
What this interaction means in plain words
Physostigmine 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.
Why it happens
Additive bradycardic effects from cholinesterase inhibition and beta-adrenergic blockade.
What to do
Monitor heart rate and ECG during physostigmine administration in patients on timolol, and have atropine available. Avoid the combination in patients with conduction block or asthma.
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?
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Other interactions of Timolol
- Acebutolol + Timolol Major
- Albuterol + Timolol Major
- Aldesleukin + Timolol Major
- Amifostine + Timolol Major
- Amiodarone + Timolol Major
- Arformoterol + Timolol Major
Frequently asked questions
Can I take Physostigmine with Timolol?
MediHelp rates the interaction as moderate. Physostigmine 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. Physostigmine increases cholinergic tone and can cause bradycardia, and timolol also slows heart rate and AV conduction. Together they may produce marked bradycardia or heart block, and physostigmine can also provoke bronchospasm.
How serious is the interaction between Physostigmine 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 during physostigmine administration in patients on timolol, and have atropine available. Avoid the combination in patients with conduction block or asthma.
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.
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