Timolol eye drops , what time of day ?

[bunnings]

Hi l take Azarga eye drops twice a day for glaucoma , once in morning around 9am or 10 am and once at night , around 10pm or 11pm.
l saw a youtube video where an eye specialist said that  the evening drop its better to take early such as 5pm or 6pm because it can be bad for your eyes if you take it late at night, l think he said something to do with it restricting blood flow to the eye while sleeping . Do you think l would be better off taking my eye drops earlier at 5Pm or 6pm  rather then later at night such as 10pm or 11pm.

[John C Hagan III, MD, FACS, FAAO]

Timolol does not work at night, probably due to the prone position for sleep. So best to take first thing in AM and with/shortly after your evening meal.  Some drops work great at night like latanaprost and are given at bedtime.

[bunnings]

Thanks, yes l read it does'nt work as well at night , l was wondering why they tell us to take it twice a day and in the evening at all , if for example l take it at 6pm after a meal and go to bed at 10pm then l only get 4 hours of effectiveness, why not just take it once a day in the morning?

[John C Hagan III, MD, FACS, FAAO]

It doesn't mean it doesn't work at all, just means less effective at night. Besides the medicine you take has two drugs in it and the other is effective during sleep. To maintain an ideal blood level the droprs should be used about 12 hours apart.   So take first thing in morning and around your evening meal.   If people try mid evening they often forget but no one forgets to feed themselves dinner.

[bunnings]

Thankyou , one thing l read that concerned me was that timolol may not be good for you eyes if taken in the evening, could that be true? l was thinking of suggesting to my specialist instead of taking azarga  twice a day l take it once a day in the morning and take Azopt (Brinzolamide) eye drops in the evening, that way l still get the Brinzolamide but without the timolol . l was thinking that might me better for my eyes . Do you think that might be a good idea or it wont be as effective as azarga twice a day

[John C Hagan III, MD, FACS, FAAO]

There is no way that any ophthalmologist, including your own, can tell how  you will react to a change in medicine.  The primary reason to use timolol at evening meal time or very early evening is primarily because it doesn't work well once you are in bed and horizontal.  Also oral timolol is used to treat a variety of heart problems including high blood pressure.  A very long time ago doctors used to tell patients to take some of their blood pressure meds at bedtime.  Again very long ago it was found that that sometimes could lead to pathological low BP during sleep and heart/neurological problems.  If you are well controlled and tolerating the medication using first thing in moring and at end of evening meal is what most ophthalmologists would recommend.