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timolol (Timpilo / timolol, ophthalmic)

✓ Approved

Merck & Co. · ADRB1 · Small Molecule

What is timolol?

timolol is a small molecule developed by Merck & Co.. It is approved for therapeutic indications.

Drug Profile

Brand NamesTimpilo, timolol, ophthalmic
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetADRB1, ADRB2, CHRM3
StatusApproved
Sources: ClinicalTrials.gov, Merck & Co.

Mechanism of Action

Molecular Targets

timolol acts on 3 molecular targets:

ADRB1adrenoceptor beta 1 (BETA1AR, ADRB1R)
ADRB2adrenoceptor beta 2 (ADRBR, B2AR)
CHRM3cholinergic receptor muscarinic 3 (EGBRS, m3AChR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

timolol is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Eye disordersGlaucoma✓ Approved

Related Research Articles

PubMedRheumatology international2026-05-24

Major ozone therapy improves disease severity without affecting retinal microvascular parameters in fibromyalgia syndrome: an observational pre-post study.

Kocyigit Burhan Fatih BF, Öztürk Gülşah Yaşa GY, Emekli Duygu Topaktaş DT, Sahutoglu Eda E

This study aimed to assess the impact of ten sessions of major ozone therapy on disease severity and ophthalmologic parameters in patients with fibromyalgia syndrome (FMS). This observational study was conducted in the Physical Medicine and Rehabilitation and Ophthalmology clinics of a tertiary healthcare facility. The study involved 30 patients diagnosed with FMS who underwent 10 weekly sessions of major ozone therapy. Symptom severity was measured before and after treatment using the Fibromyalgia Impact Scale (FIQ). The study assessed ophthalmic parameters, including visual acuity, spherical equivalent, astigmatism, axis, intraocular pressure, and central corneal thickness. Additionally, microvascular changes were examined using optical coherence tomography angiography (OCTA). Post-treatment, FIQ scores decreased significantly (before: 67.19 ± 14.02; after: 46.78 ± 11.46; p < 0.001), indicating a notable reduction in symptom burden. The mean intraocular pressure was measured at 15.25 ± 2.67 mmHg before treatment and 15.41 ± 3.55 mmHg after treatment, while central corneal thickness was recorded as 530.50 ± 19.35 μm and 531.50 ± 19.21 μm. Superficial capillary plexus foveal vascular density was found to be 14.98 ± 7.16% before treatment and 15.34 ± 7.62% after treatment. Best-corrected visual acuity remained 1.0 ± 0.0 in both assessments. Spherical equivalent was - 0.05 ± 1.05 D pre-treatment and - 0.01 ± 1.03 D post-treatment (p = 0.380), and astigmatism was - 0.64 ± 0.60 D and - 0.64 ± 0.54 D (p = 0.100). Foveal avascular zone area (0.333 ± 0.129 vs. 0.331 ± 0.133 mm²; p = 0.732), total foveal retinal thickness (213 vs. 214 μm; p = 0.253), and deep capillary plexus foveal vascular density (30.07 ± 8.44% vs. 30.18 ± 8.18%; p = 0.786) also remained stable. No statistically significant differences were observed in anterior segment parameters, intraocular pressure, central corneal thickness, or retinal microvascular structures as measured by OCTA (p > 0.05). Ten sessions of major ozone therapy effectively reduced symptom burden in FMS patients, though short-term changes in the anterior segment and retinal microvascular structures were not measurable. Ozone therapy may serve as a complementary and supportive approach alongside existing treatments for managing FMS.

PMID 42176068
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PubMedClinical neurology and neurosurgery2026-05-23

The CSF sign - A potential biomarker in ophthalmic neuralgia?

Tanrikulu Levent L, Bagias Nikolaos N, Dömer Patrick P, Woitzik Johannes J

Specific magnetic resonance imaging sequences are utilized in the visualization of the detailed morphology of neurovascular compression (NVC) in classic trigeminal neuralgia (TN). This study focuses on essential morphological parameters especially in the clinical involvement of the ophthalmic branch (V1) of the trigeminal nerve with examination of the cerebrospinal fluid "CSF" sign, which is a separation of trigeminal fascicles by a vessel. A total of 102 patients (mean age 65.5 ± 11.3 years; f/m: 72/30, 52 left-sided/ 50 right-sided symptoms) with TN were included into this analysis. Complete clinical and radiological data were available for all patients. The patient population was divided into two groups: patients with and without clinical V1 involvement. The occurrence of the CSF sign was analyzed in the high resolution T2 weighted imaging data. A chi²-test was applied for statistical evaluation of the correlation between the existence of a CSF sign and V1-involvement. There was a statistical significant correlation between the involvement of the V1-branch in TN and the existence of a CSF sign (p = 0.00043; chi²-test). There was a statistical significance for the occurence of TN in females (p = 0.0001; chi²-test). There was no statistical significance in the lateralization of neuralgic symptoms (p = 0.78; chi²-test). A 4.4 fold higher probability of a positive CSF sign was found in patients with V1-symptoms (odds ratio 4.36 for V1 and positive CSF sign). The Cramer V-test showed a medium effect size for the association of V1 positive symptoms and existent CSF sign with a value of 0,349 (∼0.1 weak, ∼0.3 medium, ∼0.5 strong). Our study demonstrates that there is a statistical significant correlation between the existence of a CSF sign and clinical involvement of ophthalmic branch of the trigeminal nerve in TN. We could herein show, that the CSF sign may act as a potential biomarker in V1 affection in TN.

PMID 42173021
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PubMedBMC ophthalmology2026-05-23

Risk factors for ocular complications in HIV/AIDS patients: a retrospective analysis of ophthalmology consultations in a tertiary hospital in Central China.

Zhang Renfan R, Zheng Tian T, Chen Xiaomin X, Yang Lin L et al.

Acquired immunodeficiency syndrome (AIDS) affects 39.9 million people worldwide. Despite antiretroviral therapy, sight-threatening ocular complications, such as cytomegalovirus retinitis (CMVR), remain common, yet contemporary incidence data from Asian populations are scarce. To quantify the incidence of fundus lesions and identify independent predictors of ocular lesions among HIV-positive inpatients referred for ophthalmologic evaluation at a tertiary center in Central China. All consecutive HIV-1-positive inpatients aged ≥ 18 years who underwent standardized ophthalmic screening from 19 November 2019 to 9 June 2023 were included. Data on demographic, systemic, and ocular characteristics were collected. Binary logistic regression models were used to identify factors associated with fundus lesions. Of 345 eligible individuals, 117 had fundus lesions, classified into three main types. The distribution was 35.9% for opportunistic infections, 59.8% for HIV-related microangiopathy, and 4.3% for syphilis-related uveitis. The opportunistic infections group was common among the youngest age group [median age: 41.5 years, IQR: 32-54 years], with 38.1% reporting blurred vision. Patients in the microangiopathy group had the lowest CD4+ T cell count [median count: 18.5 cells/µL, IQR: 5-40.25 cells/µL] and the shortest duration of HIV/AIDS [median month: 0.7 months, IQR: 0-6.5 months]. The syphilis-related uveitis group had the longest duration of HIV/AIDS [median month: 24 months, IQR: 8.125-54 months], the highest CD4+ T cell count [median count: 166 cells/µL, IQR: 41-224.5 cells/µL], and the most frequent complaint of blurred vision (80%). In this contemporary Central-Chinese cohort, CMVR remains the leading ocular sequela despite widespread HAART. Age, nadir CD4+ < 50 cells/µL, and symptomatic visual loss are independent red flags. We propose routine dilated fundus examinations every 3 months for patients with any of these predictors and immediate ophthalmic referral at the onset of visual symptoms.

PMID 42174527
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PubMedBMJ open ophthalmology2026-05-23

Clinic-based burden of glaucoma among Sahrawi refugees in the Tindouf camps.

Mhamdi-Lehebib Ouafa O, Mendez-Hernandez Carmen C

To estimate the clinic-based frequency of glaucoma among Sahrawi refugees attending humanitarian ophthalmology missions in the Tindouf camps (Algeria), to identify demographic and clinical factors associated with glaucoma and to contextualise the clinic-based frequency of other ophthalmic diseases. We conducted a clinic-based cross-sectional study among Sahrawi refugees during Médicos del Mundo ophthalmology missions. All participants underwent a standardised ophthalmological examination including targeted history, visual acuity assessment, slit-lamp biomicroscopy and intraocular pressure (IOP) measurement. Glaucoma diagnosis relied on structural optic nerve head assessment and elevated IOP, with independent confirmation by a second ophthalmologist. Age-standardised and sex-standardised clinic-based frequencies were calculated using camp population demographics. Multivariable logistic regression identified factors associated with glaucoma. A total of 900 symptomatic care-seeking individuals were examined (56% men; median age 70 years). Overall clinic-based glaucoma frequency was 13.3% (95% CI 11.1% to 15.5%), representing the main disease of interest. After standardisation, the estimated clinic-based frequency was 6.7% (95% CI 3.8% to 9.7%). Older age was independently associated with glaucoma (adjusted OR per year 1.02; 95% CI 1.01 to 1.03; p=0.003). Inverse associations with cataract and keratopathy, likely reflected selection patterns and diagnostic overshadowing. Cataract was the most common coexisting diagnosis (59.8%), followed by keratopathy (9.1%) and retinopathy (3.4%). Among participants, 37.8% (n=340) had severe bilateral visual impairment, and 40.9% (n=368) had monocular vision; 17.5% (n=60/340) of those with bilateral impairment were blind from glaucoma. Glaucoma represents a substantial clinic-based burden among symptomatic Sahrawi refugees attending humanitarian missions, with a high proportion of irreversible visual loss. Other ophthalmic conditions were common but functioned as coexisting causes of visual impairment in this care-seeking sample. These findings highlight the need for pragmatic, context-appropriate strategies for opportunistic glaucoma detection and continuity of care in refugee settings, acknowledging limitations including the non-probabilistic, mission-based sampling and absence of visual-field testing.

PMID 42173553
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PubMednpj aging2026-05-23

A multimodal ocular aging index reveals proteomic pathways and predicts incident age-related eye diseases.

Kai Jia-Yan JY, Gong Shi-Yi SY, Li Dan-Lin DL, Lanca Carla C et al.

Chronological age incompletely captures heterogeneity in biological aging. In this prospective study of 45,819 UK Biobank participants, we developed a multimodal ocular aging index (MOAI) by integrating ophthalmic phenotypes with plasma proteomic and metabolomic profiles using machine learning. The MOAI quantifies divergence between ocular biological and chronological age. Over 13.80 years of follow-up, accelerated ocular aging was significantly associated with higher risks of incident age-related macular degeneration and cataract, even after adjustment for chronological age and established risk factors. Incorporation of the MOAI significantly improved risk reclassification beyond traditional predictors. Explainable modeling and pathway enrichment analyses identified inflammation-related proteins and pathways, including cytokine-cytokine receptor interactions and PI3K-Akt signaling, as key drivers of accelerated ocular aging. These findings establish a multimodal framework for quantifying organ-specific biological aging, link ocular aging to systemic inflammatory processes, and highlight the eye as a sensitive readout of aging biology with implications for healthspan.

PMID 42173886
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PubMedProgress in retinal and eye research2026-05-23

Diabetic Retinal Disease Cure Accelerator: Modernizing Staging and Endpoints.

Sampani Konstantina K, Fickweiler Ward W, Markel Dorene S DS, Faulkner Latrice L et al.

The "Diabetic Retinal Disease (DRD) Cure Accelerator," a joint initiative by the Mary Tyler Moore Vision Initiative and the Collaborative Community on Ophthalmic Innovation, aims to modernize clinically meaningful staging systems and endpoints for DRD. During a June 2025 workshop involving over 100 international experts, participants emphasized the urgent need for validated structural and functional endpoints grounded in the retinal neurovascular unit. Current DRD staging limitations were highlighted alongside the importance of early biomarkers, including retinal nonperfusion, inner retinal thinning, and disorganization of retinal layers. Functional priorities included contrast sensitivity, electrophysiology, and performance-based mobility parameters that reflect real-world visual impairment. Beyond clinical staging, this approach facilitates precision phenotyping to isolate specific molecular pathogenic pathways driving disease in individual patients. Mechanistic granularity provides a foundation for discovery science, enabling targeted drug re-purposing and the development of curative therapeutics. Key next steps include prospective multicenter studies, harmonized protocols, and reference standards and endpoints for AI based on patient relevant outcomes. By integrating scientific, clinical, and patient-centered perspectives, this Accelerator seeks to establish an international consensus on robust endpoints. Ultimately, this precision-based approach aims to transform DRD diagnosis and treatment, accelerating the access of patients worldwide to therapies that reduce diabetes-related vision loss.

PMID 42173402
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