TIMOLOL MALEATE（马来酸噻吗洛尔）
本品主要成分及其化学名称为：主要成分是马来酸噻吗洛尔，其化学名为：（一）-1-（叔丁氨基）-3-［（4-吗啉基-1，2，5-噻二唑-3-基）氧］-2-丙醇顺丁稀二酸盐。
C13H24N4O3S·C4H4O4，
分子量：432.49
性状：本品为无色的澄明液体。
适应症：对原发性开角型青光眼具有良好的降低眼内压疗效。对于某些继发性青光眼，高眼压症，部分原发性闭角型青光眼以及其他药物及手术无效的青光眼，加用本品滴眼可进一—步增强降眼压效果。
用法用量：滴眼，一次1滴，一日1—2次，如眼压已控制，可改为一日1次。如原用其他药物，住改用本品治疗时．原药物不宜突然停用，应自滴用本品的第二天起逐渐停用
禁忌：
1．支气管哮喘者或有支气管哮喘史者，严重慢性阻塞性肺部疾病。2．窦性心动过缓，II或III度房室传导阻滞，明显心衰，心源性休克。3．对本品过敏者。
注意事项：
1．当出现呼吸急促、脉搏明显减慢、过敏等症状时，请立即停止使用本品。2．使用中若出现脑供血不足症状时应立即停药，3．心功能损害者，使用本品时应避免服用钙离子拮抗剂．4．对无心衰史的患者，如出现心衰症状应立即停药。5.正在服用儿茶酚胺耗竭药(如利血平)者，使用本品时应严密观察。6．冠状动脉疾患、糖尿病、甲状腺功能亢进和重症肌无力患者，用本品滴眼时需遵医嘱。7．本品慎用于自发性低血糖患者及接受胰岛素或口服降糖药治疗的患者，因p受体阻滞剂可掩盖低血糖症状。8．本品不宜单独用于治疗闭角型青光眼。9．与其他滴眼液联合使用时，请间隔lO分钟以上。10．定期复查眼压，根据眼压变化调整用药方案11．用前应摇匀，避免容器尖端接触眼睛，防止滴眼液污染。[孕妇及哺乳期妇女用药]本品对于孕妇的安全性尚未确定。滴眼后可在哺乳期妇女乳汁中测到本品，因对授乳婴儿具有多种潜在不良反应．需根据滴用本品对母亲的重要性决定终止哺乳或终止用药，[儿童用药]本品对于儿童的安全性和疗效尚未确定。
药物相互作用：
1．与肾上腺素合用可引起瞳孔扩大。2．不主张两种局部p受体阻断剂同时应用。3．本品与钙通道拮抗剂合用应慎重，囚可引起房室传导阻滞，左心室衰竭及低血压。肘心功能受损的患者，应避免两种药合并使用4．正在服用儿茶酚胺耗竭药(如利血平)者，使用本品时应严密观察，因可引起低血压和明显的心动过缓。5．本品与洋地黄类和钙通道拮抗剂合用可进一步延长房室传导时间。 6，本品与奎宁丁合用能引起心率减慢等全身p受休阻断的副作用。可能的原因是奎宁丁可抑制P450酶和CYPZD6对噻吗洛尔的代谢作用。
药理作用：
药理作用：马来酸噻吗洛尔是一种非选择性p—肾上腺能受体阻滞剂，没有明显的内源性拟交感活性和局麻作用，对心肌无直接抑制作用。本品为马来酸噻吗洛尔滴眼液．对高眼压患者和正常人均有降低眼内压作用、其降低眼内压的确切机理尚不清楚，眼压描记和房水荧光光度研究提示本品的降眼压作用与减少房水生成有关非临床毒理研究：致癌性：动物实验显示长期大量口服马来酸噻吗洛尔可使雄性大鼠肾卜腺嗜铬细胞瘤，雌性小鼠良性及恶性肺部肿瘤，良性子宫息肉及乳腺痛的发生率明显增高。生殖毒性：动物实验显示大剂量门服马来酸噻吗洛尔，对雄、雌性小鼠的生殖功能均无影响。
  孕妇及哺乳期妇女用药：本品对于孕妇的安全性尚未确定。滴眼后可在哺乳期妇女乳汁中测到本品，因对授乳婴儿具有多种潜在不良反应，需根据滴用本品对母亲的重要性决定终止哺乳或终止用药。
儿童用药：本品对于儿童的安全性和疗效尚未确定。
药物相互作用：1.与肾上腺素合用可引起瞳孔扩大。2.不主张两种局部β受体阻断剂同时应用。3.本品与钙通道拮抗剂合用应慎重，因可引起房室传导阻滞，左心室衰竭及低血压。对心功能受损的患者，应避免两种药合并使用。4.正在服用儿茶酚胺耗竭药（如利血平）者，使用本品时应严密观察，因可引起低血压和明显的心动过缓。5.本品与洋地黄类和钙通道拮抗剂合用可进一步延长房室传导时间。6.本品与奎宁丁合用能引起心率减慢等全身β受体阻断的副作用。可能的原因是奎宁丁可抑制P450酶和CYPZD6对噻吗洛尔的代谢作用。
药物过量：过量应用本品可引起类似全身应用β受体阻断剂的副作用，如头晕，头痛，气短，心动过缓，支气管痉挛及心搏停止。
包装：聚乙烯塑料眼药瓶。
贮藏：遮光，密闭保存。
药物毒理：药理作用： 马来酸噻吗洛尔是一种非选择性β-肾上腺能受体阻滞剂，没有明显的内源性拟交感活性和局麻作用。对心肌无直接抑制作用。本品为马来酸噻码洛尔滴眼液，对高眼压患者和正常人均有降低眼内压作用。其降低眼内压的确切机理尚不清楚，眼压描记和房水荧光光度研 究提示本品的降眼压作用与减少房水生成有关。 非临床毒理研究： 致癌性：动物实验显示长期大量口服马来酸噻吗洛尔可使雄性大鼠肾上腺嗜铬细胞瘤，雌牲小鼠良性及恶性肺部肿瘤，良性子宫息肉及乳腺癌的发生率明显增高。 生殖毒性：动物实验显示大剂量口服马来酸噻吗洛尔，对雄、雌性小鼠的生殖功能均无影响。 
药代动力学：动物实验显示，用0．5本品对家兔单剂量滴眼，房水和血中的药物峰浓度出现在用药后30分钟，半衰期为1．5小时。全身吸收的马来酸噻吗洛尔在肝内代谢，70％的药物原型随尿排出。对6个接受治疗者的血浆药物浓度测定显示，每日用0．5％本品滴眼2次，早晨滴药后的平均血浆峰浓度为0．46ng／ml，下午滴眼后约为0．35ng/ml.

【原产地英文商品名】RYSMON TG OPHTHALMIC SOLUTION 0.5％(リズモン) 2.5ml/bottle 5bottles/box
【原产地英文药品名】TIMOLOL MALEATE
【中文参考商品译名】
注：以下产品不同规格和不同价格，购买时请以电话咨询为准！
·RYSMON TG0.25％点眼液(リズモン) 2.5毫升/瓶 5瓶/盒
·RYSMON TG0.5％点眼液(リズモン) 2.5毫升/瓶 5瓶/盒
【中文参考药品译名】马来酸噻吗洛尔
【生产厂家中文参考译名】若素制药
【生产厂家英文名】Kissei Pharma

Manufacturer's name : Kissei Pharmaceutical Co., Ltd.
Information is based on approvals granted in Japan. In some cases, the approved details may vary in countries other than Japan.

In deciding to use a medicine, the risk (side effects) of taking the medicine must be weighed against the benefit (effects) it will do. The patient's cooperation is indispensable here. 

Brand name : RYSMON TG OPHTHALMIC SOLUTION 0.5％ 

Active ingredient: Timolol maleate

Dosage form: clear and colorless to faintly yellow ophthalmic solution 

Printings on wrapping: リズモンTG点眼液0.5％ 
  
Effects of this medicine
This medicine lowers intraocular pressure by its beta-receptor blocking activity and suppresses visual field loss or visual loss. It has prolonged effect by turning into a gel with heat.
It is usually used to treat glaucoma or ocular hypertension.

Before using this medicine, tell your doctor/pharmacist
•If you have ever experienced any allergic reaction (itch, rash etc.) to any medicine.
If you are a patient with bronchial asthma, bronchospasm, chronic obstructive lung disease, heart disease, diabetic ketoacidosis, metabolic ketoacidosis or diabetes.
•If you are pregnant or breastfeeding.
•If you are using any other prescription or nonprescription (OTC) medicine. (It is important to reduce the risk of drug interactions.)
 
Dosage regimen (proper use of this medicine)
•General dosage regimen: For adults, apply a drop of 0.25% preparation at a time, once a day. If the dose seems to be insufficient, apply a drop of 0.5% preparation at a time, once a day. Strictly follow the instructions of your doctor/pharmacist.
•Missed dose: Apply the missed dose as soon as possible. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. DO NOT use double doses to make up for the missed dose.
•Overdose: If you used too much of the medicine (more than ordered), check with your doctor/pharmacist.
•Others: Do not stop using the medicine without the instructions of your doctor.
•The medicine may turn to jelly if left in room temperature for a long time. In that case, cool it in the refrigerator for some 30 minutes to be turn it back.
•If you use in combination with other eye drops, use them before this medicine. If you need to use other eye drops after the medicine, wait more than 30 minutes. (As the gelled medicine may interfere with the absorption of other eye drops.)
 
Precautions while using this medicine
•Rarely the medicine may be sticky by the heat just after applying. This is because the medicine was designed so such to keep its therapeutic effect, so there is no need to worry about this matter.
 
Side effects of this medicine
Common side effects are reported as below. If any of them occurs, check with your doctor/pharmacist: stimulating feeling in eye, itchy feeling, conjunctival congestion, foreign feeling, sticky feeling, decrease of pulse, etc.

In rare cases, symptoms described below may be the sign of side effects indicated in brackets [ ]. If they occur, stop taking your medicine and check with your doctor immediately.
•shortness of breath, breathlessness, dizziness [bronchospasm, breathing difficulty, respiratory failure]
•breathing difficulty, loss of consciousness, convulsion [cardiac block, congestive heart failure, cardiac arrest]
•headache, nausea, vomiting, temporary conscious disorder or paralysis on either side of the body [cerebrovascular disorder, cerebral ischemia]
•fever, fatigability, red rash on face [systemic erythematosus]
•blood shot eye, blurred vision, inverted eyelash [ocular pemphigoid]

Other side effects not listed here may occur. Check with your doctor/pharmacist if you have any worrisome symptom. 

Storage and other information
•Keep out the reach of children. Store away from direct sunlight. Keep under 10℃.
•Discard the remainder. Do not store them.