Association between Ophthalmic Timolol and Hospitalisation for Bradycardia

Introduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation...

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Main Authors: Nicole L. Pratt, Emmae N. Ramsay, Lisa M. Kalisch Ellett, Tuan A. Nguyen, Elizabeth E. Roughead
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2015/567387
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author Nicole L. Pratt
Emmae N. Ramsay
Lisa M. Kalisch Ellett
Tuan A. Nguyen
Elizabeth E. Roughead
author_facet Nicole L. Pratt
Emmae N. Ramsay
Lisa M. Kalisch Ellett
Tuan A. Nguyen
Elizabeth E. Roughead
author_sort Nicole L. Pratt
collection DOAJ
description Introduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation for bradycardia. Materials and Methods. A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol. Person-time after timolol initiation was partitioned into risk periods: 1–30 days, 31–180 days, and >180 days. A 30-day risk period prior to initiating timolol was also included. All remaining time was considered unexposed. Results. There were 6,373 patients with at least one hospitalisation for bradycardia during the study period; 267 were exposed to timolol. Risk of bradycardia was significantly increased in the 31–180 days after timolol initiation (incidence rate ratio (IRR) = 1.93; 95% confidence interval (CI) 1.00–1.87). No increased risk was observed in the first 30 days or beyond 180 days of continuous exposure (IRR = 1.40; 95% CI 0.87–2.26 and IRR = 1.21; 95% CI 0.64–2.31, resp.). Conclusion. Bradycardia is a potential adverse event following timolol initiation. Practitioners should consider patient history before choosing a glaucoma regime and closely monitor patients after treatment initiation with topical nonselective beta-blocker eye drops.
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spelling doaj-art-28ab4cd7fda846cf961926f816c646522025-02-03T06:00:53ZengWileyJournal of Ophthalmology2090-004X2090-00582015-01-01201510.1155/2015/567387567387Association between Ophthalmic Timolol and Hospitalisation for BradycardiaNicole L. Pratt0Emmae N. Ramsay1Lisa M. Kalisch Ellett2Tuan A. Nguyen3Elizabeth E. Roughead4Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, AustraliaQuality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, AustraliaQuality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, AustraliaQuality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, AustraliaQuality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, AustraliaIntroduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation for bradycardia. Materials and Methods. A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol. Person-time after timolol initiation was partitioned into risk periods: 1–30 days, 31–180 days, and >180 days. A 30-day risk period prior to initiating timolol was also included. All remaining time was considered unexposed. Results. There were 6,373 patients with at least one hospitalisation for bradycardia during the study period; 267 were exposed to timolol. Risk of bradycardia was significantly increased in the 31–180 days after timolol initiation (incidence rate ratio (IRR) = 1.93; 95% confidence interval (CI) 1.00–1.87). No increased risk was observed in the first 30 days or beyond 180 days of continuous exposure (IRR = 1.40; 95% CI 0.87–2.26 and IRR = 1.21; 95% CI 0.64–2.31, resp.). Conclusion. Bradycardia is a potential adverse event following timolol initiation. Practitioners should consider patient history before choosing a glaucoma regime and closely monitor patients after treatment initiation with topical nonselective beta-blocker eye drops.http://dx.doi.org/10.1155/2015/567387
spellingShingle Nicole L. Pratt
Emmae N. Ramsay
Lisa M. Kalisch Ellett
Tuan A. Nguyen
Elizabeth E. Roughead
Association between Ophthalmic Timolol and Hospitalisation for Bradycardia
Journal of Ophthalmology
title Association between Ophthalmic Timolol and Hospitalisation for Bradycardia
title_full Association between Ophthalmic Timolol and Hospitalisation for Bradycardia
title_fullStr Association between Ophthalmic Timolol and Hospitalisation for Bradycardia
title_full_unstemmed Association between Ophthalmic Timolol and Hospitalisation for Bradycardia
title_short Association between Ophthalmic Timolol and Hospitalisation for Bradycardia
title_sort association between ophthalmic timolol and hospitalisation for bradycardia
url http://dx.doi.org/10.1155/2015/567387
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