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time between drops and pressure

Question:

On 18 Mar 1999 02:15:31 GMT, "W. W. Koepsel" <wkoep…@worldnet.att.net> wrote: ………. >I do believe that >the betoptic has had an effect on my sexual life however. I would >appreciate hearing from others if this is in fact a side effect.

A post of mine to this NG last year: *************************************************************************** ******* Re: TIMOPTIC   Author:              Raymond A. Chamberlin <ra…@sirius.com> Date:          1998/01/20 Forum:          alt.support.glaucoma On 24 Dec 1997 01:18:15 GMT, o60ba…@aol.com (O60Banks) wrote: >Recently heard possible link between timolol maleate and Peyronies (curvature >of penis and sexual failure) Heard on local talk radio, M.D. interview but >missed details. My opthalmologist seemed to be surprised at the suggestion. I >dont think she took me seriously. Has anyone encountered a related medical >reference?

I just checked this on the Web — about 20 references (use ‘+beta-blocker* +peyronie*’ in AltaVista search engine).  *All* beta-blockers, for either ocular or hypotensive use, seem to now list this as an uncommon side effect.  There seems to be an implication that cessation of the medication will always reverse the complaint. If this was the cause, I know of one case, where that wasn’t all that true. Medline has 2 references, one a paper having an online abstract and the other a letter (without an abstract).  See them at PubMed:         http://www4.ncbi.nlm.nih.gov/PubMed/medline.html Ray *************************************************************************** ******* And a second one: *************************************************************************** ******* Re: Combatting glaucoma simply   Author:          Raymond A. Chamberlin <ra…@sirius.com> Date:          1998/02/27 Forum:          alt.support.glaucoma On 26 Feb 1998 04:42:52 GMT, electr…@aol.com (ELECTRPOW) wrote: >Ray asked "Which type of drops did your OMD want you to take? >He prescribed once a day Timoptic eye drops (.5% strength).  I took them for 4 >months in the right eye.  During that time period I read articles in the med >school library and decided to quit the eye drops.  I tapered off the eye drops, >I didn’t know what would happen with a cold turkey dropping of them.

Some of these things can apparently cause problems over time (as opposed to non-deteriorating allergic effects), particularly depending on how much of them manages to get into the rest of the user’s system (partly related to skill in administering them to the surface of the eyes).  Someone awhile back posted to this NG and/or sci.med.vision a query about reference to one beta-blocker’s systemic side effects in the form of problems generally stuck under "Peyronie’s disease", relevant at least to older males.  I checked drug references on the Web and found that descriptions of *all* beta-blockers appearing on it now list such possible side effects.  Of course, those used for purposes other than eye treatment pose greater risk.  I took interchangeably Timoptic or Betoptic for two years, during which time neither did anything in respect to my eyes.  Just after stopping it, I did note a limited, nonreversable problem in the above category (from whatever cause). I note that this year’s PDR lists such a precaution under all beta-blockers except — I think it was — Timoptic.  I also note that the package insertion with an old sample bottle of Betoptic does *not* contain such a warning. There are also studies on animals that show some degradation by these things of the eye’s cornea. Ray (not a professional) *************************************************************************** ******* Ray

Response:

- Hide quoted text — Show quoted text -Alynn Baker wrote: > If drops are to be taken 2 or 3 times a day, do they wear off if you > are a couple of hours late?  Also, does time of day affect pressure? > I have been using xalantan and timoptic XE for a year or two.  When my > left eye’s IOP jumped from low 20’s (with eye drops) to 48 my local > doctor gave me alphagan in addition, and sent me to a specialist in > NY.  After my usual drops plus 3 times using alphagan, the next > morning my IOP was 22 (in NY).  OK, so alphagan can do that at first, > maybe. > Four weeks later it was back up to 36, alphagan not withstanding.  I > had NOTused my 2 PM dose of alphagan when I went to the local doc for > a check (I had asked him and he said not to take it until after the > appointment).  He saw me at 4 PM and my IOP was 36.  He added trusopt > drops to the list and sent me back to NY a couple of days later where > my IOP was 12!  (They dropped xalatan and combined timoptic and > trusopt into cosopt).  They doubted that trusopt would have that big > an effect. > I wonder if my IOP is much higher after a day of teaching and lower > earlier in the morning.  Or if not taking my 2 PM dose until an hour > or two later can be this dangerous. > Any information to help me? > aly…@usa.netI take betoptic, trusopt and xalatan. My IOP has remained a pproximately

in the 18  to 19. I also found that walking at least 1 mile a day keeps the pressure down. My MD verified this in studies performed by the military. I never miss my drops by as much as you say. Though I will vary by 15 to 20 minutes. I also teach at a university, though it is only part time, I do get my exercise in this manner. I do believe that the betoptic has had an effect on my sexual life however. I would appreciate hearing from others if this is in fact a side effect.

Response:

I didn’t realize it was so complicated to check IOP.  I will ask, however, if time of day has anything to do with my IOP.  I drink less than I should as I have had some bladder problems all my life.  And how does one NOT hold one’s breath when the doc says to stay perfectly still????? Thanks for the info. – Hide quoted text — Show quoted text ->From your message it appears your high readings are in the afternoon and your >low readings in the morning. You should be aware that pressures in some people >may vary as much as 20 points every day. In many people, pressure is highest 5 >to 7 a.m. and lowest 7 to 9 a.m.; peaks and valleys are reached various times >throughout the day. The way the test is given, or taken and the amount of fluid >you may have consumed shortly before can also effect the result. >You might request "serial tonometry" in which a number of readings are taken >throughout the day to establish your own individual pressure pattern. These >tests should be done on the same instrument by the same operator, and you >should be positioned the same way. >Readings can be altered by large fluid intake shortly before a test, forcibly >holding the eyelids open, looking other than straight forward, "cricking" your >neck, holding your breath, etc. There are many variables, over and above >medications (the package insert tell you how quickly maximum pressure reduction >occurs and how long it holds). >(Not a professional reply)

aly…@usa.net

Response:

If drops are to be taken 2 or 3 times a day, do they wear off if you are a couple of hours late?  Also, does time of day affect pressure? I have been using xalantan and timoptic XE for a year or two.  When my left eye’s IOP jumped from low 20’s (with eye drops) to 48 my local doctor gave me alphagan in addition, and sent me to a specialist in NY.  After my usual drops plus 3 times using alphagan, the next morning my IOP was 22 (in NY).  OK, so alphagan can do that at first, maybe.   Four weeks later it was back up to 36, alphagan not withstanding.  I had NOTused my 2 PM dose of alphagan when I went to the local doc for a check (I had asked him and he said not to take it until after the appointment).  He saw me at 4 PM and my IOP was 36.  He added trusopt drops to the list and sent me back to NY a couple of days later where my IOP was 12!  (They dropped xalatan and combined timoptic and trusopt into cosopt).  They doubted that trusopt would have that big an effect. I wonder if my IOP is much higher after a day of teaching and lower earlier in the morning.  Or if not taking my 2 PM dose until an hour or two later can be this dangerous. Any information to help me? aly…@usa.net

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