Navigating Pharmacy Shelves: Is Timolol Out of Stock?

October 10, 2025 •

4 min read

Over 90% of glaucoma cases are the open-angle type, for which timolol is a common treatment [1.9.1]. The question of 'Is timolol out of stock?' has become a significant concern for many who rely on it to prevent irreversible vision loss [1.9.2].

Quick Summary

Recent reports and FDA data indicate intermittent shortages and discontinuations of some timolol formulations, impacting glaucoma patients. Understanding the causes and available alternatives is crucial for managing treatment.

Key Points

Intermittent Shortages: While not entirely out of stock, certain formulations of timolol eye drops have faced shortages and discontinuations from various manufacturers in 2023 and 2025 [1.2.1, 1.2.6].
Glaucoma Risk: Timolol is a critical medication used to lower eye pressure in glaucoma patients; interrupting treatment can lead to irreversible optic nerve damage and vision loss [1.9.1].
Systemic Causes: Drug shortages are often caused by manufacturing quality issues, thin profit margins for generic drugs, and a fragile global supply chain for raw ingredients [1.5.3, 1.5.2].
Consult Your Doctor: If you cannot fill your timolol prescription, immediately contact your ophthalmologist to be switched to a suitable alternative; do not stop treatment [1.6.4].
Multiple Alternatives Exist: Other classes of glaucoma medications, such as prostaglandin analogs (e.g., latanoprost), other beta-blockers, and carbonic anhydrase inhibitors, are effective alternatives [1.6.1, 1.6.3].

Understanding Timolol and Its Importance

Timolol is a beta-blocker medication primarily prescribed in the form of ophthalmic eye drops to treat elevated intraocular pressure (IOP) in patients with ocular hypertension or open-angle glaucoma [1.2.4, 1.4.1]. By reducing the production of aqueous humor—the fluid inside the eye—timolol effectively lowers IOP [1.6.2]. This action is critical because high pressure can damage the optic nerve, leading to progressive and irreversible vision loss, and in advanced cases, total blindness [1.9.1]. Given that glaucoma is a leading cause of blindness, consistent access to medications like timolol is essential for preserving sight [1.9.1]. The medication is available under various brand names, including Timoptic, Betimol, and Istalol, as well as in more affordable generic versions [1.8.1, 1.8.3].

The Current Situation: Is Timolol Out of Stock?

Concerns over the availability of timolol are valid, as various formulations have experienced shortages and discontinuations. According to the American Society of Health-System Pharmacists (ASHP), several manufacturers have had issues. For instance, Bausch Health discontinued its Timoptic-XE ophthalmic gel in July 2023, and Akorn discontinued its ophthalmic solution in early 2022 [1.2.1, 1.2.2]. More recently, Australia's Therapeutic Goods Administration (TGA) noted that Timoptol supply is expected to be impacted until March 2025 due to commercial changes, with Timoptol-XE affected by manufacturing issues until April 2025 [1.2.6].

In early 2025, a Class II recall was initiated for specific batches of Timolol Maleate Ophthalmic Solution due to a defective container that prevented the solution from being dispensed [1.2.4, 1.3.5]. While the FDA classified this as unlikely to cause immediate harm, it disrupted the supply chain [1.2.4]. The ASHP database, as of September 2025, shows that while some manufacturers like Sandoz, Apotex, and Rising have timolol ophthalmic solution available, others report shortages without providing specific reasons [1.2.2, 1.4.3]. This mix of discontinuations, recalls, and ongoing manufacturing challenges creates a complex supply landscape for patients and pharmacists alike.

The Anatomy of a Drug Shortage

Drug shortages, particularly for generic medications like timolol, are a persistent problem with complex roots [1.5.2]. Key contributing factors include:

Manufacturing and Quality Issues: A primary driver of shortages is when production facilities face quality control problems. An FDA inspection that reveals violations can force a plant to slow or halt production, creating an immediate supply gap, especially if that facility is a major supplier [1.5.3, 1.5.5].
Economic Pressures: The generic drug market operates on thin profit margins. The relentless pressure from Group Purchasing Organizations (GPOs), which control purchasing for about 90% of hospitals, drives prices down to unsustainable levels [1.5.3]. This "race to the bottom" discourages investment in modernizing facilities and can lead manufacturers to discontinue less profitable drugs [1.5.3, 1.5.2].
Supply Chain Fragility: The pharmaceutical supply chain is global and brittle. A significant percentage of Active Pharmaceutical Ingredients (APIs) are manufactured overseas, with India (48%) and China (13%) being dominant sources for the U.S. market [1.5.3]. Geopolitical tensions, natural disasters, or public health crises in these regions can instantly disrupt the flow of essential raw materials [1.5.2, 1.5.3].
Sudden Demand Spikes: Unexpected increases in demand, such as during a severe flu season, can outstrip a manufacturer's ability to ramp up production quickly [1.5.2].

Comparison of Timolol Alternatives

When timolol is unavailable, it is crucial not to interrupt treatment. Patients should consult their ophthalmologist immediately to discuss alternatives. Glaucoma treatment options are diverse, and a suitable replacement is often available [1.6.4].


Medication Class	Examples	Mechanism of Action	Common Dosing	Key Considerations
Prostaglandin Analogs	Latanoprost (Xalatan), Bimatoprost (Lumigan), Travoprost (Travatan Z) [1.6.3]	Increases the outflow of fluid from the eye (uveoscleral pathway) [1.6.2]	Once daily [1.6.2]	Often first-line therapy; can cause changes in iris color and eyelash growth [1.6.4].
Other Beta-Blockers	Betaxolol (Betoptic) [1.6.3]	Reduces aqueous humor production [1.6.2]	Once or twice daily [1.6.3]	Betaxolol is β1-selective, making it a safer option for patients with certain respiratory conditions [1.6.2].
Alpha-Adrenergic Agonists	Brimonidine (Alphagan P) [1.6.3]	Decreases fluid production and increases outflow [1.6.3]	Twice or three times daily [1.7.2]	Can cause dry mouth, lethargy, or allergic reactions [1.6.2, 1.7.2].
Carbonic Anhydrase Inhibitors (CAIs)	Dorzolamide (Trusopt), Brinzolamide (Azopt) [1.6.3]	Reduces aqueous humor production [1.6.2]	Twice or three times daily [1.6.3]	Available as eye drops and pills. May cause a bitter taste or stinging [1.6.2].
Combination Drugs	Dorzolamide/Timolol (Cosopt), Brimonidine/Timolol (Combigan) [1.6.4]	Combines mechanisms from two different classes	Twice daily	Offers convenience but may not be an option if timolol itself is the issue (e.g., allergy) [1.6.4].

Navigating a Shortage: What Patients Can Do

If you find your timolol prescription cannot be filled, take these steps:

Do Not Panic or Stop Treatment: Abruptly stopping glaucoma medication can lead to a spike in IOP and risk permanent optic nerve damage [1.9.1].
Contact Your Ophthalmologist: Your doctor is your primary resource. They can assess your specific situation and prescribe the most appropriate alternative medication based on your medical history and the severity of your glaucoma [1.6.4].
Call Different Pharmacies: Availability can vary between pharmacy chains and independent stores. Some may have a remaining supply or access to a different generic manufacturer that is not experiencing a shortage [1.4.6].
Discuss Non-Medication Options: For some patients, alternatives like laser therapy (Selective Laser Trabeculoplasty, SLT) or other surgical procedures may be an option to control IOP, reducing reliance on eye drops [1.7.1, 1.7.3].

Conclusion

The availability of timolol can be inconsistent due to a fragile global supply chain and economic pressures on generic drug manufacturers [1.5.3]. While many manufacturers continue to produce timolol, intermittent shortages and recalls of specific formulations are a reality for patients managing glaucoma [1.2.2, 1.2.4]. The most critical action for any patient facing a shortage is to maintain open communication with their healthcare provider to ensure continuous treatment and prevent the irreversible vision loss associated with untreated glaucoma [1.9.2].

Understanding Glaucoma Eye Drops

Frequently Asked Questions

Timolol is a beta-blocker that lowers high intraocular pressure (IOP), a key risk factor for glaucoma. By reducing this pressure, timolol helps prevent damage to the optic nerve, which can cause permanent vision loss and blindness if left untreated [1.9.1, 1.6.2].

Yes, the FDA considers generic drugs to be as safe and effective as their brand-name counterparts. Generic timolol contains the same active ingredient and works the same way as brand names like Timoptic, but it typically costs less [1.8.1].

First, do not stop your treatment. Contact your eye doctor immediately. They can prescribe an alternative medication. You can also try calling other pharmacies, as availability may differ [1.6.4].

Common alternatives include prostaglandin analogs like latanoprost, other beta-blockers like betaxolol, alpha agonists like brimonidine, and carbonic anhydrase inhibitors like dorzolamide. Combination drops and non-medication options like laser therapy also exist [1.6.3, 1.7.1].

Shortages are complex. The main causes include manufacturing and quality problems, discontinuations due to low profitability, disruptions in the global raw material supply chain, and sudden spikes in demand [1.5.2, 1.5.3].

There is no set time frame. A shortage can last from a few weeks to over a year, depending on the reason. On average, drug shortages may persist for about 18 months before being resolved [1.5.6].

Yes, but only under a doctor's supervision. Betaxolol is another beta-blocker eye drop. It is more selective in its action and may be a suitable alternative, especially for patients with certain respiratory issues, but your doctor must make this decision [1.6.2, 1.6.5].