Can I take timolol eye drops while pregnant or breastfeeding?

Pregnancy: Teratogenic Effects Teratogenicity studies with timolol in mice, rats, and rabbits at oral doses up to 50 mg/kg/day (7,000 times the systemic exposure following the maximum recommendedhuman ophthalmic dose) demonstrated no evidence of fetal malformations. Although delayed fetal ossification was observed at this dose in rats, there were no adverse effects on postnatal development of offspring. Doses of 1000 mg/kg/day (142,000 times the systemic exposure following the maximum recommended human ophthalmic dose) were maternotoxic in mice and resulted in an increased number of fetal resorptions. Increased fetal resorptions were also seen in rabbits at doses of 14,000 times the systemic exposure following the maximum recommended human ophthalmic dose, in this case without apparent maternotoxicity. There are no adequate and well-controlled studies in pregnant women. Timolol maleate ophthalmic solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Prescribing label, section “Pregnancy”: TIMOLOL MALEATE (ophthalmic), A-S Medication Solutions. Label on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.

This quote is from the ophthalmic formulation label.

Because of the variability in excretion of timolol into breastmilk and minimal reported experience during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.

Ophthalmic use of timolol by the mother should pose little risk to the breastfed infant, although some guidelines state that gel formulations are preferred over solutions.[1,2] To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue. The manufacturer of Combigan states that it is not recommended for use during lactation, but there is no evidence for this statement.

“Summary of Use during Lactation”, LactMed record “Timolol” (LM305), quoted verbatim. Everything LactMed reports about Timolol while breastfeeding.

Nursing Mothers Timolol maleate has been detected in human milk following oral and ophthalmic drug administration. Because of the potential for serious adverse reactions from timolol maleate ophthalmic solution in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Prescribing label, section “Nursing Mothers”: TIMOLOL MALEATE (ophthalmic), A-S Medication Solutions. Label on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.

This quote is from the ophthalmic formulation label.