Bronchial reactivity in healthy individuals undergoing long-term topical treatment with beta-blockers

Arch Ophthalmol. 2005 Jan;123(1):35-8. doi: 10.1001/archopht.123.1.35.


Objective: To assess the impact of long-term treatment with topical timolol on bronchial reactivity in healthy individuals.

Methods: Twenty-one otherwise healthy individuals with high-pressure primary open-angle glaucoma were enrolled in a randomized controlled clinical trial. Eleven patients underwent 3 years of topical 0.5% timolol treatment followed by a 1-year washout period; 10 patients underwent primary argon laser trabeculoplasty. Functional variables and bronchial reactivity (forced expiratory volume in 1 second and metacholine challenge test results) were assessed in both groups at enrollment and after 3 and 4 years of follow-up.

Results: After 3 years, a measurable response to metacholine challenge was recorded in 6 of 11 otherwise symptom-free individuals treated with 0.5% timolol twice daily. A detectable response to metacholine challenge was still present in half of these individuals (3 of 6) when further washed out for 1 year from the topical beta-blocker. No significant variation in bronchial reactivity was measured in the laser-treated group during 4 years of follow-up.

Conclusions: Healthy individuals who undergo long-term topical application of a nonselective beta-blocker (0.5% timolol) can develop a subclinical increase in bronchial reactivity. This phenomenon may not be completely reversible on withdrawal of the beta-blocker.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / adverse effects*
  • Adult
  • Aged
  • Bronchial Hyperreactivity / chemically induced*
  • Bronchial Hyperreactivity / physiopathology
  • Bronchoconstrictor Agents
  • Female
  • Forced Expiratory Volume
  • Glaucoma, Open-Angle / drug therapy*
  • Humans
  • Intraocular Pressure / drug effects*
  • Long-Term Care
  • Lung / drug effects*
  • Lung / physiopathology
  • Male
  • Methacholine Chloride
  • Middle Aged
  • Ophthalmic Solutions / administration & dosage
  • Ophthalmic Solutions / adverse effects
  • Timolol / administration & dosage
  • Timolol / adverse effects*
  • Trabeculectomy


  • Adrenergic beta-Antagonists
  • Bronchoconstrictor Agents
  • Ophthalmic Solutions
  • Methacholine Chloride
  • Timolol