Netarsudil + Timolol (Eye Drop)

Netarsudil + Timolol eye drops are an investigational combination medicine used to treat open-angle glaucoma by reducing pressure inside the eye.

Drug class	Fixed-Dose Combination
Type	Combination
Forms	Eye Drop
Common strength	0.02% + 0.5%
Common Indian brands	Pipeline
Prescription status	Investigational

What Netarsudil + Timolol is used for

Netarsudil + Timolol eye drops are a combination medicine that is currently investigational. It is being explored for the treatment of certain eye conditions, specifically:

• Open-angle glaucoma: This is a common eye condition where the pressure inside your eye (intraocular pressure) becomes too high. This high pressure can damage the optic nerve, which connects your eye to your brain, and can lead to vision loss if not treated. Open-angle glaucoma often develops slowly and painlessly, so many people don’t notice symptoms until significant vision loss has occurred. Regular eye check-ups are very important for early detection and management.

It’s important to remember that this combination is still in the pipeline and not yet routinely available or approved in India. Your ophthalmologist can discuss approved and available alternatives for your condition.

How it works

Netarsudil + Timolol works as a ‘Fixed-Dose Combination’ medicine, meaning it combines two different active ingredients, Netarsudil and Timolol, to tackle high eye pressure in two different ways. This dual approach aims to provide a more effective reduction in intraocular pressure.

Netarsududil belongs to a class of medicines called ROCK inhibitors. It works by increasing the outflow of fluid from your eye, which helps to lower the pressure inside. Think of it like opening a drain to let excess water out.

Timolol is a beta-blocker. It works by reducing the production of fluid within your eye. This is like turning down the tap that fills the eye with fluid. By both increasing outflow and decreasing production, the combination helps to bring down the eye pressure more effectively.

Together, these two mechanisms help to reduce the pressure inside your eye, which is crucial for managing conditions like glaucoma and protecting your vision.

How it’s used

Netarsudil + Timolol eye drops are typically prescribed for use once a day. Your doctor will provide specific instructions on how many drops to use and at what time of day. It is very important to follow these instructions carefully to get the most benefit from your medicine and to minimise any potential risks.

Here are general steps for instilling eye drops:

1. Wash your hands: Always wash your hands thoroughly with soap and water before touching your eyes or the eye drop bottle.
2. Prepare the bottle: If the bottle has a cap, remove it and place it on a clean surface. Do not touch the tip of the dropper.
3. Tilt your head back: Gently pull down your lower eyelid with one finger to create a small pocket.
4. Instill the drop: Hold the dropper bottle upside down with the tip pointing towards your eye. Look upwards and gently squeeze the bottle to release one drop into the pocket you created. Be careful not to let the tip of the bottle touch your eye, eyelid, or any other surface to prevent contamination.
5. Close your eye: Gently close your eye for 1-2 minutes. Do not blink excessively or squeeze your eyes shut tightly, as this can push the medicine out.
6. Apply pressure: After instilling the drop, gently press your finger on the inner corner of your eye, near your nose, for 1-2 minutes. This is a very important step for this particular medicine because it helps to reduce the amount of medicine that gets absorbed into your bloodstream, thereby reducing the risk of systemic side effects.
7. Wipe away excess: Blot any excess liquid around your eye with a clean tissue.
8. Replace the cap: Put the cap back on the bottle immediately after use.
9. Wash your hands again: Wash your hands to remove any medicine residue.

If you are using other eye drops, wait at least 5-10 minutes between different medications to allow each drop to be absorbed properly.

Do not stop using this medicine suddenly without consulting your doctor, as this can lead to a sudden increase in eye pressure and worsen your condition.

Always follow your ophthalmologist’s exact instructions.

Brands available in India

• Pipeline

Brand availability and pricing vary; confirm with your pharmacist.

Precautions & side effects

Netarsudil + Timolol is an investigational medicine, and specific precautions apply, especially because it contains a beta-blocker. It is crucial to discuss your full medical history with your ophthalmologist before starting this medication.

• Beta-blocker warning: This medicine contains Timolol, which is a beta-blocker. Beta-blockers can be absorbed into the body and affect other organs, not just the eyes.
• Medical Conditions: It is very important to tell your doctor if you have any of the following conditions:
  • Asthma: Beta-blockers can worsen asthma symptoms or trigger an asthma attack.
  • COPD (Chronic Obstructive Pulmonary Disease): Similar to asthma, beta-blockers can affect breathing in individuals with COPD.
  • Slow heart rate (bradycardia) or heart disease: Beta-blockers can slow down the heart rate further or affect heart function.
• Reducing Systemic Absorption: To minimise the absorption of the beta-blocker into your body, it is highly recommended to gently press the inner corner of your eye (near your nose) for 1-2 minutes immediately after instilling the eye drop. This technique helps to block the tear duct and reduce the amount of medicine that drains into your nasal passages and gets absorbed systemically.
• Do Not Stop Suddenly: Do not stop using Netarsudil + Timolol suddenly without consulting your doctor. Abruptly stopping beta-blockers can sometimes lead to a rebound effect or worsening of your underlying condition. Your doctor will advise you on how to safely discontinue the medication if needed.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss this with your doctor. The safety of this combination during pregnancy and breastfeeding is not fully established.
• Other Medications: Inform your doctor about all other medications you are taking, including over-the-counter drugs, herbal supplements, and other eye drops, as there can be interactions.
• Contact Lenses: If you wear contact lenses, remove them before instilling the eye drops and wait at least 15 minutes before reinserting them, unless your doctor advises otherwise.
• Driving and Operating Machinery: This medicine may cause temporary blurred vision or other visual disturbances after instillation. Avoid driving or operating machinery until your vision is clear.
• Allergies: Inform your doctor if you have any known allergies to any of the ingredients in Netarsudil + Timolol or to other beta-blockers.
• Investigational Status: Please remember that Netarsudil + Timolol is currently an investigational product and is not routinely approved or available in India. Your ophthalmologist will guide you on approved and suitable alternatives for your condition.

Welcome to Pristine Eye Hospitals. We understand that managing eye conditions can sometimes feel overwhelming, but with the right information and care, you can protect your vision. This section provides general advice on eye health, how to use eye drops correctly, and when to seek medical attention.

Understanding Glaucoma: The Silent Thief of Sight

Netarsudil + Timolol is being explored for the treatment of glaucoma, specifically open-angle glaucoma. Glaucoma is a group of eye conditions that damage the optic nerve, the nerve that transmits visual information from your eye to your brain. This damage is often caused by abnormally high pressure inside your eye, known as intraocular pressure (IOP).

Open-angle glaucoma is the most common form. It’s often called the ‘silent thief of sight’ because it usually has no symptoms in its early stages. Vision loss typically begins with peripheral (side) vision, and by the time you notice changes, significant and irreversible damage may have already occurred. This is why regular comprehensive eye examinations, especially if you are over 40, have a family history of glaucoma, or have certain medical conditions like diabetes, are crucial for early detection and timely treatment.

While glaucoma cannot be cured, it can be managed effectively to prevent further vision loss. The primary goal of treatment is to lower the eye pressure to a safe level. This can be achieved through eye drops, laser treatment, or surgery. Consistent adherence to your prescribed treatment plan is vital for preserving your vision.

Correct Use and Hygiene for Eye Drops

Proper technique for instilling eye drops is essential to ensure the medicine works effectively and to prevent contamination. Here are some key points to remember:

• Always Wash Your Hands: Before touching your eyes or the eye drop bottle, wash your hands thoroughly with soap and water. This prevents germs from entering your eyes.
• Do Not Touch the Dropper Tip: The tip of the eye drop bottle is sterile. Avoid touching it with your fingers, eyes, eyelids, or any other surface. If the tip gets contaminated, it can introduce bacteria into the bottle and then into your eye, leading to infections.
• Administering the Drop: Tilt your head back, gently pull down your lower eyelid to form a pocket, and look up. Squeeze the bottle gently to release one drop into the pocket. Do not squeeze too hard.
• Gentle Closure and Punctal Occlusion: After instilling the drop, gently close your eye for 1-2 minutes. Avoid blinking or squeezing your eyes tightly. For medicines like Netarsudil + Timolol, which contain a beta-blocker, it is particularly important to gently press on the inner corner of your eye (near your nose) for 1-2 minutes. This technique, called punctal occlusion, helps to block the tear duct and reduce the amount of medicine absorbed into your bloodstream, minimising potential side effects on other parts of your body.
• Wipe Excess: Use a clean tissue to gently blot any excess liquid around your eye.
• Recap Immediately: Always replace the cap on the eye drop bottle immediately after use to keep the tip clean and prevent evaporation.
• Multiple Eye Drops: If you are prescribed more than one type of eye drop, wait at least 5-10 minutes between different medications. This ensures that each drop has enough time to be absorbed and prevents one drop from washing out another.
• Contact Lenses: If you wear contact lenses, remove them before applying eye drops unless specifically advised otherwise by your doctor. Wait at least 15 minutes after instilling the drops before reinserting your lenses. Some eye drop ingredients can be absorbed by soft contact lenses.

Storage and When to Seek Help

Proper storage and knowing when to contact your doctor are important aspects of managing your eye health.

• Storage: Store your eye drops as directed by your doctor or pharmacist. Generally, most eye drops should be stored at room temperature, away from direct sunlight and heat. Do not freeze them unless specifically instructed. Always check the expiry date on the bottle and discard any expired medicine. Once opened, eye drop bottles usually have a limited shelf life (often 28 days), even if there is still medicine left. Mark the opening date on the bottle to keep track.
• Hygiene: Never share your eye drops with anyone else, even if they have similar symptoms. This can spread infections.
• When to See a Doctor: While eye drops are generally safe, it’s important to be aware of potential issues. Contact your ophthalmologist immediately if you experience any of the following:
  • New or worsening eye pain, redness, or discomfort.
  • Sudden changes in vision, such as blurred vision, halos around lights, or flashes of light.
  • Increased sensitivity to light.
  • Any signs of an allergic reaction, such as severe itching, swelling of the eyelids, or difficulty breathing.
  • If you suspect your eye drops have become contaminated.
  • If you experience any new or unusual symptoms that you believe might be related to your eye drops, especially if you have asthma, COPD, or heart conditions, given the beta-blocker component.

Remember, your ophthalmologist at Pristine Eye Hospitals is your best resource for personalised advice and care. Do not hesitate to reach out with any questions or concerns.

Frequently asked questions

What is Netarsudil + Timolol used for?

Netarsudil + Timolol is an investigational combination eye drop used to treat open-angle glaucoma, a condition where high pressure inside the eye can damage the optic nerve and lead to vision loss.

How does Netarsudil + Timolol work?

This medicine combines two active ingredients. Netarsudil (a ROCK inhibitor) increases the outflow of fluid from the eye, while Timolol (a beta-blocker) reduces the production of fluid in the eye. Together, they help to lower the pressure inside the eye.

What are the common Indian brands for Netarsudil + Timolol?

Netarsudil + Timolol is currently an investigational medicine and is in the 'pipeline'. It is not yet routinely approved or available under specific brands in India. Your ophthalmologist can discuss approved alternatives.

How should I use Netarsudil + Timolol eye drops?

Netarsudil + Timolol eye drops are typically used once a day. After instilling the drop, it is important to gently press the inner corner of your eye for 1-2 minutes to reduce the absorption of the medicine into your body. Always follow your doctor's specific instructions.

Do I need a prescription for Netarsudil + Timolol?

Yes, this medicine is investigational and would require a prescription from an ophthalmologist. It is not currently approved or routinely available in India.

What are the key precautions I should take with Netarsudil + Timolol?

This medicine contains a beta-blocker that can be absorbed into the body. You must tell your doctor if you have asthma, COPD, a slow heart rate, or heart disease. Gently pressing the inner corner of your eye for 1-2 minutes after instilling helps reduce absorption. Do not stop using it suddenly without your doctor's advice. It is not currently approved or routinely available in India.

References

1. Glaucoma – National Eye Institute
2. What Is Glaucoma? – American Academy of Ophthalmology
3. Glaucoma – MedlinePlus
4. Blindness and vision impairment – World Health Organization
5. StatPearls – NCBI Bookshelf

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Medically reviewed by Dr. C Jagadesh Reddy, Chief Surgeon: Cornea, Cataract and Refractive Surgery — last reviewed 2026-07-28.

This page is for general education only and is not a substitute for professional medical advice, diagnosis or treatment. Never self-medicate or reuse an old prescription. Always consult a qualified ophthalmologist before starting, changing or stopping any eye medicine.