Your Patients Can't Find Timolol — Here's How You Can Help

If your office has been fielding calls from patients unable to fill their timolol prescriptions, you're not alone. The ongoing shortage of certain timolol ophthalmic formulations has created a real clinical challenge for eye care providers. Patients are anxious, pharmacies are out of stock, and the burden of solving the problem often falls on the prescribing provider.

This guide provides a practical, step-by-step framework for helping your patients find timolol — or an appropriate alternative — while the shortage continues.

For provider-specific tools, visit Medfinder for Providers.

Current Timolol Availability

Understanding the supply landscape is essential before advising patients:

• Standard ophthalmic solution (0.25%, 0.5%): Generally available. Manufactured by Apotex and other generics. This is the most accessible formulation right now.
• Gel-forming solution (generic Timoptic-XE): In shortage. Sandoz has this on indefinite back order with no estimated resupply date.
• Preservative-free solution (Timoptic in Ocudose): Available through Bausch + Lomb, but significantly more expensive ($69–$285).
• Dorzolamide/timolol combination: Supply improving after Bausch Health manufacturing delays, but may still be spotty at some pharmacies.

For the full shortage timeline and analysis, see: Timolol shortage: What providers need to know in 2026.

Why Patients Can't Find Timolol

Patients face several barriers beyond simple stock issues:

• Pharmacy defaults: Many pharmacy systems auto-select a specific NDC or manufacturer. If that manufacturer is the one in shortage, the system may show "unavailable" even if another manufacturer's product could be dispensed.
• Formulation confusion: Patients may not realize there are multiple timolol formulations. They report "timolol is unavailable" when what's actually unavailable is the gel-forming version.
• Limited pharmacy shopping: Most patients only check one or two pharmacies before giving up or calling your office.
• Insurance restrictions: Some plans may require step therapy or have preferred NDCs that happen to be from the manufacturer in shortage.

What Providers Can Do: 5 Steps

Step 1: Clarify Which Formulation the Patient Needs

Before troubleshooting, confirm which timolol product the patient is using:

• Is it the standard solution (twice daily) or gel-forming solution (once daily)?
• Do they need preservative-free (e.g., for severe dry eye or preservative sensitivity)?
• Are they on the combination dorzolamide/timolol product?

Many patients on the gel-forming solution can be switched to the standard solution with a dosing adjustment. This single change resolves the availability issue for a large portion of affected patients.

Step 2: Direct Patients to Medfinder

Recommend Medfinder as a first step for patients. The platform allows them to search for pharmacies with timolol in stock by zip code, saving time and reducing the number of calls to your office.

Consider adding a note to your after-visit summary or patient portal: "If you have trouble filling your timolol prescription, visit medfinder.com to search for pharmacies with it in stock."

Step 3: Write Prescriptions for the Available Formulation

If the patient's current formulation is in shortage, proactively write a new prescription for the available one. For patients switching from gel-forming to standard solution:

• Change dosing from once daily to twice daily
• Counsel on proper instillation technique, including nasolacrimal occlusion to minimize systemic absorption
• Schedule a follow-up IOP check in 4–6 weeks

Step 4: Suggest Independent and Specialty Pharmacies

Advise patients that independent pharmacies often source from different wholesalers and may have stock when chain pharmacies don't. If your practice has relationships with local independent pharmacies or ophthalmic specialty pharmacies, provide those names directly.

Step 5: Have an Alternative Ready

For patients who cannot find any timolol formulation, have a pre-planned alternative protocol. Based on patient profile:

• Most patients: Latanoprost 0.005% once daily at bedtime — first-line efficacy, widely available, affordable ($5–$15 with coupon)
• Patients with asthma/COPD who need beta-blocker: Betaxolol 0.5% twice daily
• Patients needing add-on therapy: Dorzolamide 2% or brimonidine 0.1–0.2%
• Combination therapy patients: Consider separate components if the combination product is unavailable

Alternatives at a Glance

• Latanoprost (generic Xalatan): Prostaglandin analog. Once daily. 25–35% IOP reduction. Widely available. $5–$15 with coupon.
• Betaxolol (generic Betoptic): Selective beta-1 blocker. Twice daily. Safer for respiratory disease. Available generic.
• Dorzolamide (generic Trusopt): CAI. Two to three times daily. Good add-on. Available generic.
• Brimonidine (generic Alphagan): Alpha-2 agonist. Two to three times daily. Dual mechanism. Avoid in young children.

For a patient-facing comparison, share: Alternatives to timolol if you can't fill your prescription.

Workflow Tips for Your Practice

Here are a few ways to reduce the burden on your team during the shortage:

• Create a shortage protocol: Document your preferred alternative pathway so clinical staff can triage patient calls without requiring a provider callback for every request.
• Proactive outreach: Run a report of patients on timolol gel-forming solution and reach out before they run out. A simple patient portal message can prevent dozens of urgent calls.
• Update EMR favorites: Temporarily add the standard timolol solution and latanoprost to your quick-prescribe list.
• Staff script: Give front desk and triage staff a brief script for timolol shortage calls: "We're aware of the shortage. Let me check with the provider about an alternative or a different formulation. In the meantime, you can check medfinder.com to see which pharmacies have it in stock."
• Track the shortage: Assign someone to monitor the ASHP Drug Shortage database monthly for updates on timolol.

Final Thoughts

The timolol shortage is an operational challenge, but with a systematic approach, you can minimize disruption to patient care. The key steps are: clarify the formulation, switch to what's available, leverage tools like Medfinder for Providers, and have alternatives ready.

Your patients trust you to keep their vision safe. By staying ahead of the shortage, you'll reinforce that trust and ensure continuity of care.

For the latest shortage data, see: Timolol shortage: What providers and prescribers need to know in 2026.

For patient-facing resources to share, see: Timolol shortage update: What patients need to know.