Provider Briefing: Timolol Supply Disruptions in 2026

Timolol maleate ophthalmic preparations — one of the most widely prescribed beta-blocker eye drops for glaucoma and ocular hypertension — continue to face supply disruptions heading into 2026. This briefing is designed to help ophthalmologists, optometrists, and other prescribers navigate the shortage, manage patient expectations, and identify practical alternatives.

For real-time availability tracking and clinical tools, visit Medfinder for Providers.

Shortage Timeline

The timolol shortage has unfolded over several phases:

• 2024–2025: Sandoz began reporting intermittent supply disruptions for timolol gel-forming ophthalmic solution (generic Timoptic-XE) in 0.25% and 0.5% concentrations. Manufacturing delays at sterile production facilities were cited as the primary cause.
• Mid-2025: Sandoz placed timolol gel-forming solution (5 mL bottles) on indefinite back order with no estimated release date. The ASHP Drug Shortage database flagged this as an active shortage.
• Late 2025–2026: Bausch Health also reported shortage of dorzolamide/timolol combination (generic Cosopt) due to manufacturing delays. The standard timolol ophthalmic solution has been more consistently available through Apotex and other generic manufacturers.

Prescribing Implications

The shortage has several clinical implications for prescribers to consider:

Formulation Availability Varies

Not all timolol products are equally affected. Understanding which formulations are available — and which are not — is critical for prescribing decisions:

• Timolol ophthalmic solution (0.25%, 0.5%): Most widely available. Apotex and other manufacturers are currently supplying. This should be the default prescription during the shortage.
• Timolol gel-forming solution (0.25%, 0.5%): In shortage (Sandoz back order, no ETA). Avoid prescribing unless patient already has a confirmed supply source.
• Timoptic in Ocudose (preservative-free): Available through Bausch + Lomb but at significantly higher cost ($69–$285). Bausch + Lomb Access Program copay card available for eligible patients.
• Dorzolamide/timolol combination: Supply recovering but may still be intermittent at some pharmacies.

Switching Gel-Forming to Standard Solution

Patients currently on timolol gel-forming solution (once-daily dosing) may need to transition to the standard solution (twice-daily dosing). Key considerations:

• Ensure patient understands the dosing change (once daily → twice daily)
• Review compliance history — patients who struggle with twice-daily dosing may benefit from switching to a prostaglandin analog instead
• Schedule a follow-up IOP check 4–6 weeks after any formulation change

Current Availability Picture

Based on ASHP and manufacturer reports as of early 2026:

• Available: Timolol ophthalmic solution (Apotex, other generics), Timoptic in Ocudose (Bausch + Lomb)
• Shortage/Back order: Timolol gel-forming solution (Sandoz — no ETA), Dorzolamide/timolol (Bausch Health — recovering)
• Oral timolol tablets: Not affected by the shortage. Available from multiple manufacturers.

For real-time stock checking across pharmacies, direct patients to Medfinder or use Medfinder for Providers to assist in your workflow.

Cost and Access Considerations

Cost should factor into prescribing decisions, especially for uninsured patients or those with high-deductible plans:

• Generic timolol solution: Retail ~$35; as low as $3.67 with discount card (GoodRx, SingleCare)
• Timoptic in Ocudose: $69–$285 — Bausch + Lomb Access Program copay card may reduce out-of-pocket costs
• Generic latanoprost: $5–$15 with coupon — an affordable first-line alternative

Most insurance plans cover generic timolol as a Tier 1 preferred generic with minimal copay. Brand-name formulations may require prior authorization.

For a patient-facing resource on savings options, share: How to save money on timolol.

Tools and Resources for Providers

• Medfinder for Providers — Real-time pharmacy stock search tool to help locate medications for patients
• ASHP Drug Shortage Database — Official shortage listings with manufacturer updates
• FDA Drug Shortage Database — Federal shortage tracking and manufacturer communications
• Bausch + Lomb Access Program — Copay card for Timoptic in Ocudose (up to 12 fills/year)

Recommended Alternatives

When timolol is unavailable, consider these evidence-based alternatives based on patient profile:

• Latanoprost (Xalatan generic): Prostaglandin analog, first-line for most patients. Once-daily dosing. Well-tolerated. Widely available and affordable.
• Betaxolol (Betoptic generic): Selective beta-1 blocker. Preferred for patients with asthma/COPD who need a beta-blocker mechanism. Twice-daily dosing.
• Dorzolamide (Trusopt generic): Carbonic anhydrase inhibitor. Good add-on therapy. Three-times-daily or twice-daily dosing.
• Brimonidine (Alphagan generic): Alpha-2 agonist. Dual mechanism (reduces production + increases outflow). Two-to-three-times-daily dosing. Avoid in young children.

For detailed alternative comparisons, see: Alternatives to timolol.

Looking Ahead

The timolol gel-forming solution shortage is expected to continue through at least the first half of 2026, as Sandoz has provided no resupply estimate. The standard solution supply appears stable for now but could be strained if gel-forming patients all switch over.

Proactive steps for your practice:

1. Audit your patient panel for those on the gel-forming solution and proactively reach out to discuss alternatives
2. Update EMR prescribing defaults to the standard solution during the shortage
3. Educate clinical staff on the shortage so they can triage patient calls effectively
4. Consider building a brief patient handout explaining the situation and linking to the patient shortage update

Final Thoughts

The timolol shortage requires proactive management from prescribers. By understanding which formulations are available, having a clear alternative strategy, and leveraging tools like Medfinder for Providers, you can minimize disruption to your patients' care and protect their long-term vision outcomes.

For a practical guide on helping patients locate timolol, see: How to help your patients find timolol in stock.