Several oral β-blockers are US Food and Drug Administration–approved for migraine prophylaxis, but their gradual absorption and modification by first-pass metabolism delays effective plasma levels for hours to days, limiting their use in acute migraines.1 Timolol eyedrops provide a rapid route of delivery with the maximum plasma concentration achieved within 15 minutes of administration.2,3 This pharmacokinetic advantage supports a potential role for timolol eyedrops in managing acute migraine.4,5
Cossack M, Nabrinsky E, Turner H, Abraham A, Gratton S. Timolol Eyedrops in the Treatment of Acute Migraine Attacks: A Randomized Crossover Study. JAMA Neurol. 2018;75(8):1024–1025. doi:10.1001/jamaneurol.2018.0970
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