A patient who has migraine headaches has begun taking timolol and 2 months after beginning this therapy reports no change in frequency of migraines.The patient's current dose is 30 mg once daily.The primary care NP should:

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When giving timolol for migraine prophylaxis,the provider should inform the patient that it may take several weeks for therapy to be effective.The dose should be titrated and maintained for a minimum of 3 months before the treatment is deemed a failure.It may be necessary to change to propranolol if the therapy is not effective in 1 month.The maximum dose of timolol for migraine prophylaxis is 30 mg.Drug effectiveness is determined by patient response,not serum drug levels.

A Patient Who Has Migraine Headaches Has Begun Taking Timolol