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Timolol Maleate/Bendroflumethiazide

Prestim is a combination drug used to lower high blood pressure. It contains two types of active ingredient: a diuretic, and a beta-blocker.

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PLEASE NOTE: This treatment is not available through our online pharmacy service. This page is for information only. If you are experiencing any of the symptoms related to the condition(s) this medication treats, we strongly recommend that you see your GP in person.

This content was reviewed by a clinician on

23 September 2020
dr daniel

Dr Daniel Atkinson

(GP Clinical Lead - GMC No. 4624794) 23 September 2020
Product information

Prestim is a drug used in the treatment of mild to moderate cases of high blood pressure. It contains two active constituents: a diuretic called bendroflumethiazide; and a beta-blocker called timolol maleate. Prestim is made by Meda Pharmaceuticals and is supplied in the form of a tablet.

  1. Effective at relieving high blood pressure
  2. Branded tablet from Meda
  3. Simple to take one- or two-a-day dose

High blood pressure is a condition which doesn’t produce any immediate noticeable effects, meaning that those who have it are not always likely to realise that they do. It is, in fact, very common, and is thought to affect over one in four people in the UK. One of the main health risks associated with high blood pressure when left untreated is cardiovascular disease, such as stroke, heart attack, and angina.

During a blood pressure check, levels will be gauged with a device which uses a mercury-lined meter. The blood pressure figure is therefore given as reading of millimetres of mercury (mmHg). A reading contains two numbers, and these are measurements of systolic and diastolic pressure.

Systolic pressure defines the amount of force the heart needs to use when pumping blood out during a beat; whereas diastolic pressure is the space between beats, and provides an indication of the resistant pressure in the arteries. For example, a reading might be 120 (systolic) over 80 (diastolic). In cases where this reading is 140 over 90 or above, high blood pressure is said to be present.

There is no one single cause of the condition, but it is much more likely to occur in those who are older. Certain lifestyle factors can increase a person’s susceptibility to high blood pressure, including having a high salt intake, smoking, drinking too much alcohol, not doing enough physical exercise, and being overweight. In some instances, persons who have a family member with the condition may also be more prone to encountering it themselves.

One of the first courses of action a doctor may suggest is to address any potential contributing behaviours. They may, for instance, advise a patient to drink less alcohol, stop smoking, or change their diet and exercise regimen to help combat high blood pressure. But for some, these measures may not be enough to help lower levels, and treatment may be recommended.

Containing two functioning constituents, Prestim is a tablet which can help to relieve non-severe instances of high blood pressure. Timolol, which is a beta-blocker, works by inhibiting the action of certain hormones which can cause the heart to beat with more force. In doing this, it helps to reduce blood pressure.

The other ingredient is bendroflumethiazide, which is a type of drug called a diuretic. This works by increasing the rate at which the liver draws out salt from the blood, before transferring it into the urine. As this salt is extracted, it carries water alongside it. This lowers the presence of water in the blood, and also causes blood pressure to fall.

Please note that this item is not available to buy through our site.

Page last reviewed:  23/09/2020


Before using this product, make sure you have familiarised yourself with the instructions in the patient information leaflet. During application, you should also follow the directions supplied by your prescribing doctor. These measures will help you to reduce the likelihood of potential side effects and get the best possible results out of your medication.

  1. Take as directed.
  2. A typical dose will be between one and four tablets per day.
  3. This may be taken as one dose, or split into two doses (one morning, and one evening).
  4. Swallow whole with a glass of water.
  5. You may be required to have your blood pressure monitored at regular intervals during use.
  6. Never take more than the amount specified by your prescribing doctor.
  7. Do not make up for a missed dose with a double administration. If you forget your dose, simply skip it and take your next one as scheduled, carrying on the course as before.

The above directions are only intended as a guide. For more detailed instructions, please consult the accompanying leaflet.

Page last reviewed:  23/09/2020
Please read the patient information leaflet for this medicine fully before use:

Prestim 2.5mg/10mg

Side effects & Warnings

Side effects

Side effects

Although they may not affect all who use it, it is still important to be aware of the side effects associated with this product. Some may necessitate immediate medical assistance. Tell your doctor right away if you notice any signs of: severe abdominal pain and vomiting; an allergic reaction; inflammation of the blood vessels with small red or purple skin lesions on the legs, hands, or elsewhere, or blue fingers or toes; skin rash; visual disturbances; or dry eyes.

Other side effects: 

Stomach upset, dizziness, tiredness, depression, weakness, insomnia, breathing difficulties, decreased heartbeat or other heart problems, tired or painful muscles, feeling thirsty, lowered urinary frequency, poor blood circulation, low blood pressure, pins and needles, tingling in the hands or feet, a worsening of any problems with blood circulation in your legs or erection problems, joint pain, feeling sick or being sick, diarrhoea, headaches, depression, hallucinations, confusion or other mental problems.

This is not a complete list of side effects. A more detailed account can be found in the leaflet supplied.


Taking it with other medicines

This item may not be suitable for use in conjunction with other treatments. Let your prescriber know if you are using any other prescription, non-prescription or remedial products.

Prestim may interact with the following: high blood pressure drugs such as lignocaine, tocainide, diltiazem, quinidine, verapamil, disopyramide, amiodarone, clonidine, digitalis glycosides, hydralazine, dihydropyridine derivatives or class I antiarrhythmic agents; any items which affect the QT interval of the heart, including astemizole, terfenadine, halofantrine, pimozide and sotalol; antidepressants such as lithium, tricyclic antidepressants, monoamine oxidase inhibitors or phenothiazines; barbiturates; cimetidine; rifampicin; tetracyclines; some painkillers such as ibuprofen and aspirin; steroids; theophylline; sympathomimetic agents, for example salbutamol or isoprenaline; insulin or antidiabetic drugs; or certain anaesthetics such as ether, cyclopropane, or trichloroethylene.

Conditions to look out for

Do not use Prestim Tablets if you have any of the following: bronchial asthma or chronic lung disease; a history of wheezing or asthma; serious kidney or liver problems; difficulty urinating; lower blood levels than is normal of potassium or sodium; high uric acid levels in your blood; Addison’s disease; uncontrolled heart failure, a very slow heart rate, other heart problems or Prinzmetal’s angina; low blood pressure or problems with blood circulation; phaeochromocytoma; or metabolic acidosis.

It may also not be safe for those who have or have ever had: diabetes; hypoglycaemia; heart, liver or kidney problems; portal hypertension; higher than normal potassium, sodium or calcium levels in the blood; swelling in the ankles, hands or eyes; kidney problems; hyperaldosteronism; myasthenia gravis; an overactive thyroid gland; gout; systemic lupus erythematosus; or psoriasis.

Pregnancy and breastfeeding

This medicine should not be taken during pregnancy, and may not be suitable for use during breastfeeding. If you are pregnant, planning to become pregnant, or are breastfeeding, speak to your GP about other more suitable treatment options.

Driving and using machinery

Possible side effects of this treatment include dizziness and tiredness. Do not drive or use machinery if you are affected by these.

Food, drink or alcohol

Excessive alcohol consumption should be avoided when taking this medication.

Page last reviewed:  23/09/2020
Please read the patient information leaflet for this medicine fully before use:

Prestim 2.5mg/10mg


Can I still drink alcohol?

It is recommended that you do not drink large amounts of alcohol while taking this product.

Will I still be able to drive?

Yes, but only if you are able to use it without experiencing side effects. If you notice anything which may impair or hinder your ability to drive, you should not drive and let your doctor know right away.

Can I take the medicine while pregnant?

It is not suitable for women who are pregnant, and those who are breastfeeding should let their prescriber know during consultation, as they may need to suggest another form of treatment.

How should I store it?

In a safe place below 25°C.

Am I allergic to anything in the medicine?

Prestim contains the following: timolol maleate, bendroflumethiazide, microcrystalline cellulose, pregelatinised starch and magnesium stearate. Do not use it if you are allergic to any of these ingredients.

Is it available over-the-counter?

No. You will need a prescription for Prestim.

Is it right for me?

If your high blood pressure does not respond to lifestyle changes, a prescription for the most suitable medication will be started by your GP following a face-to-face consultation.

Please note that this medication is not available to buy through our site.

Page last reviewed:  23/09/2020
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