Timolol Gel for Epistaxis in Hereditary Hemorrhagic Telangiectasia

This study is a double-blinded, placebo-controlled, 8-week randomized clinical trial investigating the efficacy of timolol gel in the management of epistaxis in adults with HHT. The Specific Aims are to determine in adults with HHT-associated epistaxis: 1. If topical timolol gel is more effective than placebo in reducing the frequency and severity of epistaxis. 2. If topical timolol gel is more effective than placebo in improving hemoglobin levels. 3. The frequency of adverse events, side effects, and safety profile of topical timolol gel delivered to the nasal mucosa.