betaxolol ophthalmic, Betoptic S, Betoptic
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: betaxolol ophthalmic solution
BRAND NAMES: Betoptic, Betoptic S
DRUG CLASS AND MECHANISM: Betaxolol is a beta-adrenergic blocking agent that is used for the treatment of glaucoma. When taken by mouth, betaxolol and other beta-adrenergic blocking agents act mainly by blocking the action of the sympathetic (adrenergic) nervous system, for example, on the heart. In addition to its effect on the heart, betaxolol reduces the pressure within the eye (intraocular pressure). This effect is thought to be caused by reducing the production of the liquid (called the aqueous humor) within the anterior chamber of the eye although the precise mechanism of its effect is not known. The reduction in intraocular pressure reduces the risk of damage to the optic nerve and loss of vision in patients with elevated intraocular pressure due to glaucoma. Betaxolol was approved by the U.S. Food and Drug Administration for ocular use as a 0.5% solution (Betoptic) in 1985 and as a 0.25% solution (Betoptic S) in 1989.
GENERIC AVAILABLE: Yes
PREPARATIONS: Ophthalmic solution/suspension: 0.25%, 0.5%
STORAGE: These ophthalmic solutions should be kept upright at room temperature, 15 C to 30 C (59 F to 86 F) and protected from direct sunlight. They should be well shaken before each use.
PRESCRIBED FOR: Betaxolol is used for the treatment of increased intraocular pressure in patients with chronic open-angle glaucoma or ocular hypertension. (Oral betaxolol tablets are used for treating high blood pressure and angina, but this dosage form is not discussed here.)
DOSING: Both hands should be washed before each use of betaxolol or any other eye medication. The head should be tilted back and the lower lid pulled down with the index finger to form a pouch. The tip of the squeeze bottle should not be touch the eye or eyelid and become contaminated. The bottle should be squeezed slightly to allow the prescribed number of drops into the pouch. The eye is closed gently for 1 to 2 minutes without blinking. The usual dose is 1 drop in each affected eye twice daily. Safe use of beta blockers has been demonstrated in pediatric patients.
DRUG INTERACTIONS: Combined use of betaxolol ophthalmic solution with oral beta- adrenergic blocking agents, for example, propranolol (Inderal), atenolol (Tenormin), metoprolol (Lopressor) or carvedilol (Coreg) can result in additive effects. Thus, patients may experience excessively low blood pressure or reductions in heart rate.
PREGNANCY: It is unknown if the small amount of betaxolol that is absorbed into the blood after administration into the eye affects the fetus. Safe use of betaxolol during pregnancy has not been established.
NURSING MOTHERS: It is not known whether betaxolol is excreted into breast milk. Safe use of betaxolol during nursing thus has not been established.
SIDE EFFECTS: Ophthalmic betaxolol can cause side effects which are usually mild and transient. The most common side effect is transient ocular (temporary eye) discomfort. Blurred vision, itching, swelling, eye pain, and dryness may occur. Rarely, betaxolol eye drops can result in side effects that are seen with oral beta-adrenergic blockers. For example, persons can experience fatigue, insomnia, nausea, dizziness, lightheadedness, depression, slow heart rate, low blood pressure, cold extremities, and shortness of breath or wheezing.
Reference: FDA Prescribing Information
Last Editorial Review: 3/19/2013
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