Betoptic S (betaxolol hydrochloride ophthalmic) Side Effects, Warnings, and Drug Interactions

Betoptic S (betaxolol hydrochloride ophthalmic) is a beta-adrenergic blocking agent (beta-blocker) used to treat glaucoma. When taken orally, beta-blockers 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 pressure within the eye (intraocular pressure). This effect is thought to be caused by reducing the production of the liquid (aqueous humor) within the anterior chamber of the eye although the mechanism of its effect is unknown. 

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. 

Common side effects of Betoptic S include:

• temporary eye discomfort or irritation,
• blurred vision,
• itching,
• swelling,
• eye pain,
• eye dryness,
• blurred vision,
• feeling like something is in the eye, and
• increased sensitivity to light.

Serious side effects of Betoptic S include: 

• bronchospasm (wheezing, chest tightness, trouble breathing),
• shortness of breath while lying down,
• chest pain,
• cough with foamy mucus,
• swelling,
• rapid weight gain,
• drooping eyelids, and
• muscle weakness in the arms or legs.

Drug interactions of Betoptic S include oral beta-adrenergic receptor inhibitors, which can have a potential additive effect. Betoptic S taken with catecholamine-depleting drugs may cause possible additive effects and the production of low blood pressure and slow heart rate. Betoptic S is an adrenergic receptor inhibitor and should be used cautiously in patients using concomitant adrenergic psychotropic drugs. 

There are no adequate and well-controlled studies of Betoptic S in pregnant women. Betoptic S should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if Betoptic S is excreted into breast milk. Safe use of Betoptic S while breastfeeding has not been established.

Common side effects of Betoptic S include:

• temporary eye discomfort or irritation,
• blurred vision,
• itching,
• swelling,
• eye pain,
• eye dryness,
• blurred vision,
• feeling like something is in the eye, and
• increased sensitivity to light.

Serious side effects of Betoptic S include: 

• bronchospasm (wheezing, chest tightness, trouble breathing),
• shortness of breath while lying down,
• chest pain,
• cough with foamy mucus,
• swelling,
• rapid weight gain,
• drooping eyelids, and
• muscle weakness in the arms or legs.

Ophthalmic betaxolol can cause side effects which are usually mild and transient. The most common side effects are:

• transient ocular (temporary eye) discomfort,
• blurred vision,
• itching,
• swelling, eye pain, and
• dryness.

Rarely, betaxolol eye drops can result in side effects that are seen with oral beta-adrenergic blockers. Other important side effects include:

• fatigue,
• insomnia,
• nausea,
• dizziness,
• lightheadedness,
• depression,
• slow heart rate,
• low blood pressure,
• cold extremities, and
• shortness of breath, or
• wheezing.

Oral Beta-Adrenergic Receptor Inhibitors

Patients who are receiving a beta-adrenergic receptor inhibitor orally and betaxolol ophthalmic should be observed for a potential additive effect either on the intraocular pressure or on the known systemic effects of beta blockade.

Catecholamine-Depleting Drugs

Close observation of the patient is recommended when a beta–adrenergic receptor inhibitor is administered to patients receiving catecholamine-depleting drugs such as reserpine, because of possible additive effects and the production of hypotension and/or bradycardia which may result in vertigo, syncope, or postural hypotension.

Concomitant Adrenergic Psychotropic Drugs

Betaxolol is an adrenergic receptor inhibitor; therefore, exercise caution in patients using concomitant adrenergic psychotropic drugs.