Classes
DEA Class; Rx
Common Brand Names; Betagan, AKBeta
- Antiglaucoma, Beta-Blockers
Description
Ophthalmic, nonselective beta-blocker
Used to lower intraocular pressure in open-angle glaucoma or ocular hypertension
Bronchospasm may occur in patients with underlying pulmonary disease; bradycardia is possible with significant systemic absorption
Indications
Indicated for the treatment of chronic open-angle glaucoma or ocular hypertension.
Contraindications
Asthma, uncompensated CHF, any beta-blocker side effects, COPD, sinus bradycardia, 2°/3° AV block, hypersensitivity
Cardiogenic shock or with overt cardiac failure not adequately compensated (eg, treated with cardiac glycosides &/or diuretics)
Adverse Effects
- Mild ocular stinging
- Ataxia
- Burning
- Lethargy
- Discomfort
- Band keratopathy
- Respiratory failure
- Blepharitis
- Impotence
- Blepharoconjunctivitis
- Conjunctivitis
- Decreased visual acuity
- Erythema
- Iridocyclitis
- Itching sensation
- Decreased corneal sensitivity
- Tearing
- Urticaria
- Paresthesia
- Ptosis
- Cerebral ischemia
- Decreased blood pressure
- Hypersensitivity reactions
- Heart block
- Syncope
- Reduction of resting heart rate
Warnings
Caution on inadequate cardiac function, latent cardiac insufficiency, cerebrovascular insufficiency, sick sinus syndrome, peripheral vascular disease, history of psychiatric illness, heart failure, diminished pulmonary function, nonallergic bronchospasm, diabetes mellitus, myasthenia gravis
Ophthalmic beta-blockers may impair compensatory tachycardia and increase risk of hypotension
Patients receiving topical levobunolol & a systemic ß-adrenergic blocking agent concomitantly should be observed carefully for potential additive effects on IOP &/or systemic effects of ß-adrenergic blockade
May mask signs of hyperthyroidism (ie, tachycardia)
May potentiate syndromes associated with vascular insufficiency (i.e. Raynaud’s phenomenon); use with caution
Choroidal detachment after filtration procedures reported with administration of aqueous suppressant therapy
Preservative benzalkonium chloride may be absorbed by soft contact lenses; patients wearing soft (hydrophilic) contact lenses should be instructed to remove contact lenses before administration of the solution and wait at least 15 minutes after instilling therapy before reinserting soft contact lenses
Use with a miotic in angle-closure glaucoma
Pregnancy and Lactation
There are no adequate and well-controlled studies in pregnant women; ophthalmic solution should be used during pregnancy only if potential benefit justifies potential risk to fetus
It is not known whether drug is excreted in human milk; systemic beta-blockers and topical timolol maleate are known to be excreted in human milk; exercise caution when administered to a nursing woman
Maximum Dosage
4 drops/day of 0.25% solution or 2 drops/day of 0.5% solution per affected eye.
4 drops/day of 0.25% solution or 2 drops/day of 0.5% solution per affected eye.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Levobunolol hydrochloride
ophthalmic solution
- 0.25%
- 0.5%