Drugs List

Therapeutic Indications

Uses

Treatment of elevated intraocular pressure in chronic open-angle glaucoma
Treatment of elevated intraocular pressure in ocular hypertension

Contraindications

Sinus node dysfunction
Cardiogenic shock
Second degree atrioventricular block
Severe asthma
Severe chronic obstructive pulmonary disease
Sinoatrial exit block
Sinus bradycardia
Third degree atrioventricular block
Uncontrolled cardiac failure

Precautions and Warnings

Atopy
Children under 18 years
General anaesthesia
History of allergies including anaphylaxis
Asthma
Breastfeeding
Cardiac failure
Corneal disorder
Coronary arteriosclerosis
Diabetes mellitus
First degree atrioventricular block
History of bronchospasm
Hyperthyroidism
Hypotension
Myasthenia gravis
Obstructive pulmonary disease
Pregnancy
Prinzmetal's angina
Raynaud's syndrome
Severe peripheral circulatory disorder
Sjogren's syndrome
Uncontrolled phaeochromocytoma

Advise diabetic patients that hypoglycaemic symptoms may be reduced/altered
Give concurrent miotic treatment if used to treat narrow angle glaucoma
May mask symptoms of hyperthyroidism
May unmask the symptoms of myasthenia gravis
Advise ability to drive/operate machinery may be affected by side effects
Advise patient blurred vision may affect ability to drive/operate machinery
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Monitor patient with history of severe cardiac disease for signs of failure
Beta blockers may reduce the response to adrenaline in anaphylaxis
Systemic absorption & adverse effects of systemic beta blockers may occur
Consider gradual withdrawal of treatment prior to general anaesthesia
Do not withdraw this drug suddenly
Discontinue at the first signs of cardiac failure
Not licensed for use in children under 18 years
Advise patient to avoid touching the eye/other surfaces with container tip
If soft contact lenses worn,insert them 15 minutes after using eye drops

Pregnancy and Lactation

Pregnancy

Use betaxolol eye drops with caution during pregnancy.

The manufacturer advises that betaxolol eye drops should not be used during pregnancy unless clearly necessary.

The administration of beta-blockers via the oral route may increase a risk of intra-uterine growth retardation and cause signs and symptoms of beta-blockade in the neonate.

Newborns exposed to betaxolol suspension should be monitored during the first days of life.

Closing eyelids for 2 minutes and using nasolacrimal occlusion can help reduce the systemic absorption.

Lactation

Use betaxolol eye drops with caution during breastfeeding.

The manufacturer advises caution if betaxolol eye drops are used when breastfeeding.

Betaxolol is excreted in breast milk.

When betaxolol is used ophthalmically, plasma levels and subsequent levels in breast milk are likely to be low, but if used during nursing, the infant should be closely observed for hypotension, bradycardia and other signs or symptoms of beta-blockade.

Compression of the lacrimal sac after ocular administration may further reduce systemic absorption.

Side Effects

Abdominal pain
Allergic reaction
Alopecia
Anaphylaxis
Angioedema
Anisocoria
Anxiety
Arrhythmias
Asthenia
Asthma
Atrioventricular block
AV conduction disorders
Blepharitis
Blepharospasm
Blurred vision
Bradycardia
Bronchospasm
Cardiac arrest
Cardiac failure
Cerebral ischaemia
Cerebrovascular accident
Chest pain
Choroidal detachment (following filtration surgery)
Cold extremities
Confusion
Congestive cardiac failure
Corneal disorders
Corneal staining
Cough
Cyanosis of extremities
Decreased corneal sensitivity
Depression
Dermatitis
Diarrhoea
Diplopia
Dizziness
Dry eyes
Dry mouth
Dysgeusia
Dyspepsia
Dyspnoea
Erythema
Exacerbation of intermittent claudication
Exacerbation of myasthenia gravis
Exacerbation of psoriasis
Eye pain
Fatigue
Gastro-intestinal symptoms
Hallucinations
Headache
Hypoglycaemia
Hypotension
Impaired vision
Impotence
Increased atrioventricular block
Insomnia
Itching
Keratitis
Memory loss
Myalgia
Nausea
Nightmares
Ocular discharge
Ocular discomfort
Ocular hyperaemia
Ocular itching
Oedema
Palpitations
Paraesthesia
Photophobia
Pruritus
Psychoses
Ptosis
Rash
Raynaud's syndrome
Reduced libido
Rhinitis
Rhinorrhoea
Sexual dysfunction
Syncope
Tearing
Urticaria
Vomiting

Presentation

Eye drops containing betaxolol (preservative-free).

Drugs List

Therapeutic Indications

Uses

Treatment of elevated intraocular pressure in chronic open-angle glaucoma
Treatment of elevated intraocular pressure in ocular hypertension

Dosage

Adults

Children

Contraindications

Sinus node dysfunction
Cardiogenic shock
Second degree atrioventricular block
Severe asthma
Severe chronic obstructive pulmonary disease
Sinoatrial exit block
Sinus bradycardia
Third degree atrioventricular block
Uncontrolled cardiac failure

Precautions and Warnings

Atopy
Children under 18 years
General anaesthesia
History of allergies including anaphylaxis
Asthma
Breastfeeding
Cardiac failure
Corneal disorder
Coronary arteriosclerosis
Diabetes mellitus
First degree atrioventricular block
History of bronchospasm
Hyperthyroidism
Hypotension
Myasthenia gravis
Obstructive pulmonary disease
Pregnancy
Prinzmetal's angina
Raynaud's syndrome
Severe peripheral circulatory disorder
Sjogren's syndrome
Uncontrolled phaeochromocytoma

Advise diabetic patients that hypoglycaemic symptoms may be reduced/altered
Give concurrent miotic treatment if used to treat narrow angle glaucoma
May mask symptoms of hyperthyroidism
May unmask the symptoms of myasthenia gravis
Advise ability to drive/operate machinery may be affected by side effects
Advise patient blurred vision may affect ability to drive/operate machinery
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Monitor patient with history of severe cardiac disease for signs of failure
Beta blockers may reduce the response to adrenaline in anaphylaxis
Systemic absorption & adverse effects of systemic beta blockers may occur
Consider gradual withdrawal of treatment prior to general anaesthesia
Do not withdraw this drug suddenly
Discontinue at the first signs of cardiac failure
Not licensed for use in children under 18 years
Advise patient to avoid touching the eye/other surfaces with container tip
If soft contact lenses worn,insert them 15 minutes after using eye drops

Pregnancy and Lactation

Pregnancy

Use betaxolol eye drops with caution during pregnancy.

The manufacturer advises that betaxolol eye drops should not be used during pregnancy unless clearly necessary.

The administration of beta-blockers via the oral route may increase a risk of intra-uterine growth retardation and cause signs and symptoms of beta-blockade in the neonate.

Newborns exposed to betaxolol suspension should be monitored during the first days of life.

Closing eyelids for 2 minutes and using nasolacrimal occlusion can help reduce the systemic absorption.

Lactation

Use betaxolol eye drops with caution during breastfeeding.

The manufacturer advises caution if betaxolol eye drops are used when breastfeeding.

Betaxolol is excreted in breast milk.

When betaxolol is used ophthalmically, plasma levels and subsequent levels in breast milk are likely to be low, but if used during nursing, the infant should be closely observed for hypotension, bradycardia and other signs or symptoms of beta-blockade.

Compression of the lacrimal sac after ocular administration may further reduce systemic absorption.

Side Effects

Abdominal pain
Allergic reaction
Alopecia
Anaphylaxis
Angioedema
Anisocoria
Anxiety
Arrhythmias
Asthenia
Asthma
Atrioventricular block
AV conduction disorders
Blepharitis
Blepharospasm
Blurred vision
Bradycardia
Bronchospasm
Cardiac arrest
Cardiac failure
Cerebral ischaemia
Cerebrovascular accident
Chest pain
Choroidal detachment (following filtration surgery)
Cold extremities
Confusion
Congestive cardiac failure
Corneal disorders
Corneal staining
Cough
Cyanosis of extremities
Decreased corneal sensitivity
Depression
Dermatitis
Diarrhoea
Diplopia
Dizziness
Dry eyes
Dry mouth
Dysgeusia
Dyspepsia
Dyspnoea
Erythema
Exacerbation of intermittent claudication
Exacerbation of myasthenia gravis
Exacerbation of psoriasis
Eye pain
Fatigue
Gastro-intestinal symptoms
Hallucinations
Headache
Hypoglycaemia
Hypotension
Impaired vision
Impotence
Increased atrioventricular block
Insomnia
Itching
Keratitis
Memory loss
Myalgia
Nausea
Nightmares
Ocular discharge
Ocular discomfort
Ocular hyperaemia
Ocular itching
Oedema
Palpitations
Paraesthesia
Photophobia
Pruritus
Psychoses
Ptosis
Rash
Raynaud's syndrome
Reduced libido
Rhinitis
Rhinorrhoea
Sexual dysfunction
Syncope
Tearing
Urticaria
Vomiting

Overdosage

It is strongly recommended that UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller the relevant local centre (0844) 892 0111.

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: December 2021

Reference Sources

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

Summary of Product Characteristics: Betoptic Suspension Single Dose 0.25% Eye Drops. Novartis Pharmaceuticals UK Limited. Revised December 2019.

US national Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Betaxolol Last revised: September 2021
Last accessed: 15 December 2021