betaxolol ophthalmic (Rx)

Brand and Other Names:Betoptic, Betoptic S
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.5% (Betoptic)

ophthalmic suspension

  • 0.25% (Betoptic S)

Elevated Intraocular Pressure

Suspension: 1 gtt in affected eye q12hr

Solution: 1-2 gtt in affected eye q12hr

Dosage Forms & Strengths

ophthalmic solution

  • 0.5% (Betoptic)

ophthalmic suspension

  • 0.25% (Betoptic S)

Elevated Intraocular Pressure

0.25% suspension: 1 gtt in affected eye q12hr

Open Angle Glaucoma

0.25% suspension: 1 gtt in affected eye q12hr

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Adverse Effects

>10%

Ocular effects

  • Short term discomfort (<25%)

Frequency Not Defined

Ocular

  • Blurred vision
  • Corneal punctate keratitis
  • Itching and/or foreign body sensation erythema
  • Inflammation
  • Ocular pain and/or discharge
  • Ocular drynes
  • Photophobia

Systemic

  • Bradycardia, congestive heart failure, heart block
  • Depression, dizziness, headache, insomnia, lethargy, vertigo
  • Hair loss, hives, toxic epidermal necrolysis
  • Glossitis
  • Bronchospasm, dyspnea
  • Increase in signs and symptoms of myasthenia gravis
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Warnings

Contraindications

Hypersensitivity, sinus bradycardia, cardiogenic shock, >1st deg AV block, overt cardiac failure

Cautions

As with many topically applied ophthalmic drugs, this drug is absorbed systemically; same adverse reactions found with systemic administration of beta-adrenergic receptor inhibitors may occur with topical administration; that includes severe respiratory reactions and cardiac reactions, including death due to bronchospasm in patients with asthma, and death due to cardiac failure, reported with topical application of beta-adrenergic receptor inhibitors

Beta-adrenergic receptor inhibitors should be administered with caution in patients subject to hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents; beta-adrenergic receptor inhibitors may mask the signs and symptoms of acute hypoglycemia

Beta-adrenergic receptor inhibitors may mask certain clinical signs (eg, tachycardia) of hyperthyroidism; patients suspected of developing thyrotoxicosis should be managed carefully to avoid abrupt withdrawal of beta-adrenergic receptor inhibitors, which might precipitate a thyroid storm

Beta-adrenergic receptor inhibitors reported to potentiate muscle weakness consistent with certain myasthenic symptoms (eg, diplopia, ptosis, and generalized weakness)

Exercise caution in the treatment of glaucoma patients with excessive restriction of pulmonary function; there have been reports of asthmatic attacks and pulmonary distress during betaxolol treatment

Although rechallenges of some such patients with ophthalmic betaxolol have not adversely affected pulmonary function test results, the possibility of adverse pulmonary effects in patients sensitive to beta-adrenergic receptor inhibitors cannot be ruled out

While taking beta-adrenergic receptor inhibitors, patients with history of atopy or history of severe anaphylactic reaction to variety of allergens may be more reactive to repeated accidental, diagnostic, or therapeutic challenge with such allergens; such patients may be unresponsive to usual doses of epinephrine used to treat anaphylactic reactions

In patients with angle-closure glaucoma, immediate treatment objective is to reopen the angle; this may require constricting the pupil; therapy has little or no effect on pupil and should not be used alone in treatment of angle-closure glaucoma

Because of potential effects of beta-adrenergic receptor inhibitors on blood pressure and pulse, these inhibitors should be used with caution in patients with vascular insufficiency; if signs or symptoms suggesting reduced cerebral blood flow or Raynaud’s phenomenon develop following initiation of therapy with this drug, alternative therapy should be considered

Bacterial keratitis may occur with use of multiple-dose containers of topical ophthalmic products when these containers are inadvertently contaminated by patients who, in most cases, had a concurrent corneal disease or a disruption of the ocular epithelial surface; instruct patients on appropriate instillation techniques

Choroidal detachment after filtration procedures reported with administration of aqueous suppressant therapy

The preservative benzalkonium chloride may be absorbed by soft contact lenses; contact lenses should be removed during instillation of the drug but may be reinserted 15 minutes after instillation

Surgical anesthesia

  • The necessity or desirability of withdrawal of beta-adrenergic receptor inhibitors prior to major surgery is controversial; beta-adrenergic receptor inhibitors impair the ability of the heart to respond to beta adrenergically mediated reflex stimuli; this may augment the risk of general anesthesia in surgical procedures
  • Some patients receiving beta-adrenergic receptor inhibitors have experienced protracted, severe hypotension during anesthesia; difficulty in restarting and maintaining the heartbeat has also been reported
  • In patients undergoing elective surgery, consider gradual withdrawal of beta-adrenergic receptor inhibitors
  • If necessary, during surgery, the effects of beta-adrenergic receptor inhibitors may be reversed by sufficient doses of adrenergic agonists
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Pregnancy & Lactation

Pregnancy Category: C

Lactation: Excretion in milk unknown; use with caution

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Selective beta1-blocker; reduces intraocular pressure by reducing production of aqueous humor

Pharmacokinetics

Onset: Within 30 min

Duration: 12 hr

Excretion: Urine (80%)

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
betaxolol oral
-
10 mg tablet
betaxolol oral
-
20 mg tablet
betaxolol oral
-
10 mg tablet
betaxolol ophthalmic (eye)
-
0.5 % drops
betaxolol ophthalmic (eye)
-
0.5 % drops
betaxolol ophthalmic (eye)
-
0.5 % drops
betaxolol ophthalmic (eye)
-
0.5 % drops
betaxolol ophthalmic (eye)
-
0.5 % drops
Betoptic S ophthalmic (eye)
-
0.25 % drops
Betoptic S ophthalmic (eye)
-
0.25 % drops

Copyright © 2010 First DataBank, Inc.

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Patient Handout

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Patient Education
betaxolol oral

BETAXOLOL - ORAL

(be-TAX-oh-lol)

COMMON BRAND NAME(S): Kerlone

WARNING: If you have chest pain (angina) or have heart disease (e.g., coronary artery disease, ischemic heart disease, high blood pressure), do not stop using this drug without first consulting your doctor. Your condition may become worse when the drug is suddenly stopped. If your doctor decides you should no longer use this drug, you must gradually decrease your dose according to your doctor's instructions.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease the work on the heart. Seek immediate medical attention if you develop: worsening chest pain, tightness/pressure in the chest, chest pain spreading to the jaw/neck/arm, sweating, trouble breathing, or fast/irregular heartbeat.

USES: This medication is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Betaxolol belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural chemicals in your body such as epinephrine that affect the heart and blood vessels. This results in a lowering of the heart rate and blood pressure.

HOW TO USE: Take this medication by mouth, usually once daily with or without food or as directed by your doctor.Dosage is based on your medical condition and response to therapy. Patients with kidney disease should not take more than 20 milligrams daily.Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.For the treatment of high blood pressure, it may take several months before the full benefit of this drug takes effect.Inform your doctor if your condition worsens (e.g., your routine blood pressure readings increase).

SIDE EFFECTS: Dizziness, lightheadedness, drowsiness, and headache may occur as your body adjusts to the medication. Trouble sleeping, decreased sexual ability, stomach upset, nausea, diarrhea, sore throat, cold hands and feet, dry eyes, tingling, numbness, and weakness may also occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), slow/irregular heartbeat, back pain, mental/mood changes (e.g., depression, hallucinations), trouble breathing, joint pain, easy bruising/bleeding, increased thirst/urination, vision changes, slow wound healing, sweating, confusion, fainting, stomach/abdominal pain, blue fingers/toes/nails, finger/toe/leg cramps.A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: See also warning section.Before taking betaxolol, tell your doctor or pharmacist if you are allergic to it; or to other beta blockers (e.g., atenolol, metoprolol); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as a slow heartbeat, second- or third-degree atrioventricular block), blood circulation problems (such as Raynaud's disease, peripheral vascular disease), breathing problems (such as asthma, chronic bronchitis, emphysema), glaucoma, heart failure, kidney disease, liver disease, mental/mood disorders (such as depression), a certain muscle disease (myasthenia gravis), skin conditions (such as psoriasis), overactive thyroid disease (hyperthyroidism), a certain type of tumor (untreated pheochromocytoma), serious allergic reactions (including those needing treatment with epinephrine).This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you have diabetes, this product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of low blood sugar level, such as dizziness and sweating, are not affected by this drug. This product may also make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be at greater risk for low blood sugar (hypoglycemia), especially if they are vomiting or not eating regularly. To help prevent low blood sugar, feed children on a regular schedule. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, seizures), stop this medication and tell the doctor right away.Kidney function declines as you grow older. This medication is removed by the kidneys. Elderly people may be at a greater risk for slowed heartbeat while using this drug.This drug should be used only if clearly needed during pregnancy. Newborns whose mothers have taken this drug near the date of delivery may have problems such as low blood pressure, low heart rate and low birth weight, and may require special medical monitoring. Discuss the risks and benefits of taking this medication during pregnancy with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (such as prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: epinephrine, fenoldopam, fingolimod, general anesthesia, other heart drugs (e.g., digoxin), other drugs to treat high blood pressure (e.g., clonidine), St John's wort.Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).This medication may interfere with glaucoma screening tests, possibly causing false test results. Make sure your eye doctor knows you use this drug.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fainting, severe weakness, very slow heartbeat, irregular heartbeat, sudden weight gain, sudden swelling, trouble breathing.

NOTES: Do not share this medication with others.Lifestyle changes such as starting a stress reduction program, stopping smoking, limiting alcohol, exercising, and making diet changes, may increase the effectiveness of this medication. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Have your blood pressure and pulse checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure and pulse. Discuss this with your doctor.

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at room temperature between 59-77 degrees F (15-25 degrees C) away from moisture and sunlight. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

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Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
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6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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Code Definition
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.