Dosing & Uses
Dosage Forms & Strengths
ophthalmic solution
- 0.3%
Open-Angle Glaucoma
1 gtt in affected eye(s) q12hr
Safety & efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (2)
- digoxin
metipranolol ophthalmic increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor.
- fingolimod
metipranolol ophthalmic increases effects of fingolimod by pharmacodynamic synergism. Use Caution/Monitor. Both medications decrease heart rate. Monitor patients on concomitant therapy, particularly in the first 6 hours after fingolimod is initiated or after a treatment interruption of at least two weeks, for bradycardia and atrioventricular block. To identify underlying risk factors of bradycardia and AV block, obtain a new or recent ECG in patients using beta-blockers prior to starting fingolimod.
Minor (25)
- acebutolol
metipranolol ophthalmic increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- amlodipine
metipranolol ophthalmic increases effects of amlodipine by pharmacodynamic synergism. Minor/Significance Unknown.
- atenolol
metipranolol ophthalmic increases effects of atenolol by pharmacodynamic synergism. Minor/Significance Unknown.
- betaxolol
metipranolol ophthalmic increases effects of betaxolol by pharmacodynamic synergism. Minor/Significance Unknown.
- bisoprolol
metipranolol ophthalmic increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- carvedilol
metipranolol ophthalmic increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.
- celiprolol
metipranolol ophthalmic increases effects of celiprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- clevidipine
metipranolol ophthalmic increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.
- diltiazem
metipranolol ophthalmic increases effects of diltiazem by pharmacodynamic synergism. Minor/Significance Unknown.
- esmolol
metipranolol ophthalmic increases effects of esmolol by pharmacodynamic synergism. Minor/Significance Unknown.
- felodipine
metipranolol ophthalmic increases effects of felodipine by pharmacodynamic synergism. Minor/Significance Unknown.
- isradipine
metipranolol ophthalmic increases effects of isradipine by pharmacodynamic synergism. Minor/Significance Unknown.
- labetalol
metipranolol ophthalmic increases effects of labetalol by pharmacodynamic synergism. Minor/Significance Unknown.
- metoprolol
metipranolol ophthalmic increases effects of metoprolol by pharmacodynamic synergism. Minor/Significance Unknown.
- nadolol
metipranolol ophthalmic increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.
- nebivolol
metipranolol ophthalmic increases effects of nebivolol by pharmacodynamic synergism. Minor/Significance Unknown.
- nicardipine
metipranolol ophthalmic increases effects of nicardipine by pharmacodynamic synergism. Minor/Significance Unknown.
- nifedipine
metipranolol ophthalmic increases effects of nifedipine by pharmacodynamic synergism. Minor/Significance Unknown.
- nisoldipine
metipranolol ophthalmic increases effects of nisoldipine by pharmacodynamic synergism. Minor/Significance Unknown.
- penbutolol
metipranolol ophthalmic increases effects of penbutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- pindolol
metipranolol ophthalmic increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.
- propranolol
metipranolol ophthalmic increases effects of propranolol by pharmacodynamic synergism. Minor/Significance Unknown.
- sotalol
metipranolol ophthalmic increases effects of sotalol by pharmacodynamic synergism. Minor/Significance Unknown.
- timolol
metipranolol ophthalmic increases effects of timolol by pharmacodynamic synergism. Minor/Significance Unknown.
- verapamil
metipranolol ophthalmic increases effects of verapamil by pharmacodynamic synergism. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Ocular
- Burning sensation in eye
- Blepharitis
- Blurred vision
- Light intolerance
- Uveitis
- Tearing
- Eyelid dermatitis
- Browache
Systemic
- Similar to systemic beta-blockers including bradycardia, aggravation of CHF, nausea, asthma, nightmares, impotence, tiredness, cough, dyspnea, epistaxis, rhinitis, myalgia, arthritis, rash
- Reduction of systemic side effects by putting finger in corner of eye (occluding punctum) or by gentle eyelid closure (without opening & closing lid) for 3 min
Warnings
Contraindications
Hypersensitivity
Asthma, uncompensated CHF, severe COPD, symptomatic sinus bradycardia, 2nd or 3rd degree AV block, cardiogenic shock
Cautions
Caution in diabetes (may mask signs of hypoglycemia)
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
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)
Remove contact lens prior to administration
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Excretion in breast milk unknown; use 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.Pharmacology
Mechanism of Action
Nonselective beta-adrenergic receptor blocker; lacks intrinsic sympathomimetic activity and membrane stabilizing effects; reduces IOP by reducing production of aqueous humor
Pharmacokinetics
Onset of action: <30 min
Peak effect: ~2 hr
Half-life: 3 hr
Duration: Up to 24 hr (intraocular pressure reduction)
