Betaxolol

Intraocular pressure can be successfully managed with beta-adrenergic receptor blocking agent, Betaxolol – an ophthalmic solution.

Overview

Individuals who are diagnosed with glaucoma or ocular eye hypertension often suffer from increased pressure in the eyes, which can be very discomforting, or worse, lead to vision loss. To alleviate these symptoms and risks, ophthalmologists often prescribe a beta blocker by the name of Betaxolol in the form of an optical solution. Singular treatments with Betaxolol may be enough to manage the symptoms of Intraocular pressure, but in some cases, this medicine may be combined with another drug.

About Intraocular Pressure

Intraocular pressure, otherwise known as IOP, presents a number of risks to patients. Left untreated, IOP could lead to permanent impairment of one's vision, including:

  • Glaucomatous Field Loss
  • Optic Nerve Damage
  • Visual Field Loss

Fortunately, intraocular pressure is very treatable. One drop of Betaxolol can generally provide 12 hours of relief for ocular pressure within 30 minutes of topical application.

Betaxolol is available by prescription only in the form of an eye solution under the U.S. brand Betoptic S.

Other Trade Names Include:

  • Betoptic
  • Lokren
  • Kerlone

A Little Bit of History

Betaxolol was first approved for use by the FDA in 1985. The prescription provides an effective way to reduce high levels of intraocular pressure in patients of all age groups, including children, adults, and seniors. The mechanisms of action are thought to be its liquid reducing effect, or more specifically, its ability to decrease the output of the aqueous humor.

Condition(s) Treated

  • Glaucoma
  • Ocular (Eye) Hypertension
  • Anti-Glaucoma Medicine

Type of Medicine

  • Beta Blocker, Beta-Adrenergic Receptor Blocking Agent

Side Effects

The most common side effect of taking Betaxolol is eye discomfort and/or pain. This generally dissolves when the body becomes acclimatized to daily use. Patients are often advised to give it some time to adjust to its effects but call a doctor if worrisome symptoms arise and do not go away.

Less Common Side Effects

There are also some less common side effects of Betaxolol observed in medical studies. These include:

  • Abscesses in the Mouth
  • Blue-Colored Nails and Skin
  • Blurred or Distorted Vision
  • Changes in Pupil Size
  • Chest Pain
  • Clumped Eyelashes
  • Double Vision
  • Droopy Eyes
  • Enlarged Veins in the Neck
  • Excess Mucus
  • Eye Dryness
  • Fainting or Dizzy Spells
  • Fevers or Chills
  • Insomnia
  • Irregular Heartbeat
  • Labored Breathing
  • Low Volumes of Urine
  • Pain in the Joints or Muscles
  • Panting or Puffing
  • Peeling Skin
  • Skin Rashes
  • Slurred Speech
  • Sore Throat
  • Sweating
  • Swollen Face
  • Swollen Limbs
  • Teary Eyes
  • Trouble Breathing or Swallowing
  • Upset Stomach
  • Weakness
  • Weight Gain

Rare Side Effects of Betaxolol

A few examples of rare side effects reported while taking Betaxolol include:

  • Appetite Changes
  • Bitter Aftertaste in the Mouth
  • Depression
  • Difficulty Focusing
  • Dizziness
  • Extreme Sluggishness
  • Hair Loss
  • Headaches
  • Hypersensitivity to Odors
  • Mood Swings
  • Noticeable Differences in Taste
  • Sensory Issues
  • Sleep Changes

Dosage

The medicinal dosage for Betaxolol differs from one patient to another and is normally dependent on a number of variables, including the patient’s age, medical history, and the medicinal strength of Betaxolol.

It is important that all instructions on prescription labels are followed precisely. Moreover, dosages of Betaxolol should never be altered, unless ordered by a medical provider.

The average solution dosage of ophthalmic Betaxolol, used for the treatment of pressure in the eyes due to glaucoma or ocular hypertension is:

  • Children: 1 Drop | 2X Daily | for Each Affected Eye
  • Adults: 1 Drop | 2X Daily | for Each Affected Eye

Medication Strength

Each bottle of Betaxolol is generally filled with one of the following volumes of 0.25% sterile ophthalmic suspension:

  • 2.5 ML
  • 5 ML
  • 10 ML
  • 15 ML

How to Administer

Follow the below guidelines to ensure the proper use of Betaxolol.

Be sure to read the prescription label in full, as well as any illustrations and warnings to reduce the risk of eye injury or side effects.

If you have any questions while taking this medication, consult your healthcare professional or local pharmacist for help.

Steps to Take

  1. Wash Your Hands – Lather your hands with a disinfecting soap and scrub thoroughly. Rinse under hot running water before handling the dispenser.
  2. Shake for Homogenous Distribution – Before each use, the solution should be shaken thoroughly.
  3. Refer to the Illustration – Generally, your prescription will come with a step-by-step diagram depicting how to use the eye drop.
  4.  Rewash Hands – To avoid cross-contamination and the risk of eye infection, be sure to repeat the handwashing process before resealing the applicator tip.

Lean your head back and gently pull back the lower eyelid to dispense the medicine. Follow the dosage instructions exactly as prescribed by dropping the ordered amount in the inner corner of each affected eye. For maximum effectiveness, close each eye after instilling the eye solution drop and apply gentle pressure to the inner corner of the eye for a minute or two.

Other precautions include never placing the tip of the applicator directly on the eyes. Instill the medicine slowly, one drop at a time. After use, reseal the cap tightly and pay attention to the storage instructions listed below in this guide.

Note: Do not use Betaxolol if on the first use the seal is tampered or broken.

Missed Dosage

Betaxolol is generally taken twice daily. If you miss a dose, take it as soon as you remember. If the second dose for the time is drawing closer, skip the missed dose, and resume the next dose as normally scheduled.

Pharmacists recommend setting up an automated alarm daily, twice per day in order to meet all dosage requirements on time.

Overdose

If you mistakenly drop more than the prescribed amount in each eye, flush with warm, running water. If serious symptoms are observed, call 911 right away, as this topical medication is absorbed systematically and an overdose could lead to severe adverse reactions.

Interactions

Betaxolol may cause negative reactions when used simultaneously with other medicines or substances. The following summary provides a brief overview of precautions to take as it relates to interactions or contraindications with this particular medication.

Drug Interactions

There are a number of medications that have demonstrated negative effects when used in conjunction with Betaxolol.

Medical providers should always refer to a drug interaction checker to verify if Betaxolol is safe for use with current prescriptions patients are taking. Prescribed amounts may need to be altered to reduce the risk of side effects.

Patients, too, should always discuss any current medications or underlying medical conditions with a healthcare provider before commencing any new treatments.

The following list outlines some of the most widely reported negative interactions with Betaxolol. The list includes but isn’t limited to the following medications:

  • Trimazosin
  • Emflex
  • Insulin
  • Metildigoxin
  • Trulicity
  • Rivastigmine
  • Morniflumate
  • Invokana
  • VIMPAT
  • Niflumic Acid
  • Piroxicam
  • Nexterone and Pacerone
  • Propyphenazone
  • Vildagliptin
  • Hifenac, Cincofen, Zerodol, Nacsiv, or Arenac
  • GLYBURIDE
  • Arthropan
  • indocin
  • Etodolac
  • Dorixina
  • Pioglitazone
  • Andante and E-643
  • Celebrex
  • Dipyrone
  • Repaglinide
  • Kapvay
  • Precose
  • Prexige
  • Feprazone
  • Cataflam, Voltaren
  • Rofecoxib
  • Diabenese
  • Sulindac
  • Dolobid
  • Tamsulosin
  • FARXIGA
  • Orudis
  • Certain Anti-Inflammatory Eczema Creams such as Bufexamac
  • Cardizem
  • Jardiance
  • Lanoxin
  • Piketoprofen
  • Cedilanide Novartis
  • Prolensa and BromSite
  • Rosiglitazone
  • Uroxatral
  • Glucophage
  • St John's Wort
  • Miglitol
  • Toradol
  • Advil, Motrin (Ibuprofen)
  • Bayer, Ecotrin (Aspirin)
  • Losartan
  • Digitaline
  • Paracetamol
  • Proquazone
  • Xalkori and Pfizer
  • Nesina
  • Glipizide
  • Mibefradil

This is an extensive list, and to summarize, the most noteworthy drug interaction classes that have been observed with Betaxolol ophthalmic solution include:

  • Oral Beta-Adrenergic Receptor Inhibitors
  • Catecholamine-Depleting Drugs
  • Concomitant Adrenergic Psychotropic Drugs

Patients who are taking these medicines concurrently with Betaxolol should be closely observed.

Food Interactions

Speak with your medical provider about your dietary and lifestyle habits before starting treatment with Betaxolol. Certain foods may interact adversely with the medicine. You should also talk to your doctor if you frequently drink alcoholic beverages or smoke.

Warnings

Betaxolol falls under a class of drugs demonstrated to cause very serious side effects in some cases. Observe all precautions outlined by your medical provider before use and note what to do in the event of an adverse effect.

The following section provides a brief overview of general warnings while taking Betaxolol, or Betoptic S, as it is most commonly known:

Systematic Absorption

Betaxolol ophthalmic solutions are applied topically to the eyes. However, patients should heed the same warnings given to patients that are prescribed the oral route of administration.

This is because topical applications of the drug are absorbed systematically by the human body. The most critical concern when taking this medicine is the risk of respiratory or cardiac failure, some rare but serious side effects of Betaxolol. If signs of these conditions occur, seek medical help right away.

Follow-Up Appointments

Due to the serious side effects that could develop while taking Betaxolol, patients should be closely monitored. Follow-up visits should be intermittently scheduled to weigh progress or setbacks that could implicate adjustments in dosage.

When to Call a Doctor

As Betaxolol is known to cause heart failure in susceptible groups, patients should call 911 and alert a medical provider if the following symptoms are noticed:

  • Chest Pain
  • Extreme Lethargy
  • Irregular Heartbeat
  • Sudden Weight Gain
  • Swollen Face or Limbs
  • Trouble Breathing

Allergic Reactions

Inform your medical provider if you’ve ever had allergic sensitivities to food, dyes, preservatives, or animal products before starting Betaxolol treatments, or any other medicines.

Even if this medication does not trigger an allergic reaction, Betaxolol could potentially decrease the effectiveness of epinephrine used to treat other allergies. It is therefore important to speak with your doctor about any history of allergies.

Emergency Allergy Plan

Most of the common side effects of Betaxolol go away over time. However, patients should seek medical intervention when certain symptoms persist, such as:

  • Eye Irritation
  • Swollen Eyelids
  • Red Eyes

These could be signs of allergic sensitivities. Patients should stop using the medicine and contact 911 immediately.

Surgery

Patients should inform their medical surgeon of Betaxolol use before scheduling minor or major procedures, as this medication could increase the risks associated with general anesthesia.

Dental Health

Inform your dental provider if you are taking Betaxolol, as certain drugs commonly used in dental offices could interact negatively with this medicine.

Underlying Medical Conditions

Certain pre-existing conditions may worsen while taking Betaxolol. Patients should notify their medical provider of any underlying medical conditions. In particular, inform your doctor if you have a history of:

  • Blood Vessel Disease
  • Diabetes
  • Heart Attack
  • Hyperthyroidism
  • Low Blood Sugar
  • Myasthenia Gravis
  • Respiratory Illness
  • Stroke

Your doctor may prescribe an alternative to Betaxolol or adjust the dose based on a full review of your medical history.

Moreover, severe contraindications have been reported in patients diagnosed with:

  • Atrioventricular Block
  • Cardiogenic Shock
  • Overt Cardiac Failure
  • Sinus Bradycardia

Diabetes

Betaxolol could potentially conceal the signs of hypoglycemia. As a result, medical providers should exercise extra care when prescribing this medication to diabetic patients, especially individuals who are currently taking insulin.

Pregnancy

Pregnant or nursing women should always consult a medical provider before using medicines, including Betaxolol ophthalmic solution.

Pediatric and Geriatric Applications

Betaxolol is prescribed in pediatric and geriatric populations. Medical studies have not found enough evidence to restrict use in these groups.

Storage

To store Betaxolol, ensure it is tightly sealed and positioned upright at all times following use. Place in a cool and dry area, and away from extreme temperatures, such as in direct sunlight or in a refrigerator, for example. This medication should never be frozen.

As with all medications, Betaxolol should never be placed within the reach of children or pets. As an extra precaution, place the contact number for the American Association of Poison Control Centers in a visible area. In the event of accidental dosage, the official number to call is (800) 222-1222.

Summary

Betaxolol is a sterile ophthalmic solution intended for intraocular pressure (IOP) caused by ocular hypertension or glaucoma. Unresolved intraocular pressure could lead to vision loss or optic nerve damage. As a result, medical providers generally take a proactive approach to treating IOP using a beta-blocking agent.

Betaxolol falls under this same class of beta-adrenergic receptor inhibitor drugs. It is available by RX only under the U.S. brand Betoptic S.

Beta-blocking agents, whether orally or topically applied, could lead to major side effects. In particular, respiratory and heart failure have been noted. It is therefore imperative for patients to disclose their full medical history to providers to lower the risks.

Medical providers too should assess the risks vs. benefits to determine if Betaxolol is a suitable fit for high-risk patients. Close monitoring is needed for all groups of patients taking Betaxolol.

Betaxolol is generally prescribed twice per day in 12-hour intervals. Both children and adults typically complete one metered drop in each affected eye at the time of each respective application. Patients should follow all instructions listed for use and storage.

Betaxolol comes with a number of risks, which doctors calculate before prescribing. The benefit, however, is its efficiency in deterring vision loss in patients with underlying conditions, such as glaucoma and ocular hypertension.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017