II. Indications
- Open Angle Glaucoma first line agent
III. Contraindications: Relative (related to systemic absorption risk described below)
- Asthma
- Chronic Obstructive Pulmonary Disease
- Congestive Heart Failure
- Cardiac conduction disturbance
- Depression
- Concurrent systemic Beta Blocker use
IV. Mechanism
- Decreases formation of Aqueous Humor (lowers IOP 20-25%)
- Does not interfere with Vision
V. Medications (Yellow Caps)
-
Betaxolol (Betoptic): $39
- Only selective Beta Blocker eye drop (may be used in COPD, Asthma)
- Concentrations: 0.25%, 0.5%
- Dose: 1 gtt bid
- Levobunolol (Betagan): $29-34
- Concentrations: 0.25%, 0.5%
- Dose: 1 gtt qd-bid
- Metipranolol (OptiPranolol): $24
- Concentrations: 0.3%
- Dose: 1 gtt bid
-
Timolol (Timoptic): $30-35
- Concentrations: 0.25%, 0.5%
- Dose: 1 gtt bid
- Timoptic XE: $17-21
- Concentration: 0.25%, 0.5%
- Dose: 1 gtt qd
VI. Technique: Instillation
- See Don't Open Eyes Technique for Eye Drop Instillation
- Reduces systemic absorbtion
VII. Adverse effects
- Generally well tolerated
- Corneal hypesthesia (decreased Sensation)
- Burning or stinging
- Systemically absorbed (e.g. Timolol 0.5% one drop each eye is equivalent to Timolol 10 mg orally daily)
- Systemic cardiopulmonary effects may occur (Bradycardia, AV Block, CHF exacerbation)
- Fatal bronchospasm has occurred (avoid in Asthma and COPD, except Betaxolol which is selective)
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Related Studies
| betoptic (on 7/27/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| BETOPTIC S 0.25% EYE DROP | $34.45 per ml | |
| BETOPTIC S 0.25% EYE DROPS | $31.35 per ml | |
| levobunolol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LEVOBUNOLOL 0.5% EYE DROPS | Generic | $2.16 per ml |
| timoptic (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| TIMOPTIC 0.5% OCUDOSE DROP | Generic | $4.67 each |