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Intraocular Beta Blocker
Aka: Intraocular Beta Blocker, Betaxolol, Betoptic, Levobunolol, Betagan, Metipranolol, OptiPranolol, Intraocular Timolol, Timoptic, Timoptic XE
- Indication
- Open Angle Glaucoma first line agent
- 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
- Mechanism
- Decreases formation of Aqueous Humor
- Does not interfere with Vision
- Preparations
- 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
- Technique: Instillation
- See Don't Open Eyes Technique for Eye Drop Instillation
- Reduces systemic absorbtion
- Adverse effects
- Generally well tolerated
- Systemically absorbed (e.g. Timolol 0.5% one drop each eye is equivalent to Timolol 10 mg orally daily)
- Systemic cardiopulmonary effects may occur
- Fatal bronchospasm has occurred (avoid in Asthma and COPD, except Betaxolol which is selective)
- Reference
- (1995) Med Lett Drugs Ther 37:(956):76-77 [PubMed]