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BETA-ADRENERGIC BLOCKING AGENTS (Ophthalmic)
Some commonly used brand names are:
In the U.S.—
Betaxolol, carteolol, levobetaxolol, levobunolol, metipranolol, and timolol are used to treat certain types of glaucoma. They appear to work by reducing the production of fluid in the eye. This lowers the pressure in the eye.
These medicines are available only with your doctor"s prescription, in the following dosage forms:
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ophthalmic beta-adrenergic blocking agents, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to any of the beta-adrenergic blocking agents, either ophthalmic or systemic, such as acebutolol, atenolol, betaxolol, bisoprolol, carteolol, labetalol, levobetaxolol, levobunolol, metipranolol, metoprolol, nadolol, oxprenolol, penbutolol, pindolol, propranolol, sotalol, or timolol. Also tell your health care professional if you are allergic to any other substances, such as sulfites or preservatives.
Pregnancy—Ophthalmic beta-adrenergic blocking agents may be absorbed into the body. These medicines have not been studied in pregnant women. Studies in animals have not shown that betaxolol, levobunolol, metipranolol, or timolol causes birth defects. However, high doses of levobetaxolol given by mouth to pregnant rabbits have been shown to cause birth defects in rabbit babies, and very large doses of carteolol given by mouth to pregnant rats have been shown to cause wavy ribs in rat babies. In addition, some studies in animals have shown that beta-adrenergic blocking agents increase the chance of death in the animal fetus. Before using ophthalmic beta-adrenergic blocking agents, make sure your doctor knows if you are pregnant or if you may become pregnant.
Breast-feeding—Betaxolol and timolol, and maybe other beta-adrenergic blocking agents, when taken by mouth, may pass into the breast milk. Since ophthalmic beta-adrenergic blocking agents may be absorbed into the body, they, too, may pass into the breast milk. However, it is not known whether ophthalmic beta-adrenergic blocking agents pass into the breast milk, and these medicines have not been reported to cause problems in nursing babies.
Children—Infants may be especially sensitive to the effects of ophthalmic beta-adrenergic blocking agents. This may increase the chance of side effects during treatment.
Older adults—Elderly people are especially sensitive to the effects of ophthalmic beta-adrenergic blocking agents. If too much medicine is absorbed into the body, the chance of side effects during treatment may be increased.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Other medical problems—The presence of other medical problems may affect the use of ophthalmic beta-adrenergic blocking agents. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
Use this medicine only as directed . Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of too much medicine being absorbed into the body and the chance of side effects.
Dosing—The dose of betaxolol, carteolol, levobetaxolol, levobunolol, metipranolol, or timolol will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses. If your dose is different, do not change it unless your doctor tells you to do so.
The number of doses of medicine that you use also depends on the strength of the medicine .
Missed dose—If you miss a dose of this medicine and your dosing schedule is:
If you have any questions about this, check with your doctor.
Storage—To store this medicine:
Precautions While Using This Medicine
Your doctor should check your eye pressure at regular visits to make certain that your glaucoma is being controlled.
Contact your physician immediately if you are having eye surgery, you experience trauma to your eye, or you develop an eye infection to determine if you should continue to use your present container of eye drops.
For a short time after you use this medicine, your vision may be blurred. Make sure your vision is clear before you drive, use machines, or do anything else that could be dangerous if you are not able to see well.
Before you have any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine . Using an ophthalmic beta-adrenergic blocking agent during this time may cause an increased risk of side effects.
For diabetic patients:
Some ophthalmic beta-adrenergic blocking agents (betaxolol, carteolol, and metipranolol) may cause your eyes to become more sensitive to light than they are normally. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Redness of eyes or inside of eyelids
Less common or rare
Blurred vision or other change in vision; different size pupils of the eyes; discoloration of the eyeball; droopy upper eyelid; eye pain; redness or irritation of the tongue; seeing double; swelling, irritation or inflammation of eye or eyelid
Symptoms of too much medicine being absorbed into the body
Ankle, knee, or great toe joint pain; ankle, knee, or great toe joint swelling; anxiety or nervousness; bloody or cloudy urine; breast pain; burning or prickling feeling on body; change in taste; chest pain; chills; clumsiness or unsteadiness; confusion or mental depression; coughing, wheezing, or troubled breathing; decreased sexual ability; diarrhea; difficult, burning, or painful urination; dizziness or feeling faint; drowsiness; dryness or soreness of throat; ear pain; feeling of constant movement; fever; hair loss; hallucinations (seeing, hearing, or feeling things that are not there); headache; hoarseness; irregular, fast, slow, or pounding heartbeat; lightheadedness; lower back or side pain; muscle or joint aches or pain; muscle tightness or stiffness; nausea or vomiting; raw, red, blistering, scaly, or crusted areas of the skin; ringing or buzzing in the ears; runny, stuffy, or bleeding nose; skin rash, hives, or itching; swelling of feet, ankles, or lower legs; trouble in sleeping; unusual tiredness or weakness
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Blurred vision, temporary; decreased night vision; stinging of eye or other eye irritation (when medicine is applied)
Less common or rare
Acid or sour stomach; belching; browache; constipation; crusting of eyelashes; dryness of eye; dry skin; feeling of something in the eye; heartburn; increased sensitivity of eye to light; indigestion; itching, stinging, burning, or watering of eye or other eye irritation; pain, redness, warmth, or swelling of muscles
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
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