Dosing and uses of Betagan, AKBeta (levobunolol)
Adult dosage forms and strengths
ophthalmic solution
- 0.25%
- 0.5%
Open-angle Glaucoma
0.25%: 1-2 gtt in affected eye(s) q12hr
0.5%: 1-2 gtt in affected eye(s) qDay, may increase to q12hr; >1 gtt q12hr generally not more effective; consider concomitant therapy if IOP not at satisfactory level on this regimen
Pediatric dosage forms and strengths
Safety & efficacy not established
Betagan, AKBeta (levobunolol) adverse (side) effects
Frequency not defined
Mild ocular stinging
Ataxia
Burning
Lethargy
Discomfort
Band keratopathy
Respiratory failure
Blepharitis
Impotence
Blepharoconjunctivitis
Conjunctivitis
Decreased visual acuity
Erythema
Iridocyclitis
Itching sensation
Decreased corneal sensitivity
Tearing
Urticaria
Paresthesia
Ptosis
Cerebral ischemia
Decreased blood pressure
Hypersensitivity reactions
Heart block
Syncope
Reduction of resting heart rate
Warnings
Contraindications
Asthma, uncompensated CHF, any beta-blocker side effects, COPD, sinus bradycardia, 2°/3° AV block, hypersensitivity
Cardiogenic shock or with overt cardiac failure not adequately compensated (eg, treated with cardiac glycosides &/or diuretics)
Cautions
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
Use with a miotic in angle-closure glaucoma
Pregnancy and lactation
Pregnancy category: C
Lactation: Not known if distributed into milk, 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 of Betagan, AKBeta (levobunolol)
Mechanism of action
Nonselective beta-adrenergic receptor blocker; reduces IOP by reducing production of aqueous humor
Pharmacokinetics
Peak Plasma Time: 30 min
Onset of action: 1hr
Peak effect: 2-6hr
Duration: Up to 24hr
