Betaxolol Other names: Betaxolol hydrochloride

Chemical formula: C₁₈H₂₉NO₃  Molecular mass: 307.428 g/mol  PubChem compound: 2369

Interactions

Betaxolol interacts in the following cases:

Sympathomimetic agents

Caution is required when co-administering betaxolol with sympathomimetic agents due to a potential risk of lowering beta-blocker activity.

Corticosteroids, tetracosactide

Caution is required when co-administering betaxolol with corticosteroids, tetracosactide due to possible reduced antihypertensive action (retention of water and sodium with corticosteroids).

Imipramine related (tricyclic) antidepressants, neuroleptics

Caution is required when co-administering betaxolone with imipramine-related (tricyclic) antidepressants, neuroleptics due to possible increased antihypertensive action and risk of orthostatic hypotension (cumulative effect).

Insulin, hypoglycemic sulfonamides

All beta-blockers can cover the symptoms of hypoglycaemia, e.g. palpitations and tachycardia.

Calcium channel blockers

A combination of betaxolol with calcium channel blockers (verapamil, bepridil, diltiazem and mephedradil) can cause heart rhythm disorders (severe bradycardia, atrioventricular conduction disorders, sinus stoppage) and heart failure (synergistic effect).

Diagnostic contrast media containing iodine

In cases of shock or hypotension due to the use of iodine-containing diagnostic agents, β-blockers reduce cardiovascular compensatory responses. When possible, treatment with β-blockers should be discontinued prior to radiographic testing. If continued treatment is necessary, the physician should have appropriate intensive care equipment.

Amiodarone

Co-administration of betaxolol with amiodarone is not recommended as it can lead to contractility, automation and conduction disorders (suppression of sympathetic compensation mechanisms).

Baclofen

Caution is required when co-administering betaxolol with baclofen due to possible increased antihypertensive effects. Blood pressure should be monitored and the dosage of antihypertensive drugs adjusted accordingly, if necessary.

Clonidine

Patients who are about to discontinue clonidine treatment and who received a β-blocker should be monitored for possible hypertension. Stop the beta-blocker administration several days before the gradual reduction of clonidine doses.

Digoxin

Digoxin

Mefloquine

Caution is required when co-administering betaxolol with mefloquine due to a potential risk of bradycardia (adding bradycardia-inducing effects).

Calcium channel blockers (dihydropyridines such as nifedipine)

Caution should be exercised when co-administering betaxolol with dihydropyridines such as nifedipine due to the possible occurrence of hypotension, heart failure in patients with latent or uncontrolled heart failure. The presence of β-blocker therapy may also minimize the sympathetic reflex response resulting from excessive hemodynamic impact.

Antiarrhythmic drugs (propafenone, quinidine, hydroquinidine, disopyramide)

Caution is required when co-administering betaxolol with antiarrhythmic drugs (propafenone and class Ia: quinidine, hydroquinidine and disopyramide) due to possible suppression of sympathetic compensation mechanisms.

Verapamil

Betaxolol should not be taken in parallel with verapamil or for several days after treatment with verapamil (and vice versa).

Calcium channel blockers (verapamil, bepridil, diltiazem, mephedradil)

Caution is required when co-administering betaxolol with calcium channel blockers (verapamil, bepridil, diltiazem and mebefradil) due to the possible occurrence of heart rhythm disorders (severe bradycardia, atrioventricular conduction disorders, sinus arrest) and heart failure (synergistic effect).

Disorder of cornea

Ophthalmic beta-blockers may induce dryness of eyes. Caution should be exercised in the use of beta-blocking agents in patients with corneal diseases, Sicca Syndrome or similar tear film abnormalities.

First degree atrioventricular block

Betaxolol should be administered with caution to patients with first degree atrioventricular block.

Hemodialysis

In cases of chronic hemodialysis (blood or peritoneal) the recommended starting dose is 10 mg daily, given regardless of the rate and times of hemodialysis sessions.

Hyperthyroidism

Beta-adrenergic blocking agents may mask the signs of hyperthyroidism. Patients suspected of developing thyrotoxicosis should be managed carefully to avoid abrupt withdrawal of beta-adrenergic blocking agents, which might precipitate a thyroid storm.

General anesthesia

Β-blockers create attenuation of reflex tachycardia and increased risk of hypotension. Continuing treatment with beta-blockers reduces the risk of arrhythmia, myocardial ischemia and hypertensive seizures. The anesthetist should be informed if the patient is treated with β-blockers.

Psoriasis

The benefits of using β-blockers in psoriatic patients should be weighed very carefully because it has been reported that the use of β-inhibitors causes worsening of psoriasis.

Pregnancy

Studies in animals with betaxolol HCl was not shown to be teratogenic and there were no other adverse effects on reproduction at subtoxic dose levels.

There are no adequate data for the use of betaxolol in pregnant women. Betaxolol should not be used during pregnancy unless clearly necessary.

Epidemiological studies have not revealed malformative effects but show a risk for intra-uterine growth retardation when beta-blockers are administered by the oral route. In addition, signs and symptoms of beta-blockade (e.g. bradycardia, hypotension, respiratory distress and hypoglycaemia) have been observed in the neonate when beta-blockers have been administered until delivery. If betaxolol suspension is administered until delivery, the neonate should be carefully monitored during the first days of life.

Nursing mothers

Beta-blockers are excreted in breast milk, having the potential to cause serious undesirable effects in the infant of the nursing mother. However, at therapeutic doses of betaxolol in eye drops, it is not likely that sufficient amounts would be present in breast milk to produce clinical symptoms of beta-blockade in the infant.

Carcinogenesis, mutagenesis and fertility

Fertility

There are no data on the effects of betaxolol on human fertility.

Effects on ability to drive and use machines

Betaxolol has no or negligible influence on the ability to drive and use machines.

Temporary blurred vision or other visual disturbances may affect the ability to drive or use machines. If blurred vision occurs the patient must wait until the vision clears before driving or using machinery.

Adverse reactions


Like other topically applied ophthalmic drugs, betaxolol is absorbed into the systemic circulation. This may cause similar undesirable effects as seen with systemic beta-blocking agents. Incidence of systemic ADRs after topical ophthalmic administration is lower than for systemic administration. Listed adverse reactions include reactions seen within the class of ophthalmic beta-blockers.

Summary of the safety profile

In clinical trials with betaxolol eye drops the most common adverse reaction was ocular discomfort, occurring in 12.0% of patients.

The following adverse reactions have been reported during clinical trials or post marketing surveillance with betaxolol eye drops and are classified according to the subsequent convention: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000) and frequency unknown/cannot be estimated from the available data.

Within each frequency-grouping, adverse reactions are presented in order of decreasing seriousness.

Immune system disorders

Frequency unknown: hypersensitivity

Psychiatric disorders

Rare: anxiety, insomnia, depression

Nervous system disorders

Common: headache

Rare: syncope

Frequency unknown: dizziness

Eye disorders

Very common: ocular discomfort

Common: vision blurred, lacrimation increased

Uncommon: punctate keratitis, keratitis, conjunctivitis, blepharitis, visual impairment, photophobia, eye pain, dry eye, asthenopia, blepharospasm, eye pruritus, eye discharge, eyelid margin crusting, eye inflammation, eye irritation, conjunctival disorder, conjunctival oedema, ocular hyperaemia

Rare: cataract, decreased corneal sensitivity, erythema of eyelid

Cardiac disorders

Uncommon: bradycardia, tachycardia

Frequency unknown: arrhythmia

Vascular disorders

Rare: hypotension

Respiratory, thoracic and mediastinal disorders

Uncommon: asthma, dyspnoea, rhinitis,

Rare: cough, rhinorrhoea

Gastrointestinal disorders

Uncommon: nausea

Rare: dysgeusia

Skin and subcutaneous tissue disorders

Rare: dermatitis, rash, alopecia

Reproductive system and breast disorders

Rare: libido decreased

General disorders and administration site conditions

Frequency unknown: asthenia

Description of selected adverse reactions

Additional adverse reactions have been seen with ophthalmic beta-blockers and may potentially occur with benzalkonium:

Immune system disorders

Frequency unknown: Systemic allergic reactions including angioedema, urticaria, localized and generalized rash, pruritus, anaphylactic reaction.

Metabolism and nutrition disorders:

Frequency unknown: Hypoglycaemia.

Psychiatric disorders

Frequency unknown: nightmares, memory loss, hallucinations, psychoses, confusion

Nervous system disorders

Frequency unknown: cerebrovascular accident, cerebral ischemia, increases in signs and symptoms of myasthenia gravis, paraesthesia

Eye disorders

Frequency unknown: choroidal detachment following filtration surgery, corneal erosion, ptosis, diplopia.

Cardiac disorders

Frequency unknown: Chest pain, palpitations, oedema, congestive heart failure, atrioventricular block, cardiac arrest, cardiac failure. A slowed AV-conduction or increase of an existing AV-block

Vascular disorders

Frequency unknown: Raynaud’s phenomenon, cold and cyanotic hands and feet, Increase of an existing intermittent claudication

Respiratory, thoracic, and mediastinal disorders

Frequency unknown: Bronchospasm (predominantly in patients with pre-existing bronchospastic disease),

Gastrointestinal disorders

Frequency unknown: dyspepsia, diarrhoea, dry mouth, abdominal pain, vomiting.

Skin and subcutaneous tissue disorders

Frequency unknown: Psoriasiform rash or exacerbation of psoriasis.

Musculoskeletal and connective tissue disorders

Frequency unknown: Myalgia

Reproductive system and breast disorders

Frequency unknown: Sexual dysfunction, impotence.

General disorders and administration site conditions

Frequency unknown: fatigue

An increase in Anti Nuclear Antibodies (ANA) has been seen; its clinical relevance is unclear.

Cross-check medications

Review your medication to ensure that there are no potentially harmful drug interactions or contraindications.

Ask the Reasoner

Related medicines

© All content on this website, including data entry, data processing, decision support tools, "RxReasoner" logo and graphics, is the intellectual property of RxReasoner and is protected by copyright laws. Unauthorized reproduction or distribution of any part of this content without explicit written permission from RxReasoner is strictly prohibited. Any third-party content used on this site is acknowledged and utilized under fair use principles.