Chemical formula: C₁₈H₂₉NO₃ Molecular mass: 307.428 g/mol PubChem compound: 2369
Betaxolol interacts in the following cases:
Caution is required when co-administering betaxolol with sympathomimetic agents due to a potential risk of lowering beta-blocker activity.
Caution is required when co-administering betaxolol with corticosteroids, tetracosactide due to possible reduced antihypertensive action (retention of water and sodium with corticosteroids).
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).
All beta-blockers can cover the symptoms of hypoglycaemia, e.g. palpitations and tachycardia.
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).
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.
Co-administration of betaxolol with amiodarone is not recommended as it can lead to contractility, automation and conduction disorders (suppression of sympathetic compensation mechanisms).
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.
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.
Caution is required when co-administering betaxolol with mefloquine due to a potential risk of bradycardia (adding bradycardia-inducing effects).
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.
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.
Betaxolol should not be taken in parallel with verapamil or for several days after treatment with verapamil (and vice versa).
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).
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.
Betaxolol should be administered with caution to patients with first degree atrioventricular block.
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.
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.
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.
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.
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.
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.
There are no data on the effects of betaxolol on human fertility.
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.
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.
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.
Frequency unknown: hypersensitivity
Rare: anxiety, insomnia, depression
Common: headache
Rare: syncope
Frequency unknown: dizziness
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
Uncommon: bradycardia, tachycardia
Frequency unknown: arrhythmia
Rare: hypotension
Uncommon: asthma, dyspnoea, rhinitis,
Rare: cough, rhinorrhoea
Uncommon: nausea
Rare: dysgeusia
Rare: dermatitis, rash, alopecia
Rare: libido decreased
Frequency unknown: asthenia
Additional adverse reactions have been seen with ophthalmic beta-blockers and may potentially occur with benzalkonium:
Frequency unknown: Systemic allergic reactions including angioedema, urticaria, localized and generalized rash, pruritus, anaphylactic reaction.
Frequency unknown: Hypoglycaemia.
Frequency unknown: nightmares, memory loss, hallucinations, psychoses, confusion
Frequency unknown: cerebrovascular accident, cerebral ischemia, increases in signs and symptoms of myasthenia gravis, paraesthesia
Frequency unknown: choroidal detachment following filtration surgery, corneal erosion, ptosis, diplopia.
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
Frequency unknown: Raynaud’s phenomenon, cold and cyanotic hands and feet, Increase of an existing intermittent claudication
Frequency unknown: Bronchospasm (predominantly in patients with pre-existing bronchospastic disease),
Frequency unknown: dyspepsia, diarrhoea, dry mouth, abdominal pain, vomiting.
Frequency unknown: Psoriasiform rash or exacerbation of psoriasis.
Frequency unknown: Myalgia
Frequency unknown: Sexual dysfunction, impotence.
Frequency unknown: fatigue
An increase in Anti Nuclear Antibodies (ANA) has been seen; its clinical relevance is unclear.
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