Betoptic, Betoptic-S, Kerlone
Classifications: eye preparation; miotic (antiglaucoma agent); beta-adrenergic blocker; antihypertensive agent; Therapeutic: antiglaucoma agent (miotic); antihypertensive agent
Pregnancy Category: C
10 mg, 20 mg tablets; 0.25%, 0.5% ophthalmic solution
Acts as a beta1-selective adrenergic receptor blocking agent, especially in the cardioselective beta1 receptors. Its antihypertensive effect is thought to be due to: (1) decreasing cardiac output, (2) reducing sympathetic
nervous system outflow to the periphery resulting in vasodilatation, and (3) suppression of renin activity in the kidney.
It reduces intraocular pressure within the eye by decreasing the production of aqueous humor.
All three mechanisms result in its antihypertensive effect.
Hypertension. Ocular use for intraocular hypertension, chronic open angle glaucoma (see Appendix A-1).
Sinus bradycardia, AV block greater than first degree, cardiogenic shock, severe left ventricular heart failure; glaucoma,
angle closure (unless with a miotic); pregnancy (category C); children <18 y.
Concomitant use of systemic beta-adrenergic blocking agents; history of heart failure; renal impairment, elderly; hyperthyroidism
or thyrotoxicosis; diabetes mellitus; with evidence of airflow obstruction or reactive airway disease; depression; lactation.
Route & Dosage
Adult: PO 510 mg q.d. (max: 20 mg/d in 12 divided doses)
Clcr <10mL/min: administer 50% of dose
- Check pulse before administering betaxolol, oral or ophthalmic. If there are extremes (rate or rhythm), withhold medication
and call the physician.
- Be aware tablet may be crushed before administration and taken with fluid of patient's choice.
Adverse Effects (≥1%) CV:
Bradycardia, hypotension. CNS: Depression
Increased airway resistance. Special Senses:
With ophthalmic solution, mild ocular stinging
and discomfort, tearing.
and other catecholamine-depleting agents
may cause additive hypotensive effects or bradycardia. Verapamil
may cause additive heart block.
90% of PO dose reaches systemic circulation. Onset:
0.51 h. Peak:
2 h. Duration:
>12 h. Metabolism:
In liver by CYP1A2 and 2D6. Elimination:
3040% in urine, 5060% in bile and feces. Half-Life:
Assessment & Drug Effects
- Monitor pulse rate and BP at regular intervals in patients with severe heart disease.
- Monitor therapeutic effectiveness. Some patients develop tolerance during long-term therapy.
Patient & Family Education
- Report unusual pulse rate or significant changes to physician according to parameters provided.
- Adhere to regimen EXACTLY as prescribed. Do not stop drug abruptly; angina may be exacerbated; dosage is reduced over a period of 12 wk.
- Report difficulty in breathing promptly to physician. Drug withdrawal may be indicated.