Before Using

Drug information provided by: Merative, Micromedex®

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Infants may be especially sensitive to the effects of ophthalmic beta-adrenergic blocking agents. This may increase the chance of side effects during treatment.

Geriatric

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.

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.

Breastfeeding

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.

Drug Interactions

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. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Albuterol
  • Ceritinib
  • Clonidine
  • Cobicistat
  • Crizotinib
  • Darunavir
  • Desvenlafaxine
  • Diltiazem
  • Dronedarone
  • Duloxetine
  • Epinephrine
  • Escitalopram
  • Fenoldopam
  • Fingolimod
  • Fluoxetine
  • Formoterol
  • Indacaterol
  • Iohexol
  • Lacosamide
  • Levalbuterol
  • Olodaterol
  • Oxymetazoline
  • Paroxetine
  • Ponesimod
  • Rivastigmine
  • Salmeterol
  • Sertraline
  • Terbutaline
  • Verapamil
  • Vilanterol

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergic reactions, severe (history of)—Use of an ophthalmic beta-adrenergic blocking agent may reduce the effectiveness of the medicine (epinephrine) used to treat severe allergic reactions.
  • Asthma (or history of), chronic bronchitis, emphysema, or other lung disease—Severe breathing problems, including death due to bronchospasm (spasm of the bronchial tubes), have been reported in patients with asthma following use of some ophthalmic beta-adrenergic blocking agents (carteolol, levobunolol, metipranolol, and timolol). Although most often not a problem, the possibility of wheezing or troubled breathing also exists with betaxolol and levobetaxolol.
  • Type 2 diabetes mellitus or
  • Hypoglycemia (low blood sugar)—Ophthalmic beta-adrenergic blocking agents may cover up some signs and symptoms of hypoglycemia (low blood sugar), such as fast heartbeat and trembling, although they do not cover up other signs, such as dizziness or sweating.
  • Heart or blood vessel disease—Ophthalmic beta-adrenergic blocking agents may decrease heart activity.
  • Myasthenic conditions—Ophthalmic beta-adrenergic blocking agents may worsen muscle weakness caused by diseases such as myasthenia gravis.
  • Overactive thyroid—Ophthalmic beta-adrenergic blocking agents may cover up certain signs and symptoms of hyperthyroidism (overactive thyroid). Suddenly stopping the use of ophthalmic beta-adrenergic blocking agents may cause a sudden and dangerous increase in thyroid symptoms.

Portions of this document last updated: Feb. 01, 2024

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