A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Betagan Side Effects, and Drug Interactions - Levobunolol
Betagan Side Effects, and Drug Interactions - Levobunolol
SIDE EFFECTS
In clinical trials
the use of BETAGAN has been associated with transient ocular burning
and stinging in up to 1 in 3 patients, and with blepharoconjunctivitis
in up to 1 in 20 patients. Decreases in heart
rate and blood
pressure have been
reported (see CONTRAINDICATIONS
and WARNINGS).
The following adverse reactions have been reported rarely with
the use of BETAGAN: iridocyclitis, headache,
transient ataxia,
dizziness, lethargy,
urticaria, and pruritus. Decreased corneal sensitivity
has been noted in a small number
of patients. Although levobunolol has minimal
membrane-stabilizing activity, there remains a possibility of decreased
corneal sensitivity
after prolonged use. The following additional adverse reactions
have been reported either with BETAGAN or ophthalmic
use of other beta-adrenergic receptor
blocking agents:
Body as a Whole: Headache, asthenia,
chest pain.
Cardiovascular: Bradycardia, arrhythmia,
hypotension, syncope,
heart block, cerebral
vascular accident, cerebral ischemia,
congestive heart failure,
palpitation, cardiac arrest.
Digestive: Nausea, diarrhea.
Psychiatric: Depression, confusion,
increase in signs and symptoms of myasthenia
gravis, paresthesia.
Skin: Hypersensitivity, including localized
and generalized rash, alopecia,
Stevens-Johnson Syndrome.
Respiratory: Bronchospasm (predominantly in patients with
pre-existing bronchospastic disease), respiratory failure, dyspnea,
nasal congestion.
Urogenital: Impotence.
Endocrine: Masked symptoms of hypoglycemia
in insulin dependent
diabetics (see WARNINGS).
Special Senses: Signs and symptoms of keratitis,
blepharoptosis, visual
disturbances including refractive changes (due to withdrawal
of miotic therapy
in some cases), diplopia, ptosis.
Other reactions associated with the oral
use of non-selective adrenergic receptor blocking
agents should be considered potential
effects with ophthalmic use of these agents.
DRUG INTERACTIONS
Although BETAGAN used alone has little or no effect
on pupil size, mydriasis
resulting from concomitant
therapy with BETAGAN and epinephrine
may occur.
Close observation of the patient
is recommended when a beta-blocker is administered to patients receiving
catecholamine-depleting drugs such as reserpine, because of possible
additive effects and
the production of
hypotension and/or marked bradycardia,
which may produce vertigo, syncope or postural
hypotension.
Patients receiving beta-adrenergic blocking
agents along with either oral or intravenous
calcium antagonists
should be monitored for possible atrioventricular conduction
disturbances, left ventricular
failure and hypotension.
In patients with impaired
cardiac function, simultaneous
use should be avoided altogether.
The concomitant
use of beta-adrenergic blocking
agents with digitalis and calcium
antagonists may have additive
effects on prolonging atrioventricular conduction time.
Phenothiazine-related compounds and beta-adrenergic blocking
agents may have additive
hypotensite effects due to the inhibition
of each other’s metabolism.
Risk of anaphylactic reaction: While taking beta-blockers,
patients with a history
of severe anaphylactic reaction
to a variety of allergens
may be more reactive to repeated challenge, either accidental, diagnostic,
or therapeutic. Such patients may be unresponsive to the usual doses
of epinephrine used to treat allergic
reaction.
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