Betaxolol ophthalmic solution is indicated for reducing intraocular pressure and is used in the treatment of ocular hypertension and chronic open-angle glaucoma. It may be used alone or in combination with other medications that lower intraocular pressure.

Betaxolol is a selective beta-1 adrenergic receptor blocker that lacks significant membrane-stabilizing (local anesthetic) activity and has no intrinsic sympathomimetic effect. When applied to the eye, it lowers both elevated and normal intraocular pressure, whether or not glaucoma is present. Elevated intraocular pressure can lead to optic nerve damage and visual field loss due to reduced ocular perfusion. Betaxolol reduces intraocular pressure primarily by decreasing aqueous humor production, as demonstrated by tonography and aqueous fluorophotometry. It does not cause pupil constriction (miosis) or accommodation spasm, which are commonly associated with miotic agents.

The onset of action usually occurs within 30 minutes, with maximum effect observed around 2 hours after application. A single dose can reduce intraocular pressure for up to 12 hours, and twice-daily use typically maintains intraocular pressure below 22 mm Hg in most patients.

0.5% ophthalmic solution: The usual dose is 1 drop of Betaxolol Hydrochloride ophthalmic solution in the affected eye(s) twice daily. In some patients, the intraocular pressure-lowering response may require a few weeks to stabilize. Clinical follow-up should include a determination of the intraocular pressure during the first month of treatment. Thereafter, intraocular pressure should be determined on an individual basis at the judgment of the physician.

0.25% ophthalmic solution: The recommended dose is one to two drops of Betaxolol Hydrochloride ophthalmic solution in the affected eye(s) twice daily.

Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Geriatric Use: No overall differences in safety or effectiveness have been observed between elderly and younger patients.

Patients receiving oral beta-blockers along with Betaxolol Hydrochloride ophthalmic solution should be monitored for additive effects on intraocular pressure or systemic beta-blocker effects. Careful monitoring is recommended when used with catecholamine-depleting drugs (e.g., reserpine) due to the risk of hypotension and/or bradycardia. Caution is also advised when used with adrenergic psychotropic medications. In angle-closure glaucoma, immediate treatment involves pupil constriction with a miotic agent; Betaxolol has minimal effect on the pupil. Therefore, when used in such cases, it should be combined with a miotic and not used alone.

Contraindicated in patients with hypersensitivity to any component of the product. Betaxolol should not be used in patients with sinus bradycardia, greater than first-degree atrioventricular block, cardiogenic shock, or a history of overt cardiac failure.

Ocular: Transient eye discomfort and occasional tearing may occur. Rare effects include reduced corneal sensitivity, redness, itching, corneal staining, keratitis, swelling, and sensitivity to light (photophobia).

Systemic: Systemic adverse effects are rare but may occur. These include:

• Cardiovascular: bradycardia, heart block, congestive heart failure
• Respiratory: bronchospasm, respiratory failure
• Others: hives, toxic epidermal necrolysis, hair loss, and glossitis

There are no adequate and well-controlled studies in pregnant women. Betaxolol ophthalmic solution should be used during pregnancy only if the expected benefit outweighs the potential risk to the fetus. It is not known whether Betaxolol is excreted in human breast milk. The potential risk of hypoglycemia and bradycardia in nursing infants has not been fully evaluated. Therefore, breastfeeding is not recommended during treatment.

In angle-closure glaucoma, immediate treatment aims to reopen the angle by constricting the pupil with a miotic agent. Betaxolol does not affect the pupil; therefore, it should be used in combination with a miotic agent rather than alone. Beta-adrenergic blockers should be used cautiously in patients prone to spontaneous hypoglycemia or in diabetic patients, as these drugs may mask the signs and symptoms of acute hypoglycemia.

No specific information is available regarding overdose. In case of topical overdose, the eyes may be rinsed with warm water to remove excess medication.

Drugs used in glaucoma and miotic therapy.

Store at room temperature. It is recommended not to use the contents for more than one month after first opening the bottle.