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Angle on Glaucoma: Medications
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bottle of Betagan   Betagan ®

Generic name: levobunolol hydrochloride
Concentration: 0.25%, 0.5%
Mechanism of action: This beta blocker reduces the aqueous humor production and changing blood flow in the eye, thus lowering the pressure.
Indications: Treatment of open angle glaucoma or ocular hypertension.
Dosage: Instill 1 or 2 drops of the 0.5% solution in the eye(s) once per day or 1 or 2 drops of the 0.25% solution twice per day. In severe glaucoma, put 1 or 2 drops of the 0.5% solution in the eye(s) twice per day. Consult your doctor for the correct dosage.
Use with caution in patients with/during:
  1. Levobunolol should NOT be used in patients with preexisting cardiac disease, such as severe bradycardia, advanced AV block, cardiogenic shock, coronary artery disease, vasospastic angina, or congestive heart failure, particularly those with severe left ventricular dysfunction.
  2. Hyperthyroidism because it may mask tachycardia.
  3. Diabetes mellitis because it can mask symptoms of hypoglycemia.
  4. Asthma or pulmonary disease (COPD, emphysema, bronchitis).
  5. Sulfite hypersensitivity.
  6. Myasthenia gravis.
  7. Pregnancy, breast feeding or in children.
Side effects:
Common
  • Pulse under 50 beats/minute
  • Transient stinging or burning on instillation
  • Hypotension

Life Threatening Symptoms

  • Arrhythmias (irregular heart rhythm)
  • Cardiac arrest
  • Cerebrovascular accident (stroke)
  • Congestive heart failure (severe shortness of breath, rapid heartbeat)
  • Heart block

Less Common to Rare
  • Dizziness
  • Transient ataxia (temporary loss of coordination)
  • Difficulty breathing
  • Urticaria (an itching attack, may be due to drug sensitivity)
  • Rash
  • Pruritus (itching)
  • Lethargy (state of unconsciousness)
  • Asthenia (weakness)
  • Dry, burning eyes
  • Chest pain
  • Headache
Notes: Side effects of levobunolol are usually mild and temporary. They seem to subside the longer the drug is used.

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URL: http://www.opt.indiana.edu/clinics/pteduc/glaucoma/meds/betagan.htm
Revised: March 19, 2002
IU Optometry home page: http://www.opt.indiana.edu/
Comments: Web Administrator
Page design and coding: Terri Greene
Copyright © 2002, The Trustees of Indiana University