Pronunciation: (LEE-voe-BYOO-no-lahl)Class: Beta-adrenergic blocking agent, Ophthalmic
Trade Names:Betagan Liquifilm- Solution 0.25%- Solution 0.5%PMS-Levobunolol
Reduces IOP by reducing aqueous humor production.
1 h after treatment.
2 to 6 h.
Up to 24 h.
Indications and Usage
Treatment of IOP in chronic open-angle glaucoma or ocular hypertension.
Bronchial asthma; severe COPD; sinus bradycardia; second- and third-degree AV block; cardiac failure; cardiogenic shock.
Dosage and AdministrationAdults
Topical 1 drop in affected eye(s) once or twice daily.
- Position patient with head tilted back. Instruct patient to look upward. Gently depress conjunctival sac to create small area for medication administration.
- Compress lacrimal sac for at least 1 min after administration to delay drainage of medication into nasolacrimal duct and to prevent systemic absorption.
- Have patient tilt head back, pull lower lid out to make pocket, and instill medication into conjunctival sac. Have patient close eyes and apply light finger pressure to bridge of nose for 1 to 2 min. Advise patient to not blink or rub eyes.
Store at room temperature. Protect from light.
Drug InteractionsBeta blockers, oral
Additive effects on systemic beta blockade.Epinephrine, ophthalmic
Hypertension caused by unopposed alpha-adrenergic stimulation.
Laboratory Test Interactions
None well documented.
Arrhythmia; bradycardia; hypotension; syncope; heart block; cerebrovascular accident; cerebral ischemia; CHF; cardiac arrest.
Keratitis; blepharoptosis; visual disturbances; diplopia; ptosis; transient burning; stinging; blepharoconjunctivitis; decreased corneal sensitivity.
Category C .
Safety and efficacy not established.
Special Risk Patients
Use with caution in patients with cerebrovascular insufficiency and bronchial diseases.
Contains metabisulfite, which may cause allergic-type reactions in susceptible persons.
May mask hypoglycemic symptoms in patients with insulin-dependent diabetes. Use with caution.
Adverse reactions like those seen with systemic beta-blockers may occur, due to absorption.
May mask clinical signs of hyperthyroidism.
Bradycardia, hypotension, bronchospasm, heart failure.
- Instruct patient in proper administration. Advise patient that if dose is missed, it should be administered as soon as possible unless close to time of next dose. Do not double up.
- Caution patient not to stop taking medication unless instructed to do so by health care provider.
- Emphasize importance of washing hands before drug administration and of not allowing dropper to come into contact with any surface, including eyelashes.
- Instruct patient to report the following symptoms to health care provider: eye infection, inflammation, rash, itching or decreased vision.
- Instruct patient to notify health care provider immediately if severe or sudden eye pain occurs.
- Advise diabetic patient that drug may mask signs of hypoglycemia and to monitor glucose levels carefully.
- Advise patient to inform health care provider or dentist of medication regimen before surgical or dental procedures. Gradual withdrawal of medication may be necessary before procedure.
- Explain importance of scheduling regular follow-up examinations while taking medication.
Copyright © 2009 Wolters Kluwer Health.
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