Betaxolol

Administration

• Type: Beta blocker
• Dosage Forms: 10 mg, 20 mg, 0.5% ophthalmic solution, 0.25% suspension
• Routes of Administration: Oral, ophthalmic
• Common Trade Names: Kerlone

Adult Dosing

• 5-80 mg PO daily
• 1-2 drops in affected eye BID

Pediatric Dosing

Safety/efficacy of oral forms and 0.5% solution not established in peds

• 0.25% suspension: 1 drop in affected eye BID

Special Populations

• Pregnancy Rating: C; Caution advised in 2nd and 3rd trimesters. Risk of intrauterine growth restriction and neonatal adverse effects including bradycardia and hypoglycemia.
• Lactation risk: L3; Safety unknown
• Severe renal impairment: Start at 5mg PO daily, increase by 5mg/day q2wk to max daily dose 20mg
• Hepatic dosing: no adjustment

Contraindications

• Allergy to class/drug
• Sinus bradycardia, 2nd or 3rd degree AV block, sick sinus syndrome (without pacemaker)
• Decompensated heart failure, cardiogenic shock
• Untreated pheochromocytoma
• Avoid abrupt withdrawal

Adverse Reactions

Serious

• CHF
• Severe bradycardia, heart block
• Angina exacerbation, ventricular arrythmia, or MI with abrupt discontinuation
• Bronchospasm
• Hypersensitivity reaction
• Psoriasis exacerbation, lupus erythematosus, Raynaud's phenomenon

Common

• Bradycardia, chest pain
• Headache, dizziness, fatigue
• Dyspepsia, diarrhea
• Arthralgia
• URI, pharyngitis
• Dyspnea

Pharmacology

• Half-life: 14-22 hr
• Metabolism: Liver extensively; CYP450: Unknown
• Excretion: Urine > 80% (15% unchanged)

Mechanism of Action

• Selectively antagonizes beta-1 adrenergic receptors.

See Also

• Beta-blockers

References

Authors

Jonathan Warren, Claire