Effect of Adding Betaxolol to Dipivefrin Therapy

Weinreb, Robert N.; Ritch, Robert; Kushner, F H

doi:10.1016/0002-9394(86)90594-5

Cited by 24 publications

(3 citation statements)

References 14 publications

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“…However, there is evidence for an additive effect with betaxolol and epinephrine (Clark et al 1989;Cyrlin et al 1982;Keates & Stone 1981;Thorson 1981;Weinreb et al 1986), and some authors found the addition of epinephrine was more effective with betaxolol than with timolol (Allen & Epstein 1986) although we believe that there was a fall in lOP in some eyes only and patients should be assessed individually (Clark et al 1989). Studies with timolol and epinephrine usually show little or no additive effect, although individual patients do vary and certain regimens may produce an additive effect.…”

Section: Combination With Other Drugsmentioning

confidence: 83%

Ocular ??-Blockers in Glaucoma Management

Brooks

Gillies

1992

Drugs & Aging

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Topical beta-blockers reduce the intraocular pressure (IOP) by blockade of sympathetic nerve endings in the ciliary epithelium causing a fall in aqueous humour production. Two types of topical beta-blockers are available for use in glaucoma: nonselective, which block both beta 1- and beta 2-adrenoceptors; and cardioselective, which block only beta 1-receptors. Of the beta-Blockers commercially available, timolol, levobunolol, metipranolol and carteolol are nonselective, and betaxolol is cardioselective. Twice-daily timolol is probably the most effective agent in lowering IOP, although levobunolol is equally effective and can be used once daily with little difference in effect. Carteolol is used twice daily and any theoretical advantage in diminished side effects conferred by its partial beta-agonist activity compared with timolol has not been fully substantiated. Metipranolol is effective twice daily and does not have partial beta-agonist activity. Betaxolol has an effect comparable to timolol in lowering IOP, but is less effective in some patients. beta-Blockers can be used with other antiglaucoma medications, but their combined action with epinephrine (adrenaline) is suspect, particularly in the case of the nonselective beta-blockers, and the effect should be assessed in patients on an individual basis. Local stinging can be a problem in some patients with betaxolol. The most serious side effects of beta-blockers are the exacerbation of chronic obstructive airways disease with nonselective agents and the precipitation of bronchospasm in some patients. Betaxolol seems relatively free of adverse respiratory effects, although this may be dose-related and extreme caution should still be exercised in patients with any history of respiratory illness. Because of the lower risk of precipitating side effects, betaxolol is probably the beta-blocker of first choice for use in glaucoma; timolol or levobunolol are reserved for patients who do not respond satisfactorily to betaxolol and are quite free of respiratory disease.

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Section: Combination With Other Drugsmentioning

confidence: 83%

Ocular ??-Blockers in Glaucoma Management

Brooks

Gillies

1992

Drugs & Aging

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“…22 The amount of fall was small in most patients, and in one or two patients there was a small rise, but intraocular pressure can vary easily in these old patients and strict observance of the drop routine is not always ideal. In all patients the glaucoma was of long standing, and all but one were already on intensive miotic and/or adrenaline therapy so that a small fall in pressure was important.…”

Section: Commentmentioning

confidence: 99%

Betaxolol Eye Drops as a Safe Medication to Lower Intraocular Pressure

Brooks

Gillies

West

1987

Australian and New Zealand Journal of Ophthalmology

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“…They lower the intraocular pressure mainly by depressing the production of aqueous. Local anaesthetic effects of blockers may be from membrane stabilisation'2 or inhibition of corneal epithelial chloride transport,3 which is independent of their 13 blocking effect.…”

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confidence: 99%

Effects of topical timolol (0.5%) and betaxolol (0.5%) on corneal sensitivity.

Weissman

Asbell

1990

British Journal of Ophthalmology

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There are conflicting reports on the propensity of topical 1B blockers to produce corneal anaesthesia. We measured corneal sensitivity thresholds quantitatively for 10 minutes following the administration of one drop of topical timolol maleate (0.5%), betaxolol hydrochloride (0.5%), or saline in 30 eyes of 18 normal subjects in a randomised, doublemasked study. Most subjects had insignificant changes in corneal sensitivity thresholds. We identified, however, a subgroup of four subjects (five eyes) that had a marked and prolonged increase of corneal sensitivity threshold (corneal anaesthesia) after timolol (three eyes) and betaxolol (two eyes). The group mean age of these 'responders' (49.0 years) was significantly greater (p<0005) than that of the non-responders (35.0). We recommend periodic measurements of corneal sensitivity in older patients receiving topical timolol or betaxolol, especially when given in higher concentrations, to identify responders, who may be at risk of developing keratitis.

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Effect of Adding Betaxolol to Dipivefrin Therapy

Cited by 24 publications

References 14 publications

Ocular ??-Blockers in Glaucoma Management

Ocular ??-Blockers in Glaucoma Management

Betaxolol Eye Drops as a Safe Medication to Lower Intraocular Pressure

Effects of topical timolol (0.5%) and betaxolol (0.5%) on corneal sensitivity.

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