Home Drug Guide Levobunolol Hydrochloride

Drug Guide

Generic Name

Levobunolol Hydrochloride

Brand Names Betagan, Akbeta

Classification

Therapeutic: Beta-adrenergic blocker, ophthalmic agent

Pharmacological: Non-selective beta-adrenergic antagonist

FDA Approved Indications

Ocular hypertension
Open-angle glaucoma

Mechanism of Action

Levobunolol reduces intraocular pressure by decreasing aqueous humor formation through non-selective beta-adrenergic blockade in the ciliary body.

Dosage and Administration

Adult: Typically, one drop in affected eye(s) twice daily.

Pediatric: Use not well established; consult specialized references.

Geriatric: Start with lower frequency or concentration; monitor appropriately.

Renal Impairment: Use with caution; adjust dosing if necessary based on renal function.

Hepatic Impairment: Use caution; no specific dose adjustment established.

Pharmacokinetics

Absorption: Minimal systemic absorption when used ocularly.

Distribution: Widely distributed; primarily local action.

Metabolism: Metabolized minimally systemically; hepatic metabolism is limited.

Excretion: Primarily eliminated via urine.

Half Life: Approximately 4-6 hours, but ocular half-life may vary.

Contraindications

Bronchial asthma or related bronchospastic conditions
Sinus bradycardia
AV block (second or third degree)
Uncompensated heart failure

Precautions

Use with caution in patients with cardiovascular diseases, diabetes, or thyroid disorders; ocular surface disease; systemic absorption risk.

Adverse Reactions - Common

Ocular irritation, including subconjunctival hemorrhage (Common)
Blurred vision (Common)

Adverse Reactions - Serious

Systemic beta-blockade effects, such as bradycardia, hypotension, bronchospasm (Rare)
Corneal anesthesia, keratopathy (Rare)

Drug-Drug Interactions

Other systemic beta-blockers; calcium channel blockers (e.g., verapamil, diltiazem); digitalis glycosides

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor intraocular pressure pre- and post-treatment; assess for systemic beta-blocker effects; check for contraindications.

Diagnoses:

Risk for systemic side effects such as bradycardia or bronchospasm
Risk for ocular surface irritation

Implementation: Administer as prescribed; educate patient on proper instillation technique; counsel on warning signs of systemic effects.

Evaluation: Evaluate reduction in intraocular pressure and monitor for adverse effects.

Patient/Family Teaching

Use drops exactly as prescribed.
Inform about potential systemic side effects, including symptoms of bradycardia or breathing difficulties.
Report any vision changes, eye irritation, or systemic symptoms promptly.
Do not discontinue abruptly without consulting healthcare provider.

Special Considerations

Black Box Warnings:

None specific for levobunolol.

Genetic Factors: Genetic variations in drug metabolism may influence individual response, but specific guidance is limited.

Lab Test Interference: May affect serum glucose levels in diabetic patients or thyroid function tests due to systemic absorption.

Overdose Management

Signs/Symptoms: Bradycardia, hypotension, bronchospasm, dizziness, fainting.

Treatment: Supportive care; administer atropine for bradycardia; avoid beta-agonists unless indicated; monitor cardiovascular status.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable until the expiration date on the container.