Cardioselective beta-blocker (eye drops + oral)
Betaxolol
Brand names: Betoptic
Adult dose
Dose: Eye: 1 drop BD; Oral hypertension: 20mg OD
Route: Ophthalmic / Oral
Frequency: BD (eye) / OD (oral)
Clinical pearls
- NICE NG81 glaucoma: cardioselective alternative to timolol where bronchospasm risk
- RCOphth
- Punctal occlusion reduces systemic absorption
Contraindications
- Severe asthma (less than non-selective)
- Bradyarrhythmia / heart block
- Decompensated heart failure
- Hypersensitivity
Side effects
- Ocular: stinging, dry eye, blurred vision; Systemic: bronchospasm (less than timolol), bradycardia, fatigue, depression
Interactions
- Systemic beta-blockers
- Verapamil/diltiazem
- Insulin/oral hypoglycaemics
Monitoring
- IOP
- Visual fields
- HR / BP
Reference: BNF; NICE NG81; RCOphth; https://bnf.nice.org.uk/drugs/betaxolol/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- DOAC Score for Selecting Direct Oral Anticoagulant in Non-Valvular AF · Anticoagulation
- MAGGIC Heart Failure Risk Score · Heart Failure
- Long QT Syndrome (Schwartz Score) · Channelopathy / Sudden Cardiac Death
- C-Peptide to Glucose Ratio · Diabetes Classification
- International Staging System (ISS) for Multiple Myeloma · Multiple Myeloma
- Revised ISS (R-ISS) for Multiple Myeloma · Haematological Malignancy
Pathways
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme