Betaxolol

How it works

It blocks beta-adrenergic receptors in the ciliary body, reducing aqueous humour production and thereby lowering intraocular pressure.

Prescribing in practice

• Even as eye drops it can be absorbed systemically, so avoid in uncontrolled heart failure, significant bradycardia or heart block, and use cautiously in asthma or COPD despite its relative beta-1 selectivity.
• Topical beta-blockers can mask the adrenergic warning signs of hypoglycaemia in people with diabetes.
• Press on the inner corner of the eye after instillation to reduce systemic absorption.

Monitoring

Monitor intraocular pressure for response and watch for systemic effects such as bradycardia or bronchospasm.

Counselling the patient

• Report breathlessness, wheeze, a slow heartbeat or dizziness.
• Transient stinging or blurred vision after instillation is common.
• Do not stop suddenly without advice if you also have heart or blood pressure conditions.

Evidence & guidelines

Betaxolol is an established topical beta-blocker for glaucoma and ocular hypertension, with comparatively favourable respiratory tolerability among ocular beta-blockers.