Beta-blocker levobunolol

Geriatric Considerations - Summary Levobunolol decreased lOP approximately 29%. Systemic absorption of ophthalmic drugs may occur and cause adverse effects in older adults. Since levobunolol is a nonselective beta-blocker, older adults may be more sensitive to the cardiovascular, CNS, and respiratory effects of the drug. Tachyphylaxis may occur after long-term therapy. 

A 60-year-old man with open-angle glaucoma developed an allergic contact conjunctivitis and dermatitis from carteolol, a topical non-cardioselective beta-blocker (149). He had extensive cross-reactivity to other topical beta-blockers, such as timolol and levobunolol. Cross-reactivity among different beta-blockers is possibly due to a common lateral aliphatic chain. 

Beta-blockers that are available as eye-drops include timolol, metipranolol, and levobunolol, which are non-selective betai- and beta2-adrenoceptor antagonists, and betaxolol, a relatively cardioselective betai-adrenoceptor antagonist. Although selective betai-blockers are less likely to precipitate bronchospasm, this and other systemic effects can nevertheless occur (SED-12,1200). 

Beta-blockers Timolol, betaxolol, carteolol, levobunolol, metipranolol Decreased aqueous secretion from the ciliary epithelium Topical drops... 

Systemic Effects. Because levobunolol is a potent and effective Pi and P2 blocker, it shares with timolol the same potential for systemic beta-blockade. Mean resting heart rate may decrease 3 to 10 bpm during use of levobunolol, and some reduction in blood pressure may occur.Topical ocular dosing with levobunolol results in plasma levels of approximately 1 ng/ml. As with timolol, 0.5% levobunolol reduces maximal exercise-induced heart rate by approximately 9 bpm. 

Beta-adrenergic blockers Betaxolol Carteolol Levobunolol Metipranolol Timolol Decrease aqueous inflow Stinging, dry eyes, blurred vision, blepharitis... 

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