Betaxolol
Antiglaucoma agents
Antiglaucoma agents
A β1-selective beta-blocker eye drop for glaucoma. It affects the airways less than timolol, but can still slow the heart.
Quick facts
- Group
- Antiglaucoma agents
- Target
- β1 adrenergic receptor (cardioselective)
- Used for
- Chronic open-angle glaucoma · Ocular hypertension
- Key effects
- Brief eye discomfort or stinging · Tearing
- Monitor
- Intraocular pressure · Pulse and blood pressure
- ATC
- S01ED02
No doses: the clinician sets them by the current guideline.
Mechanism of action
Betaxolol is a cardioselective (β1) blocker without intrinsic sympathomimetic or significant local anaesthetic activity. In the eye it lowers intraocular pressure mainly by reducing aqueous humour production. Because it spares β2 receptors more than timolol, it has less effect on lung function, yet absorbed drug can still cause systemic beta-blockade.
- Betaxolol blocks β1 receptors in the ciliary body
- Less aqueous humour is produced
- Intraocular pressure falls; β2 in bronchi is largely spared
Indications
- Chronic open-angle glaucoma Open-angle glaucoma →
- Ocular hypertension
Adverse effects
Common
- Brief eye discomfort or stinging
- Tearing
- Blurred vision, dry eye, itching
Contraindications
- Sinus bradycardia or AV block greater than first degree
- Cardiogenic shock or overt heart failure
- Hypersensitivity to any component
- Caution in asthma or severe reactive airway disease
Key interactions
- Oral beta-blockers
- Additive effect on eye pressure and on systemic beta-blockade
- Catecholamine-depleting drugs (reserpine)
- Hypotension and bradycardia
- Epinephrine for anaphylaxis
- Patients may not respond to usual epinephrine
What is monitored
- Intraocular pressure
- Pulse and blood pressure
- Breathlessness or wheeze
- Blood glucose in diabetes
Administration and safety
- In acute angle-closure glaucoma it is used only together with a miotic, never alone (it does not constrict the pupil).
- Pressing on the inner corner of the eye after the drop reduces the amount that reaches the blood.
- The anaesthetist is told about the drop before surgery.
Pregnancy and breastfeeding
There are no adequate human studies; it is used only if the benefit justifies the risk to the fetus.
Nursing care
- Ask about asthma, COPD, slow pulse, heart block and heart failure before the first dose.
- Check pulse and blood pressure at the start and at follow-up.
- Teach that a racing heart may not warn of hypoglycaemia.
- Teach to report wheeze, fainting or swollen ankles.
Pharmacokinetics
- Absorption
- Can be absorbed into the systemic circulation from the eye
- Onset and duration
- Effect usually seen within half an hour, peaking at about two hours, lasting about half a day
Test yourself
Think of the answer, then tap the question to see it.
How does betaxolol differ from timolol?
It is β1-selective, so it has less effect on the airways.
Which cardiac conditions contraindicate it?
Sinus bradycardia, AV block greater than first degree, cardiogenic shock or overt heart failure.
Why is it not used alone in acute angle closure?
It does not constrict the pupil, so the angle stays closed; it is given with a miotic.
Connections
← Back to the class: Antiglaucoma agents
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - BETAXOLOL HYDROCHLORIDE solution/ drops (DailyMed (U.S. National Library of Medicine), 2026); Betaxolol Ophthalmic: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.