📋 Indications & Clinical Dosage
*Reduction of intra-ocular pressure in primary open-angle glaucoma:*
Adult: Apply twice daily.
*Ocular hypertension, chronic open angle glaucoma, secondary glaucoma:*
Adults: Initially 1 drop of 0.25% soln. twice daily changing to 0 50% soln. twice daily if required.
⛔ Contraindications
Sinus bradycardia, 2nd or 3rd degree AV block, uncompensated cardiac failure, cardiogenic shock, hypotension, severe Raynauds disease, unstable angina, asthma history of obstructive pulmonary disease, soft contact lenses.
⚠️ Precautions & Warnings
Hepatic and renal impairment, sick sinus syndrome, metabolic acidosis, 1st degree AV block, history of severe cardiac disease, hyperthyroidism, diabetes. Advise patient to report any inter current ocular condition. Monitor cardiac function and treatment following filtration procedures. Withdraw gradually.
🔄 Drug Interactions
Floctafenine, amiodarone, MAOIs, verapamil, diltiazem, nifedipine, antihypertensives, adrenaline, oral Beta-blockers, digoxin, disopyramide, lidocaine, quinidine, clonidine, insulin, oral hypoglycaemics.
⚠️ Adverse Reactions / Side Effects
Anaphylaxis, burning, corneal disorders, dry eyes, blepharoconjunctivitis, erythema, itching, ocular stinging, pain, ocular irritation, transient blurred vision, bronchospasm, exacerbation of myasthenia gravis, GI and CNS disturbances, rash, systemic beta-blocker effects.
🤰 Pregnancy & Lactation Safety
Lactation / Breastfeeding:
Not recommended, avoid
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.