Levobunolol

Levobunolol Brand Names- Ak-Beta | Betagan

What is Levobunolol

Levobunolol is an ophthalmic beta-blocker. It is ‘nonselective’ (i.e., equally effective at beta-1 and beta-2 receptor sites).

Levobunolol is the levorotatory isomer of bunolol, which is structurally similar to propranolol. Levobunolol has a 60-fold and 3-fold greater potency compared with the dextrorotatory isomer and the racemic compound, respectively.

Only the levo isomer is used clinically as an ophthalmic agent for the treatment of increased IOP due to open-angle glaucoma or ocular hypertension.

Levobunolol was approved by the FDA in December 1985.

Indications

• glaucoma
• ocular hypertension

For the treatment of chronic open-angle glaucoma or ocular hypertension

Side Effects

1. alopecia
2. anaphylactoid reactions
3. arrhythmia exacerbation
4. asthenia
5. ataxia
6. AV block
7. blepharitis
8. bradycardia
9. bronchospasm
10. cardiac arrest
11. chest pain (unspecified)
12. confusion
13. conjunctivitis
14. depression
15. diarrhea
16. diplopia
17. dizziness
18. dyspnea
19. foreign body sensation
20. headache
21. heart failure
22. hypotension
23. impotence (erectile dysfunction)
24. keratitis
25. lethargy
26. myasthenia
27. nasal congestion
28. nausea
29. ocular irritation
30. palpitations
31. paresthesias
32. pruritus
33. ptosis
34. rash
35. respiratory arrest
36. Stevens-Johnson syndrome
37. stroke
38. syncope
39. urticaria
40. uveitis
41. visual impairment
42. weakness

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• acute bronchospasm
• asthma
• AV block
• bradycardia
• breast-feeding
• bronchitis
• cardiac disease
• cardiogenic shock
• cerebrovascular disease
• chronic obstructive pulmonary disease (COPD)
• closed-angle glaucoma
• contact lenses
• coronary artery disease
• diabetes mellitus
• emphysema
• geriatric
• heart failure
• hepatic disease
• hyperthyroidism
• hypotension
• myasthenia gravis
• peripheral vascular disease
• pheochromocytoma
• pregnancy
• Raynaud’s phenomenon
• sick sinus syndrome
• sulfite hypersensitivity
• surgery
• thyroid disease
• thyrotoxicosis
• vasospastic angina
• ventricular dysfunction

Interactions

• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Adenosine
• Albiglutide
• Aldesleukin, IL-2
• Alemtuzumab
• Alfentanil
• Alfuzosin
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Alogliptin; Metformin
• Alpha-blockers
• Alpha-glucosidase Inhibitors
• Alprostadil
• Amifostine
• Amiodarone
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amyl Nitrite
• Antithyroid agents
• Apomorphine
• Apraclonidine
• Aripiprazole
• Articaine; Epinephrine
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atazanavir
• Atazanavir; Cobicistat
• Baclofen
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Beta-agonists
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bosentan
• Bretylium
• Brexpiprazole
• Bupivacaine; Lidocaine
• Cabergoline
• Caffeine; Ergotamine
• Canagliflozin; Metformin
• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
• Cariprazine
• Ceritinib
• Cevimeline
• Chloroprocaine
• Chlorthalidone; Clonidine
• Choline Salicylate; Magnesium Salicylate
• Clevidipine
• Clonidine
• Clozapine
• Co-Enzyme Q10, Ubiquinone
• Cocaine
• Conivaptan
• Crizotinib
• Dapagliflozin; Metformin
• Desflurane
• Dexmedetomidine
• Dextromethorphan; Quinidine
• Diazoxide
• Dihydroergotamine
• Dipeptidyl Peptidase-4 Inhibitors
• Dipyridamole
• Doxazosin
• Dronedarone
• Dulaglutide
• Dutasteride; Tamsulosin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enflurane
• Epoprostenol
• Ergonovine
• Ergotamine
• Ertugliflozin; Metformin
• Estradiol
• Estradiol Cypionate; Medroxyprogesterone
• Etomidate
• Exenatide
• Fenoldopam
• Fingolimod
• Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
• Fluorescein
• Fluoxetine; Olanzapine
• food
• Fospropofol
• Galantamine
• General anesthetics
• Ginger, Zingiber officinale
• Glipizide; Metformin
• Glucagon
• Glyburide; Metformin
• Guanabenz
• Guanfacine
• Halothane
• Hydralazine; Isosorbide Dinitrate, ISDN
• Icosapent ethyl
• Iloperidone
• Iloprost
• Incretin Mimetics
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Intravenous Lipid Emulsions
• Isocarboxazid
• Isoflurane
• Isosorbide Dinitrate, ISDN
• Isosorbide Mononitrate
• Isradipine
• Ivabradine
• Ketamine
• Lacosamide
• Lanreotide
• Lasmiditan
• Levobupivacaine
• Levodopa
• Levothyroxine
• Levothyroxine; Liothyronine (Porcine)
• Levothyroxine; Liothyronine (Synthetic)
• Lidocaine
• Lidocaine; Prilocaine
• Linagliptin; Metformin
• Linezolid
• Liothyronine
• Liraglutide
• Lithium
• Lixisenatide
• Lovastatin; Niacin
• Lurasidone
• Magnesium Salicylate
• Mefloquine
• Meglitinides
• Mestranol; Norethindrone
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methacholine
• Methohexital
• Methylergonovine
• Methysergide
• Milrinone
• Nefazodone
• Nesiritide, BNP
• Neuromuscular blockers
• Niacin, Niacinamide
• Niacin; Simvastatin
• Nifedipine
• Nimodipine
• Nitrates
• Nitroglycerin
• Nitroprusside
• Non-Ionic Contrast Media
• Nonsteroidal antiinflammatory drugs
• Octreotide
• Olanzapine
• Oxymetazoline
• Paliperidone
• Pasireotide
• Pentoxifylline
• Perindopril; Amlodipine
• Phenelzine
• Phenoxybenzamine
• Phentolamine
• Pilocarpine
• Pramlintide
• Prazosin
• Prilocaine
• Prilocaine; Epinephrine
• Procaine
• Propofol
• Quinidine
• Rasagiline
• Remifentanil
• Reserpine
• Rivastigmine
• Ropivacaine
• Salsalate
• Semaglutide
• Sevoflurane
• SGLT2 Inhibitors
• Silodosin
• Siponimod
• Sufentanil
• Sulfonylureas
• Sympathomimetics
• Tacrine
• Tamsulosin
• Tasimelteon
• Terazosin
• Tetrabenazine
• Tetracaine
• Thalidomide
• Thiazolidinediones
• Thiopental
• Thyroid hormones
• Tizanidine
• Tranylcypromine
• Trazodone
• Yohimbine
• Ziprasidone