· Chronic open-angle glaucoma

· Intraocular Hypertonia.

· The recommended dosage is one drop of BETOPTIC 0.25%, ophthalmic suspension in the affected eye, twice a day (morning and evening).

· In some patients, normalization of pressure, intraocular pressure by BETOPTIC 0.25 PERCENT, suspension, ophthalmic sometimes requires a few weeks, so evaluation of the treatment should include a determination of the intra-ocular pressure -ocular after one treatment period with BETOPTIC 0.25 PERCENT, one month ophthalmic suspension. Subsequently, the control of intraocular pressure will be carried out according to the patient, according to a frequency left to the discretion of the physician. >
Due to the normal nycthemeral variations in intraocular tension it is preferable to evaluate the efficacy of BETOPTIC 0.25 PERCENT Ophthalmic suspension by measuring the tension at different times of the day. >

In the event that the BETOPTIC 0.25 PERCENT, Ophthalmic Suspension should take over from an anti-glaucomatous treatment, previous, superimpose the two treatments for one day. The following day, the previous treatment can be suppressed and continue with BETOPTIC 0.25 PERCENT, ophthalmic suspension alone.

When substitute BETOPTIC 0.25 PERCENT, suspension, ophthalmic to several anti-glaucomatous drugs, the doctor may, depending on the case, interrupt some or decide to stop all. Deletions shall be consecutive and shall involve only one medicinal product at a time, observing an interval of at least one week between two successive deletions
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The ophthalmologist may, if he deems necessary, associate with the BETOPTIC treatment 0.25 PERCENT, suspension, ophthalmic

O or an anti-glaucomatous sympatho- or para-sympathomimetic eye drops

O or a general treatment with the aid of a carbonic anhydrase inhibitor to obtain a maximum result

The patient will strictly comply with the medical prescription which will be accompanied by monitoring of intraocular pressure, especially during the period of adjustment of the dosage.

Pharmacotherapeutic group: Beta-blockers, ATC code: S01ED02.

· After ocular instillation, betaxolol lowers intraocular tension, associated or not with glaucoma. Ophthalmic suspension of BETOPTIC 0.25 PERCENT Ophthalmic suspension has an ocular hypotensive effect equivalent to 0.5% BETOPTIC eye drops
· A drop in pressure is obtained 30 minutes after, the single instillation of a drop of BETOPTIC 0.25 PERCENT, ophthalmic suspension, the maximum effect occurs after 2 hours and the decrease is always significant 12 Hours after

The stability of the hypotensive effect was observed over a period of 3 years, which would have to demonstrate, if not the absence of tachyphylaxis, betaxolol at least the low frequency of the cases, "therapeutic exhaust".

Betaxolol showed virtually no change in pupillary diameter and accommodation No cases of blurred vision or night blindness common to myotics were observed and subjects with nuclear opacities Of the lens do not suffer from visual discomfort caused by a miosis

Due to its polar nature, betaxolol can induce discomfort at instillation. In the present formula, the betaxolol molecules are attached by ionic bonds to the amberlite resin. During the instillation, the molecules of betaxolol are exchanged with the sodium ions contained in the lacrimal film. This exchange requires several minutes, which improves comfort at the instillation of betaxolol.
· The pharmacological characteristics of betaxolol are

O, β 1-selectivity or "cardioselectivity": hence a large margin of safety in subjects with bronchial hyperreactivity

O absence of sympathomimetic activity intrinsic (A.S.I.)

O a local anesthetic effect (membrane stabilizer), negligible

· Congestive heart failure not monitored.

· Atrioventricular block of high degree (not paired).

· Significant bradycardia (
· Monitor the onset of signs of heart failure, especially if there is a history of heart failure, and in the elderly.
· Use in the CHILD: absence of studies, pediatric clinics.

Ophthalmologic surveillance is necessary in case of concomitant treatment with eye drops containing adrenaline (risk of mydriasis).

· Although BETOPTIC 0.25 PERCENT, ophthalmic suspension, used in glaucomatous contact lens wearers and aphatics was well tolerated during treatment, wearing contact lenses is not recommended In general, because of the risk

O reduction of lachrymal secretion bound in general to beta-blockers

Of adsorption on the lens of certain components of eye drops

A decrease in receptivity to betaxolol may occur after prolonged treatment, the increase in doses would be without effect in long-term treatments and should be checked annually for absence of escape Therapeutic ".

Due to the presence of benzalkonium chloride, this drug may cause eye irritation. Avoid contact with soft contact lenses. Remove contact lenses before application and wait at least 15 minutes before reuse. Benzalkonium chloride may discolor contact lenses, soft.

Bradycardiac medications

Many medications can cause bradycardia. This is particularly the case; antiarrhythmics class of beta-blockers, certain; class III antiarrhythmics, certain calcium antagonists, digitalis, pilocarpine, of; cholinesterase inhibitors, etc.

Associations, deprecated

(See Warnings and Precautions for Use).

+ Bépidril

Disorders of the automatism (bradycardia, excessive, sinus stop), conduction disorders Sino-auricular and auriculo-ventricular and increased risk, disorders of the ventricular rhythm (torsades de pointes) as well as cardiac failure.

Such association should be made only under close clinical supervision and ECG, in particular, in the elderly or at the beginning of treatment.

+ Diltiazem, verapamil

Disorders of the automatism (bradycardia, excessive, sinus stop), disorders of the conduction, sino-auricular and cardiac failure.
Such association should be made only under close clinical supervision and ECG, in particular, in the elderly or at the beginning of treatment.

Associations that are the subject of precautions for use

+ Amiodarone (see also below, "Drugs likely to give twists and spikes")

Disorders of automatism and conduction (suppression of sympathetic mechanisms, compensators).

Clinical Surveillance and ECG.

+ Volatile anesthetics, halogenated

Reduction of reactions, cardiovascular compensation by beta-blockers.

The beta-adrenergic inhibition can be lifted during the intervention by beta-stimulants

As a general rule, do not stop the beta-blocking treatment and, in any event, avoid a sudden stop. Inform the anesthesiologist of this treatment.

+ Antiarrhythmics class I; (except lidocaine) (cibenzoline, disopyramide, flecainide, hydroquinidine, mexiletine, propafenone, quinidine).

Disorders of contractility, automatism and conduction (suppression of sympathetic compensatory mechanisms). Surveillance, Clinical and ECG.

+ Central antihypertensive agents, clonidine, guanfacine, methyldopa, moxonidine, rilménidine
Significant increase in arterial pressure in the event of abrupt cessation of treatment with the central antihypertensive drug

Avoid abrupt cessation of treatment by the central antihypertensive agent. Clinical Surveillance.
+ Baclofen

Increased risk of hypotension, especially orthostatic.

Blood Pressure Monitoring and Dosage Adjustment of the Antihypertensive Medication If Needed

+ Insulin, sulfonamides, hypoglycaemic drugs

All beta-blockers may mask certain symptoms of hypoglycemia, palpitations and tachycardia.
Prevent the patient and strengthen, especially at the beginning of treatment, self-monitoring, blood.