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Kerlone

Generic Name: Betaxolol Hydrochloride
Drug Category: Beta Blocker
Litigation Alert Level: Low
This drug has been approved for use by males and females over the age of 18 years old for a maximum duration of 2 years.

Approved Uses

• Indicated in the management of hypertension. It may be used alone or concomitantly with other antihypertensive agents, particularly thiazide-type diuretics.

Kerlone is contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock, and overt cardiac failure.

Patients with bronchospastic disease should not in general receive beta-blockers. Because of its relative ß1 selectivity (cardioselectivity), low doses of Kerlone may be used with caution in patients with bronchospastic disease who do not respond to or cannot tolerate alternative treatment. Since ß1 selectivity is not absolute and is inversely related to dose, the lowest possible dose of Kerlone should be used (5 to 10 mg once daily) and a bronchodilator should be made available. If dosage must be increased, divided dosage should be considered to avoid the higher peak blood levels associated with once-daily dosing. 

Beta-blockers should be used with caution in diabetic patients. Beta-blockers may mask tachycardia occurring with hypoglycemia patients should be warned of this), although other manifestations such as dizziness and sweating may not be significantly affected. Unlike nonselective beta-blockers, Kerlone does not prolong insulin-induced hypoglycemia.

Beta-adrenergic blockade may mask certain clinical signs of hyperthyroidism (eg, tachycardia).

Beta-adrenoceptor blockade can cause reduction of intraocular pressure.

Abrupt cessation of therapy with certain beta-blocking agents in patients with coronary artery disease has been followed by exacerbations of angina pectoris and, in some cases, myocardial infarction has been reported. Therefore such patients should be warned against interruption of therapy without the physician’s advice.

The value of using beta-blockers in psoriatic patients should be carefully weighed since they have been reported to cause an aggravation in psoriasis.

Although it is known that patients on beta-blockers may be refractory to epinephrine in the treatment of anaphylactic shock, beta-blockers can, in addition, interfere with the modulation of allergic reaction and lead to an increased severity and/or frequency of attacks.

Catecholamine-depleting drugs (e.g., reserpine) may have an additive effect when given with beta-blocking agents. Patients treated with a beta-adrenergic receptor blocking agent plus a catecholamine depletor should therefore be closely observed for evidence of hypotension or marked bradycardia, which may produce vertigo, syncope, or postural hypotension.

Hypotension, AV conduction disturbances, and left ventricular failure have been reported in some patients receiving beta-adrenergic blocking agents when an oral calcium antagonist was added to the treatment regimen.

Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.

Amiodarone is an antiarrhythmic agent with negative chronotropic properties that may be additive to those seen with beta blockers.

Disopyramide is a Type I antiarrhythmic drug with potent negative inotropic and chronotropic effects. Disopyramide has been associated with severe bradycardia, asystole and heart failure when administered with beta blockers.

Particular care should be taken when using anesthetic agents which depress the myocardium, such as ether, cyclopropane, and trichloroethylene.

Beta-blockers reduce placental perfusion, which may result in intrauterine fetal death, immature and premature deliveries. In addition, adverse effects (especially hypoglycemia and bradycardia) may occur in fetus.

The beta-blocker action persists in the neonate for several days after birth to a treated mother: there is an increased risk of cardiac and pulmonary complications in the neonate in the postnatal period. Bradycardia, respiratory distress and hypoglycemia have also been reported. Accordingly, attentive surveillance of the neonate (heart rate and blood glucose for the first 3 to 5 days of life) in a specialized setting is recommended.

Since betaxolol is excreted in human milk in sufficient amounts to have pharmacological effects in the infant, caution should be exercised when betaxolol tablets, USP is administered to a nursing mother.

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Off-label Uses

• Dosage greater than 20 mg per day. GoToSource 

• Use in patients under the age of 18. GoToSource 

• Anxiety, obsessive compulsive disorder, post-traumatic stress disorder and panic disorder. GoToSource

• Chronic heart failure. GoToSource 

• Glaucoma. GoToSource 

• Prevention of perioperative atrial fibrillation. GoToSource  

• Intractable hemolysis due to paraprosthetic leakage. GoToSource 

• Stable angina pectoris. GoToSource 

Adverse Events

Neonatal injury and malformations and fetal death. GoToSource

Bronchospasm (muscles lining airways of the lungs constrict or tighten) and worsening of asthma. GoToSource

Bronchiolitis obliterans with pneumonitis (lung disease causing inflammation and blockage of smallest airways in lungs). GoToSource

Drug-induced lupus. GoToSource

Hypotension (low blood pressure), dizziness, depression, insomnia (sleep disorder), memory loss and  impotence. GoToSource

Bradycardia (slow heart rate) and fatigue. GoToSource

Aggravation of psoriasis. GoToSource

Litigation

No major injury lawsuits reported.

The material contained in GoToPills is for informational purposes only and not intended to replace the judgment, evaluation and treatment of physicians, pharmacists and other healthcare providers. GoToPills does not provide medical advice, diagnoses or treatment. Always seek the advice of your physician or other qualified health provider regarding a medical condition or treatment.

 

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Site Last Updated March 28, 2024