Betaxolol
/api/v1/drug/betaxololMechanism of action
Sourced from openFDABetaxolol HCl, a cardioselective (beta-1-adrenergic) receptor inhibitor, does not have significant membrane-stabilizing (local anesthetic) activity and is devoid of intrinsic sympathomimetic action. Orally administered beta-adrenergic receptor inhibitors reduce cardiac output in healthy subjects and patients with heart disease.
Indications
Sourced from openFDA- BETOPTIC S ® (betaxolol hydrochloride ophthalmic suspension) 0.25% is indicated for the treatment of elevated intraocular pressure (IOP) in patients with chronic open-angle glaucoma or ocular hypertension. BETOPTIC S is a beta-adrenergic receptor inhibitor indicated for the treatment of elevated intraocular pressure (IOP) in patients with chronic open-angle glaucoma or ocular hypertension.ICD-10: H40.059, H40.9
Contraindications
Sourced from openFDA- BETOPTIC S is contraindicated in patients with: sinus bradycardia greater than a first degree atrioventricular (AV) block cardiogenic shock patients with overt cardiac failure hypersensitivity to any component of this product Hypersensitivity to any component of this product. ( 4 ) Sinus bradycardia, second or third degree atrioventricular (AV) block, overt cardiac failure, and cardiogenic shock.contraindicated
Dosage & administration
Sourced from openFDAInstill one drop of BETOPTIC S in the affected eye(s) twice daily. Shake well before using. BETOPTIC S may be used alone or in combination with other IOP lowering medications. Advise patients requiring concomitant topical ophthalmic medications to administer these at least 10 minutes before instilling BETOPTIC S. Instill one drop in the affected eye(s) twice daily. ( 2 )
Warnings & precautions
Sourced from openFDASystemic Absorption : Same adverse reactions found with systemic administration of beta-adrenergic receptor inhibitors may occur with topical ophthalmic administration. ( 5.1 ) Cardiac Failure : Discontinue treatment at the first signs of cardiac failure. ( 5.2 ) Diabetes Mellitus : Beta-adrenergic receptor inhibitors may mask the signs and symptoms of acute hypoglycemia. Administer with caution in diabetic patients subject to hypoglycemia. ( 5.3 ) Thyrotoxicosis : Beta-adrenergic receptor inhibitors may mask certain clinical signs (e.g., tachycardia) or hyperthyroidism. ( 5.4 ) 5.1 Systemic Absorption As with many topically applied ophthalmic drugs, this drug is absorbed systemically. The same adverse reactions found with systemic administration of beta-adrenergic receptor inhibitors may occur with topical administration. For example, severe respiratory reactions and cardiac reactions, including death due to bronchospasm in patients with asthma, and death due to cardiac failure, have been reported with topical application of beta-adrenergic receptor inhibitors. 5.2 Cardiac Failure BETOPTIC S has been shown to have a minor effect on heart rate and blood pressure in clinical studies. Caution should be used in treating patients with a history of cardiac failure or heart block. Treatment with BETOPTIC S should be discontinued at the first signs of cardiac failure.
Adverse reactions
Sourced from openFDAThe most frequent adverse reaction is transient ocular discomfort. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Novartis Pharmaceuticals Corporation at 1-888-669-6682 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. In clinical trials, the most frequent adverse reaction associated with the use of BETOPTIC S has been transient ocular discomfort. The following other adverse reactions have been reported in small numbers of patients: Ocular: blurred vision, corneal punctate keratitis, foreign body sensation, photophobia, tearing, itching, dryness of eyes, erythema, inflammation, discharge, ocular pain, decreased visual acuity, and crusty lashes. Systemic Adverse Reactions Include : Cardiovascular: Bradycardia, heart block, and congestive failure. Pulmonary: Pulmonary distress characterized by dyspnea, bronchospasm, thickened bronchial secretions, asthma, and respiratory failure. Central Nervous System: Insomnia, dizziness, vertigo, headaches, depression, lethargy, and increase in signs, and symptoms of myasthenia gravis. Other: Hives, toxic epidermal necrolysis, hair loss and glossitis. Perversions of taste and smell have been reported.
Use in specific populations
Sourced from openFDA8.1 Pregnancy Risk Summary There are no adequate and well-controlled studies of BETOPTIC S administration in pregnant women to inform a drug-associated risk. There are limited data with the use of betaxolol eye drops in pregnant women. Epidemiological studies have not revealed malformative effects but show a risk for intrauterine growth retardation when beta-blockers are administered by the oral route. In animal reproductive studies, no drug-induced maternal toxicity or teratogenicity was observed at clinically relevant doses (see Data) . Because animal reproductive studies are not always predictive of human response, BETOPTIC S should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. In the U.S. general population, the estimated background risk of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies. Data Animal Data In a rat embryo-fetal development (EFD) study, oral administration of 4, 40, or 400 mg/kg/day betaxolol on gestational days 6 through 18, the period of organogenesis, resulted in marked embryo-fetal lethality, increased incidence of skeletal and visceral abnormalities, and decreased fetal weights at the maternally toxic dose of 400 mg/kg/day (7785 times higher than the maximum recommended human ophthalmic dose [MRHOD] of 0.0083 mg/kg/day, on a mg/m 2 basis).
Overdosage
Sourced from openFDANo information is available on overdosage in humans. The oral LD 50 of the drug ranged from 350 to 920 mg/kg in mice and 860 to 1,050 mg/kg in rats. The symptoms which might be expected with an overdose of a systemically administered beta-adrenergic receptor inhibitor are bradycardia, hypotension, bronchospasm, and acute cardiac failure. A topical overdose of BETOPTIC S may be flushed from the eye(s) with warm tap water. If overdose occurs, treatment should be symptomatic and supportive.
Approval history
Sourced from openFDA- Aug 30, 1985NDANDA019270Sandoz
- Dec 29, 1989NDANDA019845Novartis
- Oct 22, 1999ANDAANDA075541Epic Pharma
- Jun 27, 2008ANDAANDA078962Kvk Tech
Literature
Recent PubMed references pinned to Betaxolol as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Quality-by-design-based fabrication of betaxolol hydrochloride-loaded nano-ocular carrier via ternary phase mapping of solid/liquid lipids and BBD modeling for enhanced transcorneal flux and IOP-lowering effect.AAPS PharmSciTech · 2026 · Kumar N, Kumar A, Kumar S, et al.PMID 42141355DOI 10.1208/s12249-026-03432-4
- Controlled Release of Thermosensitive Hydrogel Incorporating Betaxolol-Loaded Resin Microspheres for Glaucoma Therapy.AAPS PharmSciTech · 2026 · Liu H, Zhang Z, Tang X, et al.PMID 41844913DOI 10.1208/s12249-026-03375-w
- Compounding and stability studies of liquid oral formulations of beta-blockers (bisoprolol, betaxolol, and nadolol) for paediatric patients.Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · 2025 · Dubois L, Bouguergour C, Paoli-Lombardo R, et al.PMID 41409535DOI 10.3389/jpps.2025.15387
- Effects of taurine, brimonidine and betaxolol on oscillation modulation and stimulation efficiency in degenerated rd10 mouse retinas.Scientific reports · 2025 · Schaffrath K, Ingensiep C, Müller F, et al.PMID 40542119DOI 10.1038/s41598-025-06440-9
- Enhanced ocular retention and intraocular pressure-lowering efficacy of hydrophobic microspheres for glaucoma treatment.Colloids and surfaces. B, Biointerfaces · 2025 · Li Q, Pan B, Pan K, et al.PMID 40186925DOI 10.1016/j.colsurfb.2025.114659
- Consistent Intraocular Pressure Reduction by Solid Drug Nanoparticles in Fixed Combinations for Glaucoma Therapy.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024 · Huang D, Norat P, Qi L, et al.PMID 38874068DOI 10.1002/advs.202401648
- LC and LC-MS/MS Studies for the Separation and Identification of Impurities and Degradation Products of Betaxolol.Journal of chromatographic science · 2024 · Chmangui A, Safta M, Driss MR, et al.PMID 38717216DOI 10.1093/chromsci/bmae025
- Different concentrations of betaxolol switch cell fate between necroptosis, apoptosis, and senescence in human corneal stromal cells.Chemico-biological interactions · 2024 · Sun JY, Zhao J, Qiu Y, et al.PMID 38325520DOI 10.1016/j.cbi.2024.110898
Clinical trials
The 10 most recently updated of 13 ClinicalTrials.gov registrations naming Betaxolol as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Retinal Ganglion Cell Neuroprotection Under Prostaglandin AnaloguesNot yet recruiting · Observational · 1,500 enrolled · Association for Innovation and Biomedical Research on Light and ImageNCT07074782updated 2026-05-06
- N-of-1 for Beta-Blockers in Cardiac AmyloidosisEnrolling by invitation · Phase 4 · Interventional · 20 enrolled · Weill Medical College of Cornell UniversityNCT05019027updated 2025-10-23
- A Preliminary Study for INFORMEDEnrolling by invitation · Phase 4 · Interventional · 20 enrolled · Weill Medical College of Cornell UniversityNCT05585125updated 2025-10-23
- Pilot Deprescribing N-of-1 Trials for Beta-blockers in HFpEFCompleted · Phase 4 · Interventional · 9 enrolled · Weill Medical College of Cornell UniversityNCT04757584updated 2024-04-09
- Impact of Beta-blockers on Physical Function in HFpEFCompleted · Phase 4 · Interventional · 9 enrolled · Weill Medical College of Cornell UniversityNCT04767061updated 2023-09-08
- Levobetaxolol Hydrochloride Eye Drops for Treatment of Primary Open-angle Glaucoma or Ocular HypertensionCompleted · Phase 3 · Interventional · 366 enrolled · Zhaoke (Guangzhou) Ophthalmology Pharmaceutical Ltd.NCT02617459updated 2023-05-12
- Beta Blockers Plus Intravenous Flecainide for Paroxysmal Atrial Fibrillation: a Real-world Chios Registry (BETAFLEC-CHIOS)Completed · Observational · 81 enrolled · AHEPA University HospitalNCT04991896updated 2021-08-11
- ACEI or ARB and COVID-19 Severity and Mortality in US VeteransCompleted · Observational · 22,213 enrolled · University of UtahNCT04467931updated 2021-04-28
- Safety and Efficacy Study of BETOPTIC S 0.25% and Timolol Gel-forming Solution 0.25% and 0.5% in Pediatric Patients With Glaucoma or Ocular HypertensionCompleted · Phase 3 · Interventional · 105 enrolled · Alcon ResearchNCT00061542updated 2016-11-18
- Coreg and HSRs-Updated AnalysisCompleted · Observational · 1 enrolled · GlaxoSmithKlineNCT01316952updated 2015-04-15
Pharmacogenomics
CPIC-curated drug–gene pairs for Betaxolol. Levels describe the strength of curated evidence and guideline status — never a recommendation to test or to adjust therapy.
- ADRA2CCPIC C
- ADRB1CPIC C
- CYP2D6CPIC C
- GRK4CPIC C
- GRK5CPIC C
Structural analogs
Ranked by 2D fingerprint (Tanimoto) similarity over PubChem structures. Structural proximity only — not a claim of therapeutic equivalence.
Frequently asked questions
- How does Betaxolol work?
- Betaxolol HCl, a cardioselective (beta-1-adrenergic) receptor inhibitor, does not have significant membrane-stabilizing (local anesthetic) activity and is devoid of intrinsic sympathomimetic action. Orally administered beta-adrenergic receptor inhibitors reduce cardiac output in healthy subjects and patients with heart disease.
- What is Betaxolol used for?
- According to FDA labeling, Betaxolol carries indications including: BETOPTIC S ® (betaxolol hydrochloride ophthalmic suspension) 0.25% is indicated for the treatment of elevated intraocular pressure (IOP) in patients with chronic open-angle glaucoma or ocular hypertension. BETOPTIC S is a beta-adrenergic receptor inhibitor indicated for the treatment of elevated intraocular pressure (IOP) in patients with chronic open-angle glaucoma or ocular hypertension.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Betaxolol?
- Betaxolol is classified as Beta blocking agents, Beta blocking agents, selective, beta-Adrenergic Blocker, Adrenergic beta-Antagonists, Adrenergic beta1-Antagonists, Decreased Blood Pressure, Decreased Intraocular Aqueous Secretion, Negative Chronotropy, Negative Inotropy.
- What are the brand names for Betaxolol?
- Betaxolol is marketed under brand names including Betoptic S.
- What are the contraindications for Betaxolol?
- Betaxolol labeling lists contraindications including: BETOPTIC S is contraindicated in patients with: sinus bradycardia greater than a first degree atrioventricular (AV) block cardiogenic shock patients with overt cardiac failure hypersensitivity to any component of this product Hypersensitivity to any component of this product. ( 4 ) Sinus bradycardia, second or third degree atrioventricular (AV) block, overt cardiac failure, and cardiogenic shock.. Always consult the full prescribing information and a clinician.
betaxolol is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.