Levobunolol Eye Drops: Uses, Dosage, and Side Effects Explained - The Kingsley Clinic

Summary of Key Points

Levobunolol is a prescription eye drop used to manage various eye conditions, including glaucoma and ocular hypertension. It works by lowering the pressure inside the eye, which helps prevent vision loss. Levobunolol belongs to a class of medications known as beta-blockers, which reduce eye pressure by decreasing fluid production. Always consult your healthcare provider before adjusting your dosage or starting treatment. If you need guidance, you can connect with one of our telemedicine providers.

Names of Medication

US Brand Name: Betagan (Levobunolol)

The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.

Pharmacologic Category

Beta-Blocker, Nonselective (Ophthalmic)

Levobunolol is part of the beta-blocker family, which includes other medications like timolol and carteolol. These beta-blocker eye drops are commonly prescribed to manage eye pressure and treat glaucoma.

Levobunolol Dosage

Levobunolol eye drops are prescribed to treat several eye conditions in adults. The dosage may vary depending on the specific condition being treated. Always follow your doctor’s instructions and consult them before making any changes to your dosage. If you need to speak with a healthcare provider, you can schedule a telemedicine appointment with us.

Glaucoma (Chronic Open-Angle Glaucoma)

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Ocular Hypertension

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Eye Pressure (Increased Intraocular Pressure)

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Angle-Closure Glaucoma

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Pseudotumor Cerebri

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Myopia (Nearsightedness)

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Astigmatism

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Retinal Detachment

Initial Dose: 1 to 2 drops in the affected eye(s) once daily.

Maintenance Dose: 1 drop in the affected eye(s) once daily or as directed by your healthcare provider.

Dosage Forms and Strengths

Levobunolol is available in the following ophthalmic solution strengths:

Ophthalmic Solution: 0.25% (2.5 mg/mL)
Ophthalmic Solution: 0.5% (5 mg/mL)

How to Use Levobunolol Eye Drops

Levobunolol eye drops should be used exactly as prescribed by your doctor. Follow these steps for proper administration:

Wash your hands thoroughly before applying the drops.
Tilt your head back slightly and gently pull down your lower eyelid to create a small pocket.
Hold the dropper above your eye and squeeze out one drop into the pocket.
Close your eye and gently press on the inner corner for 1-2 minutes to prevent the medication from draining away.
Avoid touching the dropper tip to your eye or any surface to prevent contamination.
If you are using other eye medications, wait at least 5 minutes before applying the next one.
If you miss a dose, apply it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to make up for the missed one.

Levobunolol Side Effects

Like all medications, Levobunolol may cause side effects. While not everyone experiences them, it’s important to be aware of potential reactions. If you experience any severe or persistent symptoms, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for further evaluation.

Common Side Effects (Occur in 1-10% of patients)

Eye irritation: Mild burning, stinging, or itching in the eye after applying the drops.
Blurred vision: Temporary blurred vision may occur immediately after applying the drops.
Dry eyes: Some patients may notice their eyes feel drier than usual.

Less Common Side Effects (Occur in less than 1% of patients)

Headache: Some patients may experience mild to moderate headaches.
Dizziness: Feeling lightheaded or dizzy, especially when standing up quickly.
Fatigue: A sense of tiredness or weakness.

Serious Side Effects (Rare, but require immediate medical attention)

Severe allergic reactions: Swelling of the face, lips, or throat, difficulty breathing, or hives.
Heart problems: Slow or irregular heartbeat, chest pain, or shortness of breath.
Eye pain or vision changes: Sudden eye pain, vision loss, or seeing halos around lights.

Contraindications

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. If you have any of the conditions listed below, taking Levobunolol may not be safe for you.

Severe Asthma or Chronic Obstructive Pulmonary Disease (COPD): Levobunolol is a beta-blocker, which can cause the airways to narrow, making it harder to breathe. This can worsen symptoms in people with asthma or COPD.
Bradycardia (Slow Heart Rate): Levobunolol can further slow down your heart rate, which can be dangerous if you already have a slow heart rate.
Heart Block or Certain Heart Rhythm Disorders: If you have a condition where the electrical signals in your heart are not properly transmitted (heart block), Levobunolol can worsen this condition, leading to serious complications.
Severe Heart Failure: Levobunolol may decrease the heart’s ability to pump blood effectively, which can be harmful if you have severe heart failure.
Allergic Reactions to Beta-Blockers: If you have had an allergic reaction to Levobunolol or other beta-blockers in the past, you should not take this medication.

Drug to Drug Interactions

Levobunolol may interact with other medications, potentially leading to harmful effects. It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Some medications that may interact with Levobunolol eye drops include:

Calcium Channel Blockers (e.g., Verapamil, Diltiazem): These medications lower heart rate and blood pressure. When combined with Levobunolol, they may cause dangerously low heart rates or blood pressure.
Clonidine (Catapres): Taking Clonidine with Levobunolol may significantly lower blood pressure or heart rate, especially if Clonidine is stopped abruptly.
Digoxin (Lanoxin): Both Digoxin and Levobunolol slow the heart rate, and using them together increases the risk of bradycardia (slow heart rate).
Antiarrhythmics (e.g., Amiodarone, Quinidine): These medications control heart rhythm, but combining them with Levobunolol may increase the risk of heart rhythm problems.
Insulin or Oral Diabetes Medications (e.g., Metformin, Glipizide): Levobunolol can mask symptoms of low blood sugar, making it harder to detect hypoglycemia.

Levobunolol in Pregnancy

Is it safe to take Levobunolol during pregnancy?

There is limited data on the safety of Levobunolol use during pregnancy. Beta-blockers, including Levobunolol, may reduce blood flow to the placenta, potentially affecting fetal growth. If you are pregnant or planning to become pregnant, discuss the risks and benefits of using Levobunolol eye drops with your healthcare provider. In some cases, your doctor may recommend an alternative treatment. If you are pregnant and need to discuss your treatment options, you can schedule a telemedicine appointment with one of our providers.

Levobunolol while Breastfeeding

Is it safe to take Levobunolol while breastfeeding?

Levobunolol may pass into breast milk in small amounts. While the effects on a nursing infant are not fully known, there is a potential risk of the medication affecting the baby’s heart rate or causing other side effects. If you are breastfeeding, it is important to talk to your healthcare provider about whether Levobunolol is the right choice for you. Your doctor may recommend an alternative treatment or monitor your baby for any potential side effects. If you need guidance, you can consult with one of our telemedicine providers.

Estimated Cost of Levobunolol Eye Drops

The estimated cost of a 30-day supply of Levobunolol (0.5% ophthalmic solution) without insurance is approximately $15 to $30 when using a GoodRx coupon. Prices may vary depending on the pharmacy and location. Be sure to check for available discounts or coupons to reduce your out-of-pocket costs.

Possible Alternatives to Levobunolol

If Levobunolol is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider before making adjustments. You can also schedule a telemedicine consultation with one of our providers to explore these options.

Glaucoma: Alternatives include other eye drops such as Latanoprost (Xalatan) or Timolol (Timoptic). In some cases, laser therapy or surgery may be recommended.
Ocular Hypertension: Other medications like Brimonidine (Alphagan) or Dorzolamide (Trusopt) may be used. Lifestyle changes, such as regular eye exams and avoiding smoking, can also help.
Eye Pressure: In addition to medications, reducing caffeine intake and maintaining a healthy weight may help lower eye pressure.
Hypertensive Crisis: This is a medical emergency. Immediate treatment with intravenous medications like Labetalol or Hydralazine may be required.
Chronic Open-Angle Glaucoma: Other treatments include Prostaglandin analogs (e.g., Travoprost) or surgical options like trabeculectomy.
Angle-Closure Glaucoma: This is a medical emergency that often requires immediate laser or surgical intervention to relieve pressure in the eye.
Pseudotumor Cerebri: Medications like Acetazolamide may help reduce pressure, and weight loss is often recommended as a lifestyle change.
Myopia (Nearsightedness): Corrective lenses or refractive surgery (e.g., LASIK) are common treatments. Regular eye exams are important to monitor changes in vision.
Astigmatism: Corrective lenses or refractive surgery can help manage this condition. Vision therapy may also be recommended in some cases.
Retinal Detachment: This is a medical emergency that requires prompt surgical intervention to prevent vision loss.

Recent Updates on Levobunolol Research

Recent studies have focused on the long-term efficacy and safety of Levobunolol in managing glaucoma and ocular hypertension. Research shows that Levobunolol remains effective in lowering intraocular pressure over extended periods, making it a reliable option for many patients. However, newer medications, such as prostaglandin analogs, are being studied for their potential to provide similar or better results with fewer side effects.

Ongoing research is also examining the use of combination therapies, where Levobunolol is used alongside other medications to enhance its effectiveness. These studies aim to provide more personalized treatment options for patients with glaucoma and other eye conditions.

As always, it’s important to stay informed about the latest research and discuss any new treatment options with your healthcare provider. If you have questions about Levobunolol or other treatment options, you can schedule a telemedicine appointment with one of our providers to get personalized advice.

James Kingsley