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Levobunolol eye drops are a beta blocking agent used to manage chronic open-angle glaucoma or ocular hypertension.
 BRAND NAMES
 MECHANISM OF ACTION
Levobunolol is a non-selective beta blocker. levobunolol lowers Intraocular pressure primarily by decreasing aqueous humor production. Elevated Intraocular pressure presents a major risk factor in glaucomatous field loss. The higher the level of Intraocular pressure, the greater the likelihood of optic nerve damage and visual field loss.
The onset of action of Levobunolol can be detected within one hour after treatment, with maximum effect seen between 2 and 6 hours.
A significant decrease of Intraocular pressure can be maintained for up to 24 hours following a single dose.
Levobunolol is used topically to manage chronic open-angle glaucoma or ocular hypertension.
- Ophthalmic solution 0.5%: The recommended starting dose is 1-2 drops in the affected eye(s) once a day.
- Ophthalmic solution 0.25%: Typical dosing is 1-2 drops twice daily.
In patients with more severe or uncontrolled glaucoma, Levobunolol 0.5% Ophthalmic solution can be administered twice daily. Dosages above one drop of Levobunolol 0.5% Ophthalmic solution twice daily are not generally more effective.
If the patient’s Intraocular pressure is not at a satisfactory level on this regimen, concomitant therapy with dipivefrin and/or epinephrine, and/or pilocarpine and other miotics, and/or systemically administered carbonic anhydrase inhibitors, such as acetazolamide, can be instituted.
Patients should not typically use two or more topical ophthalmic beta-adrenergic blocking agents simultaneously.
- Bronchial asthma, or a history of bronchial asthma, or severe chronic obstructive pulmonary disease
- heart disease: Sinus bradycardia, Second and third degree atrioventricular block, Overt cardiac failure, Cardiogenic shock
- Hypersensitivity to any component
 WARNINGS AND PRECAUTIONS
- Severe respiratory reactions and cardiac reactions, including death due to bronchospasm in patients with asthma, and rarely death in association with cardiac failure, have been reported with topical application of beta-adrenergic blocking agents.
 PREGNANCY AND LACTATION
- Pregnancy Category C (US). Levobunolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- Nursing Mothers: Caution should be exercised when Levobunolol is administered to a nursing woman.
 SIDE EFFECTS
In clinical trials the use of Levobunolol ophthalmic solution has been associated with transient ocular burning and stinging in up to 1 in 3 patients, and with blepharoconjunctivitis (Inflammation of the eyelid) in up to 1 in 20 patients.
Decreases in heart rate and blood pressure have been reported; In the elderly population or patients with heart disease, levobunolol solution may lead to significant bradycardia, which may be potentially dangerous. Levobunolol should be administered with caution and its effect should be monitored by a physician. If there is any cardiac side effect, the drug should be discontinued and alternative anti-glaucoma medications should be considered.
Rarely the following effects have been seen: Headaches, tiredness, dizziness, itching, inflammation of the iris, clumsiness and lack of coordination, hives, and decreased sensitivity of the front layer of the eyeball.