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Systemic absorption may follow topical application; therefore eye drops containing a beta-blocker are contra-indicated in patients with bradycardia, heart block or uncontrolled heart failure. Beta-blocker eye drops should be avoided in patients receiving oral verapamil.
Beta-blockers, even those with apparent cardioselectivity, should not be used in patients with asthma or a history of obstructive airways disease unless no alternative treatment is available. In such cases the risk of inducing bronchospasm should be appreciated and appropriate precautions taken.
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