Formulary

11.6.1 Beta-adrenoceptor blockers

First Line
Second Line
Specialist
Hospital Only

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.

Timolol maleate
  • Eye drops 0.25% (£2.83 = 5ml)
  • Eye drops preservative free 2.5mg/ml (£8.45 = 5ml)
  • Eye gel 0.25% (long acting) (£3.12 = 2.5ml)
  • Single unit dose preservative-free gel eye drops 1mg/g (long acting) (£7.49 = 30 x 0.4g unit dose)

Dose

  • Standard preparations: apply twice a day
  • Long acting preparations: apply once daily

Notes

  1. There is no evidence to show that 0.5% timolol is any more effective than 0.25% therefore it is not included in the formulary.
Betaxolol hydrochloride
  • Eye drops 0.25% (£2.66 = 5ml)
  • Single unit dose preservative free eye drops 0.25% (£13.77 = 50 x 0.25ml unit dose)

Dose

  • Apply twice a day
Metipranolol
  • Single use drops 0.3% (unlicensed preparation)

Indications

  • Metipranolol may be used to control postoperative raised Intra Ocular Pressure