Optipranolol

Ophthalmic metipranolol is used to treat glaucoma, a condition in which increased pressure in the eye can lead to gradual loss of vision. Metipranolol is in a class of medications called beta-blockers. It works by decreasing the pressure in the eye.

Metipranolol blocks beta1 and beta2 (non-selective) adrenergic receptors. It does not have significant intrinsic sympathomimetic activity, and has only weak local anesthetic (membrane-stabilizing) and myocardial depressant activity.

Orally administered beta-adrenergic blocking agents reduce cardiac output in both healthy subjects and patients with heart disease. In patients with severe impairment of myocardial function, beta-adrenergic receptor antagonists may inhibit the sympathetic stimulatory effect necessary to maintain adequate cardiac output.

Beta-adrenergic receptor blockade in the bronchi and bronchioles may result in significantly increased airway resistance from unopposed parasympathetic activity. Such an effect is potentially dangerous in patients with asthma or other bronchospastic conditions (see CONTRAINDICATIONS and WARNINGS).

OptiPranolol (metipranolol ophthalmic solution) Ophthalmic Solution, when applied topically in the eye, has the action of reducing elevated as well as normal intraocular pressure (IOP), whether or not accompanied by glaucoma. Elevated intraocular pressure is a major risk factor in the pathogenesis of glaucomatous visual field loss. The higher the level of intraocular pressure, the greater the likelihood of glaucomatous visual field loss and optic nerve damage.

The primary mechanism of the ocular hypotensive action of metipranolol is most likely due to a reduction in aqueous humor production. A slight increase in outflow may be an additional mechanism. OptiPranolol (metipranolol ophthalmic solution) Ophthalmic Solution reduces IOP with little or no effect on pupil size or accommodation.

In controlled studies of patients with intraocular pressure greater than 24 mmHg at baseline, OptiPranolol (metipranolol ophthalmic solution) Ophthalmic Solution reduced the average intraocular pressure approximately 20-26%.

The onset of action of OptiPranolol (metipranolol ophthalmic solution) Ophthalmic Solution, as measured by a reduction in intraocular pressure, occurs within 30 minutes after a single administration. The maximum effect occurs at about 2 hours. A reduction in intraocular pressure can be demonstrated 24 hours after a single dose. Clinical studies in patients with glaucoma treated for up to two years indicate that an intraocular pressure lowering effect is maintained.

Animal pharmacology

In rabbits administered metipranolol in one eye at 2 to 4 fold increased concentrations, multi-focal interstitial nephritis was observed in male animals, and lympho-hystiocytic and heterophilic interstitial pneumonia was observed in female animals. The clinical relevance of these findings is unknown.

Patients should be instructed to avoid allowing the tip of the dispensing container to contact the eye or surrounding structures.

Patients should be advised that OptiPranolol (metipranolol ophthalmic solution) contains benzalkonium chloride which may be absorbed by soft contact lenses. Contact lenses should be removed prior to administration of the solution. Lenses may be reinserted 15 minutes following OptiPranolol (metipranolol ophthalmic solution) administration.

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Do not use this medication if you are allergic to metipranolol, or if you have asthma, or severe chronic obstructive pulmonary disease (COPD), slow heartbeats, or a heart condition called "AV block."

Before using this medication, tell your doctor if you have breathing problems such as bronchitis or emphysema, a history of heart disease or congestive heart failure, diabetes, history of stroke, blood clot, or circulation problems, a thyroid disorder, or a muscle disorder such as myasthenia gravis.

Do not allow the dropper to touch any surface, including the eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

Metipranolol ophthalmic is sometimes given together with other eye medications. Do not use any other eye medication unless your doctor has prescribed it for you. If you use another eye medication, use it at least 10 minutes before or after using metipranolol ophthalmic. Do not use the medications at the same time.

Metipranolol ophthalmic can cause blurred vision. Be careful if you drive or do anything that requires you to be able to see clearly.

Do not use this medication while you are wearing contact lenses. Metipranolol ophthalmic may contain a preservative that can be absorbed by soft contact lenses. Wait at least 15 minutes after using metipranolol before putting your contact lenses in.

Do not use this medication if you are allergic to metipranolol, or if you have:

• asthma, or severe chronic obstructive pulmonary disease (COPD);

• slow heartbeats; or

• a heart condition called "AV block."

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

• breathing problems such as bronchitis or emphysema;

• a history of heart disease or congestive heart failure;

• diabetes;

• history of stroke, blood clot, or circulation problems;

• a thyroid disorder; or

• a muscle disorder such as myasthenia gravis.

FDA pregnancy category C. It is not known whether metipranolol ophthalmic is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether metipranolol passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

In the U.S.

• Optipranolol

Available Dosage Forms:

• Solution

Therapeutic Class: Antiglaucoma

Pharmacologic Class: Beta-Adrenergic Blocker, Nonselective

No information is available on overdosage of OptiPranolol Ophthalmic Solution in humans. The symptoms which might be expected with an overdose of a systemically administered beta-adrenergic receptor blocking agent are bradycardia, hypotension and acute cardiac failure.