Glubanol

Indications

Levobunolol eye drops are used to lower raised pressure inside the eye in open-angle glaucoma and ocular hypertension. Lowering eye pressure helps protect the optic nerve and prevent loss of vision.

How It Works

Levobunolol is a non-selective beta blocker. In the eye, it reduces the amount of fluid (aqueous humour) made inside the eye, so the pressure falls. It has little effect on pupil size or focusing.

Dosage and Administration

The usual adult dose is 1 drop of the 0.5% solution in the affected eye once or twice daily, as prescribed. Wash your hands, tilt your head back, pull down the lower lid and put one drop in. Close your eye and press gently on the inner corner of the eye for 1 to 2 minutes; this reduces the amount that reaches the rest of the body. Do not let the dropper tip touch the eye. Remove soft contact lenses before use and wait 15 minutes before putting them back. If you use other eye drops, wait at least 5 minutes between them.

Interactions

• Beta blocker tablets such as Propranolol or Atenolol: added effects on heart rate and blood pressure, and on eye pressure.
• Verapamil, Diltiazem, Digoxin or Amiodarone: risk of very slow heart rate.
• Insulin and diabetes tablets: signs of low blood sugar may be hidden.
• Adrenaline eye drops: may cause pupil widening.
• Clonidine: rebound high blood pressure if stopped suddenly.

Contraindications

• Allergy to Levobunolol or any ingredient.
• Asthma or a history of asthma, or severe chronic obstructive lung disease.
• Slow heart rate, second or third degree heart block, uncontrolled heart failure or cardiogenic shock.

Side Effects

Common side effects include brief stinging or burning in the eye, eye redness and blurred vision just after use. Because some medicine is absorbed, it can also cause a slow pulse, tiredness, dizziness, low blood pressure or breathing difficulty in sensitive people.

Get urgent medical help if you have wheezing or difficulty breathing, fainting, a very slow or irregular heartbeat, chest pain, or swelling of the face, lips or eyelids with rash.

Pregnancy and Lactation

Use in pregnancy only if your doctor decides the benefit outweighs the risk; the baby may be checked after birth for slow heart rate. It may pass into breast milk, so speak to your doctor before breastfeeding.

Precautions and Warnings

• Tell your doctor if you have heart disease, lung disease, diabetes, thyroid disease, myasthenia gravis or poor circulation.
• Tell the anaesthetist you use these drops before any operation.
• Vision may be blurred briefly after use; do not drive until it clears.
• Keep regular eye check-ups; glaucoma often has no symptoms.

Overdose

Too many drops in the eye can be rinsed out with warm water. If drops are swallowed or overused, there may be slow heartbeat, low blood pressure, breathing difficulty or dizziness. Seek medical help.

Therapeutic Class

Antiglaucoma agent, non-selective beta blocker eye drops.

Storage

Store below 30°C, away from light and out of the reach of children. Do not freeze. Discard the bottle 4 weeks after first opening.