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Comparison of the ocular beta-blockers
1Pharmacy Department, UH 1410. Indiana University Medical Center, Indianapolis, IN 46202, USA.
The Annals of Pharmacotherapy
|January 1, 1996
Summary
Timolol maleate is recommended for glaucoma treatment due to its cost-effectiveness and efficacy. While other ocular beta-blockers offer some benefits, none consistently outperform timolol.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Glaucoma management relies on ocular hypotensive agents.
- Ocular beta-blockers are a cornerstone therapy for lowering intraocular pressure.
- Comparing these agents is crucial for optimizing patient care.
Purpose of the Study:
- To compare ocular beta-blockers regarding efficacy, safety, and cost.
- To identify key differences in systemic adverse effects and local tolerability.
Main Methods:
- A comprehensive MEDLINE search and review of English-language literature.
- Analysis of clinical trials focusing on dosage, response, adverse effects, and cost.
- Evaluation of data based on study design and therapeutic outcomes.
Main Results:
- Timolol maleate, levobunolol, metipranolol, and carteolol demonstrate similar intraocular pressure-lowering effectiveness.
- Levobunolol and timolol gel formulations may allow once-daily dosing.
- Metipranolol is cost-effective but associated with more ocular irritation; betaxolol offers better systemic safety than timolol.
Conclusions:
- Timolol maleate is the recommended formulary agent for glaucoma.
- No other ocular beta-blocker consistently shows a significant advantage over timolol in terms of cost, efficacy, and safety.