OCUPRESS (CARTEOLOL HCL)

Ophthalmologist Carolina Valdivia, MD discusses Ocupress (Carteolol HCL), a medication used in the treatment of glaucoma and elevated intraocular pressure.

Use Carteolol regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day. Most people with glaucoma or high intraocular pressure do not feel sick. It is important to continue using Carteolol even if you feel well.

You should exercise care when using Carteolol ophthalmic solution for elevated intraocular pressure. It is important not to contaminate the solution, as this can cause harm to the eye. If you are using more than one eye drop to control your intraocular pressure, administration of the drugs should be spaced 10-15 minutes apart to provide adequate time for absorption.

Store at room temperature, away from bright light, and out of the reach of children.

Who should not take Ocupress ophthalmic solution?

Carteolol ophthalmic solution is not recommended or should be used only under extreme precautions if you have or have had:

• Bronchial asthma.
• Chronic obstructive pulmonary disease (COPD).
• Heart failure.
• Cardiogenic shock.
• Sinus bradycardia.
• Atrioventricular block.
• Overactive thyroid (hyperthyroidism).

Major surgery, including eye surgery, may require that you temporarily discontinue Carteolol.

What should I tell my ophthalmologist before I take the first dose?

Tell your ophthalmologist about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment. Additionally, share your complete medical history, especially if you are pregnant or plan to become pregnant. It is important to notify your ophthalmologist about previous eye infections, history of glaucoma, and diabetes.

What is the usual dosage?

The information that I share below is based upon the dosage guidelines from the manufacturer. Depending on your condition and medical history, your ophthalmologist may prescribe a different regimen. Do not change the dosage or stop taking your medication unless under a doctor's supervision.

If your intraocular pressure is not reduced to a satisfactory level on this regimen, your ophthalmologist may prescribe a second class of medication to use with Ocupress. Examples include miotics, such as dipivefrin or pilocarpine and carbonic anhydrase inhibitors, such as acetazolamide. Your ophthalmologist will not typically prescribe two or more topical ophthalmic beta-adrenergic receptor blocking agents simultaneously.

You should shake the medicine well before use. Prior to administration, wash your hands thoroughly. Remove the cap and position yourself with your head tilted back. Gently pull your lower eye lid with your index finger and administer the drops in each eye without touching the eye or eyelid with the tip of the applicator.

After administration of a drop, blink a few times and remove any excess liquid with a clean tissue. Repeat this process for the other eye and wash your hands. If more than one type of eye drop is being used, the drugs need to be spaced out by at least ten minutes.

Contamination of this product may lead to serious damage to your eye. Avoid allowing the tip of the applicator to contact your eye, finger, or any other surface. Do not use the eye drops if the liquid has changed colors or has particles in it. Call your ophthalmologist for a new prescription.

Ocupress ophthalmic solution contains benzalkonium chloride, which may be absorbed by soft contact lenses. You should remove your contact lenses before administration of the eye drops. Wait at least 15 minutes before reinserting them.

What are possible food and drug interactions associated with Ocupress ophthalmic solution?

As with other topically applied ophthalmic drugs, Carteolol may be absorbed systemically. If it is taken with certain other drugs, the effects of either could be increased, decreased, or otherwise altered. It is particularly important to check with your ophthalmologist before combining Ocupress ophthalmic solution with any of the following medications.

• Catecholamine-depleting drugs, such as reserpine and clonidine
• Anti-diabetes drugs, such as insulin and glyburide
• Beta blockers, such as metoprolol and propanolol
• Beta agonists, such as albuterol
• Calcium channel blockers, such as verapamil and diltiazem
• Phenothiazines, such as prochlorperazine
• Digitalis
• Digoxin
• Epinephrine
• Certain psychiatric drugs, such as venlafaxine, and tricyclic antidepressants such as amitriptyline).

Temporary side effects reported by some patients include.

• Watery eyes
• Blurred vision
• Itchy/red eyes
• Burning/stinging of the eyes
• Headache
• Dizziness

If any of these persist or worsen, notify your ophthalmologist or pharmacist.

Rare but serious side effects that have been associated with Carteolol include.

• Eye pain, swelling, or discharge
• Sensitivity to light (photophobia
• Vision changes
• Slow or irregular heartbeat
• Muscle weakness
• Fatigue
• Depression
• Nausea
• Difficulty breathing
• Decreased blood pressure

You should seek immediate medical attention if you experience any of these symptoms. Do not wait to see if they will go away by themselves.

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Can I take Ocupress if I am pregnant or breastfeeding?

There have been no adequate and well-controlled studies in pregnant women. Carteolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

It is not known whether Ocupress ophthalmic solution is excreted in human milk. However, beta-blockers administered systemically (orally, intramuscular injection) are known to be excreted in human milk. For this reason, caution should be exercised when Ocupress is administered to a nursing woman.

What should I do if I miss a dose of Ocupress?

If you miss a dose, take it as soon as you remember. If it is close to the time of your next dose, skip it and resume your scheduled dose. Do not double your dose.

REFERENCE:

Sweetman SC. Martindale: The Complete Drug Reference, 36th Ed. London: Pharmaceutical Press, 2009:1241.

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