Brands, Medical Use, Clinical Data
Drug Category
- Adrenergic beta-Antagonists
- Sympatholytics
- Antihypertensive Agents
- Anti-Arrhythmia Agents
Dosage Forms
Brands / Synonyms
Disorat; METIPRANOLOL HYDROCHLORIDE; Metipranolol Ophthalmic; Metipranolol [Usan:Ban:Inn]; Metipranololum [Inn-Latin]; Optipranolol; Trimepranol
Indications
Indicated in the treatment of elevated intraocular pressure in patients with ocular hypertension or open angle glaucoma.
Pharmacology
Metipranolol is a beta1 and beta2 (non-selective) adrenergic receptor-blocking agent that does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anesthetic (membrane-stabilizing) activity. Metipranolol is indicated in the treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma. Metipranolol, when applied topically to the eye, has the action of reducing elevated, as well as normal, intraocular pressure, whether or not accompanied by glaucoma. Elevated intraocular pressure is a major risk factor in the pathogenesis of glaucomatous visual field loss and optic nerve damage. Metipranolol reduces intraocular pressure with little or no effect on pupil size or accommodation in contrast to the miosis which cholinergic agents are known to produce.
Mechanism of Action
Although it is known that metipranolol binds the beta1 and beta2 adrenergic receptors, the mechanism of metipranolol's action is not known. It has no significant intrinsic sympathomimetic activity, and has only weak local anesthetic (membrane-stabilizing) and myocardial depressant activity. It appears that the ophthalmic beta-adrenergic blocking agents reduce aqueous humor production, as demonstrated by tonography and fluorophotometry. A slight increase in aqueous humor outflow may be an additional mechanism.
Absorption
Not Available
Toxicity
Not Available
Biotrnasformation / Drug Metabolism
Not Available
Contraindications
Hypersensitivity to any component of this product.
OptiPranolol Ophthalmic Solution is contraindicated in patients with bronchial asthma or a history of
bronchial asthma, or severe chronic obstructive pulmonary disease; symptomatic sinus bradycardia; greater than a
first degree atrioventricular block; cardiogenic shock; or overt cardiac failure.
Drug Interactions
OptiPranolol® Ophthalmic Solution should be used with caution in patients who are
receiving a beta-adrenergic blocking agent orally, because of the potential for additive effects on systemic
beta-blockade.
Close observation of the patient is recommended when a beta-blocker is administered to patients
receiving catecholamine-depleting drugs such as reserpine, because of possible additive effects and the production of
hypotension and/or bradycardia.
Caution should be used in the coadministration of beta-adrenergic receptor blocking agents, such as
metipranolol, and oral or intravenous calcium channel antagonists, because of possible precipitation of left
ventricular failure, and hypotension. In patients with impaired cardiac function, who are receiving calcium channel
antagonists, coadministration should be avoided.
The concomitant use of beta-adrenergic receptor blocking agents with digitalis and calcium channel
antagonists may have additive effects, prolonging atrioventricular conduction time.
Caution should be used in patients using concomitant adrenergic psychotropic drugs.
Ocular
In patients with angle-closure glaucoma, the immediate treatment objective is to re-open the angle by
constriction of the pupil with a miotic agent. OptiPranolol Ophthalmic Solution has little or no effect on the pupil,
therefore, when it is used to reduce intraocular pressur e in angle-closure glaucoma, it should be used only with
concomitant administration of a miotic agent.
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