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Kerlone (Betaxolol Hydrochloride) - Drug Interactions, Contraindications, Overdosage, etc

 
 



DRUG INTERACTIONS

Risk of anaphylactic reaction

Although it is known that patients on beta-blockers may be refractory to epinephrine in the treatment of anaphylactic shock, beta-blockers can, in addition, interfere with the modulation of allergic reaction and lead to an increased severity and/or frequency of attacks. Severe allergic reactions including anaphylaxis have been reported in patients exposed to a variety of allergens either by repeated challenge, or accidental contact, and with diagnostic or therapeutic agents while receiving beta-blockers. Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction.

OVERDOSAGE

No specific information on emergency treatment of overdosage with Kerlone is available. The most common effects expected are bradycardia, congestive heart failure, hypotension, bronchospasm, and hypoglycemia. In one acute overdosage of betaxolol, a 16-year-old female recovered fully after ingesting 460 mg.

Oral LD50s are 350 to 400 mg betaxolol/kg in mice and 860 to 980 mg/kg in rats.

In the case of overdosage, treatment with Kerlone should be stopped and the patient carefully observed. Hemodialysis or peritoneal dialysis does not remove substantial amounts of the drug. In addition to gastric lavage, the following therapeutic measures are suggested if warranted:

Hypotension

Use sympathomimetic pressor drug therapy, such as dopamine, dobutamine, or norepinephrine. In refractory cases of overdosage of other beta-blockers, the use of glucagon hydrochloride has been reported to be useful.

Bradycardia

Atropine should be administered. If there is no response to vagal blockade, isoproterenol should be administered cautiously. (see Warnings: Anesthesia and major surgery ). In refractory cases the use of a transvenous cardiac pacemaker may be considered.

Acute cardiac failure

Conventional therapy including digitalis, diuretics, and oxygen should be instituted immediately.

Bronchospasm

Use a β2-agonist. Additional therapy with aminophylline may be considered.

Heart block (2nd- or 3rd-degree)

Use isoproterenol or a transvenous cardiac pacemaker.

CONTRAINDICATIONS

Kerlone is contraindicated in patients with known hypersensitivity to the drug.

Kerlone is contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock, and overt cardiac failure. (see Warnings ).

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