Carteolol

What is Carteolol?

• Carteolol Ophthalmic Solution USP is a nonselective beta-adrenoceptor blocking agent for ophthalmic use.

Carteolol structure

Carteolol Structural Formulae V1

What are the uses of this medicine?

• Carteolol is used in lowering intraocular pressure and may be used in patients with chronic open-angle glaucoma and intraocular hypertension.
• It may be used alone or in combination with other intraocular pressure lowering medications.

How does this medicine work?

• Carteolol is a nonselective beta-adrenergic blocking agent with associated intrinsic sympathomimetic activity and without significant membrane-stabilizing activity.
• Carteolol Hydrochloride reduces normal and elevated intraocular pressure (IOP) whether or not accompanied by glaucoma.
• The exact mechanism of the ocular hypotensive effect of beta-blockers has not been definitely demonstrated.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• bronchial asthma or with a history of bronchial asthma, or severe chronic obstructive pulmonary disease
• sinus bradycardia
• second- and third-degree atrioventricular block
• overt cardiac failure
• cardiogenic shock
• hypersensitivity to any component of this product

What drug interactions can this medicine cause?

• Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Be sure to mention any of the following:

• beta-adrenergic blocking agent orally
• Catecholamine-depleting drugs such as reserpine

Is this medicine FDA approved?

• It was patented in 1972 and approved for medical use in 1980.

How should this medicine be used?

Recommended dosage:

• The usual dose is one drop of Carteolol Hydrochloride Ophthalmic Solution 1% in the affected eye(s) twice a day.

Administration:

• For topical use only.
• To prevent contaminating the dropper tip and solution, care should be taken not to touch the eyelids or surrounding areas with the dropper tip of the bottle.
• Keep bottle tightly closed when not in use.
• Protect from light.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Carteolol Hydrochloride Ophthalmic Solution USP, 1%

This medicine is available in fallowing brand namesː

• Cartrol, Ocupress, Teoptic, Arteolol, Arteoptic, Calte, Cartéabak, Carteol, Cartéol, Cartrol, Elebloc, Endak, Glauteolol, Mikelan, Poenglaucol, and Singlauc.

What side effects can this medication cause?

The most common side effects of this medicine include:

• Transient eye irritation, burning, tearing, conjunctival hyperemia, edema, blurred and cloudy vision, photophobia, decreased night vision, and ptosis and ocular signs including blepharoconjunctivitis, abnormal corneal staining, and corneal sensitivity

The following systemic events have occasionally been reported with the use of Carteolol Hydrochloride Ophthalmic Solution:

• cardiac arrhythmia, heart palpitation, dyspnea, asthenia, headache, dizziness, insomnia, sinusitis, and taste perversion.

Less common side effects, may include:

• Body As a Whole: Headache
• Cardiovascular: Arrhythmia, syncope, heart block, cerebral vascular accident, cerebral ischemia, congestive heart failure, palpitation.
• Digestive: Nausea
• Psychiatric: Depression
• Skin: Hypersensitivity, including localized and generalized rash
• Respiratory: Bronchospasm (predominantly in patients with pre-existing bronchospastic disease), respiratory failure
• Endocrine: Masked symptoms of hypoglycemia in insulin-dependent diabetics
• Special Senses: Signs and symptoms of keratitis, blepharoptosis, visual disturbances including refractive changes (due to withdrawal of miotic therapy in some cases), diplopia, ptosis.

What special precautions should I follow?

• Carteolol has not been detected in plasma following ocular instillation. However, as with other topically applied ophthalmic preparations, Carteolol may be absorbed systemically. The same adverse reactions found with systemic administration of beta-adrenergic blocking agents may occur with topical administration.
• Carteolol Hydrochloride Ophthalmic Solution should be used with caution in patients with known hypersensitivity to other beta-adrenoceptor blocking agents.
• Use with caution in patients with known diminished pulmonary function.
• In patients with angle-closure glaucoma, the immediate objective of treatment is to reopen the angle. This requires constricting the pupil with a miotic. Carteolol has little or no effect on the pupil. When Carteolol is used to reduce elevated intraocular pressure in angle-closure glaucoma, it should be used with a miotic and not alone.
• Beta-adrenergic blockade has been reported to potentiate muscle weakness consistent with certain myasthenic symptoms (e.g., diplopia, ptosis and generalized weakness).
• Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents.
• The necessity or desirability of withdrawal of beta-adrenergic blocking agents prior to major surgery is controversial. For these reasons, in patients undergoing elective surgery, gradual withdrawal of beta-adrenergic receptor blocking agents may be appropriate.
• Carteolol Hydrochloride Ophthalmic Solution should be administered with caution since it may block bronchodilation produced by endogenous and exogenous catecholamine stimulation of beta2 receptors.
• Caution should be exercised when Carteolol Hydrochloride Ophthalmic Solution is administered to nursing mothers.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• bradycardia, bronchospasm, congestive heart failure and hypotension

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• If accidental ocular overdosage occur, flush eye(s) with water or normal saline.
• In case of ingestion, treatment with Carteolol Hydrochloride Ophthalmic Solution should be discontinued and [[gastric lavage considered.
• The patient should be closely observed and vital signs carefully monitored.

The following additional measures should be considered as appropriate:

• Symptomatic Sinus Bradycardia or Heart Block: Administer atropine. If there is no response to vagal blockade, administer isoproterenol cautiously.
• Bronchospasm: Administer a beta2-stimulating agent such as isoproterenol and/or a theophylline derivative.
• Congestive Heart Failure: Administer diuretics and digitalis glycosides as necessary.
• Hypotension: Administer vasopressors such as intravenous dopamine, epinephrine or norepinephrine bitartrate.

Can this medicine be used in pregnancy?

• Pregnancy Category C.
• There are no adequate and well-controlled studies in pregnant women.
• Carteolol Hydrochloride Ophthalmic Solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Can this medicine be used in children?

• Safety and effectiveness in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

Active ingredients:

• CARTEOLOL HYDROCHLORIDE

Inactive ingredients:

• BENZALKONIUM CHLORIDE
• SODIUM CHLORIDE
• SODIUM PHOSPHATE, MONOBASIC, UNSPECIFIED FORM
• SODIUM PHOSPHATE, DIBASIC, UNSPECIFIED FORM
• SODIUM HYDROXIDE
• HYDROCHLORIC ACID
• WATER

Who manufactures and distributes this medicine?

Manufactured by:

• Alcon Laboratories, Inc.
• Fort Worth, Texas 76134 for
• Sandoz Inc.
• Princeton, NJ

What should I know about storage and disposal of this medication?

• Store at 15° to 25°C (59° to 77°F) (room temperature) and protect from light.

• Dailymed label info on Carteolol
• FDA Carteolol

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