indication

For the treatment of intraocular hypertension and chronic open-angle glaucoma

pharmacology

Carteolol 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. Carteolol, 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. Carteolol 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

The primary mechanism of the ocular hypotensive action of carteolol in reducing intraocular pressure is most likely a decrease in aqueous humor production. This process is initiated by the non-selective beta1 and beta2 adrenergic receptor blockade.

toxicity

The most common effects expected with overdosage of a beta-adrenergic blocking agent are bradycardia, bronchospasm, congestive heart failure and hypotension.

biotransformation

Hepatic.

drug interactions

Acetohexamide: The beta-blocker, carteolol, may decrease symptoms of hypoglycemia.

Aminophylline: Antagonism of action and increased effect of theophylline

Chlorpropamide: The beta-blocker, carteolol, may decrease symptoms of hypoglycemia.

Clonidine: Increased hypertension when clonidine stopped

Dihydroergotamine: Ischemia with risk of gangrene

Disopyramide: The beta-blocker, carteolol, may increase the toxicity of disopyramide.

Epinephrine: Hypertension, then bradycardia

Ergotamine: Ischemia with risk of gangrene

Fenoterol: Antagonism

Formoterol: Antagonism

Gliclazide: The beta-blocker, carteolol, may decrease symptoms of hypoglycemia.

Glyburide: The beta-blocker, carteolol, may decrease symptoms of hypoglycemia.

Ibuprofen: Risk of inhibition of renal prostaglandins

Indomethacin: Risk of inhibition of renal prostaglandins

Insulin Glargine: The beta-blocker, carteolol, may decrease symptoms of hypoglycemia.

Methyldopa: Possible hypertensive crisis

Methysergide: Ischemia with risk of gangrene

Orciprenaline: Antagonism

Oxtriphylline: Antagonism of action and increased effect of theophylline

Pipobroman: Antagonism

Piroxicam: Risk of inhibition of renal prostaglandins

Prazosin: Risk of hypotension at the beginning of therapy

Repaglinide: The beta-blocker, carteolol, may decrease symptoms of hypoglycemia.

Terazosin: Increased risk of hypotension. Initiate concomitant therapy cautiously.

Terbutaline: Antagonism

Theophylline: Antagonism of action and increased effect of theophylline

Treprostinil: Additive hypotensive effect. Monitor antihypertensive therapy during concomitant use.