Metipranolol (Betanol) is a non-selective beta-blocker that is used in the treatment of patients with raised intraocular pressure and glaucoma.

Metipranolol (Betanol) Uses:

• Elevated intraocular pressure:

  • Treatment elevated intraocular pressure in patient with chronic open-angle glaucoma or ocular hypertension.

Metipranolol Dose in Adults:

Metipranolol (Betanol) Dose in the treatment of Elevated intraocular pressure:

• Ophthalmic: 1 drop in the affected eye(s) two times a day

Use in Children:

Not indicated.

Pregnancy Risk Factor C

• In some studies on animal reproduction, adverse events were observed. 
• Similar effects to those experienced with systemic beta blocker administration
• To minimize fetal exposure, avoid pregnancy if you must use it.

Metipranolol use during breastfeeding:

• Use caution during lactation.
• To minimize infant exposure, use the lowest effective dose and punctal occlusion.

Dose in Kidney Disease:

No dose adjustment is needed.

Dose in Liver disease:

No dose adjustment is needed.

Side effects of Metipranolol (Betanol):

• Cardiovascular:

  • Angina
  • Atrial Fibrillation
  • Bradycardia
  • Hypertension
  • MI
  • Palpitation

• Central Nervous System:

  • Anxiety
  • Depression
  • Dizziness
  • Headache
  • Nervousness
  • Somnolence

• Dermatologic:

  • Rash

• Gastrointestinal:

  • Nausea

• Neuromuscular & Skeletal:

  • Arthritis
  • Myalgia
  • Weakness

• Ocular:

  • Abnormal Vision
  • Blepharitis
  • Blurred Vision
  • Conjunctivitis
  • Discomfort
  • Edema
  • Eyelid Dermatitis
  • Photophobia
  • Tearing
  • Uveitis

• Respiratory:

  • Bronchitis
  • Cough
  • Dyspnea
  • Epistaxis
  • Rhinitis

• Miscellaneous:

  • Allergic Reaction

Contraindications to Metipranolol (Betanol):

• Hypersensitivity to metipranolol and any component of the formula
• Bronchial asthma, history of bronchial asthma;
• severe COPD
• Sinus bradycardia
• Second- and Third-degree AV Block;
• Cardiac failure
• Cardiogenic shock

Warnings and precautions

• Anaphylactic reactions

  • If you have a history of severe allergic reactions to allergens, such as epinephrine, be cautious.
  • Beta-blockers can make patients more sensitive to repeated challenges.

• Bronchospastic Disease:

  • Patients with bronchospastic disorder should not use it.
  • If the drug cannot be avoided, use caution.

• Conductive abnormality

  • You should rule out conduction impairments.

• Diabetes:

  • Hypoglycemia may occur and/or symptoms may be masked.
  • Take care when administering insulin to diabetic patients.

• Heart failure:

  • Preexisting myocardial dysfunction may be worse (magnitude major).
  • Pay attention.

• Myasthenia gravis:

  • Patients with myasthenia gravis should be treated with caution.

• Peripheral Vascular Disease (PVD).

  • Patients with peripheral arterial disease should be cautious.

• Psychiatric diseases:

  • You should be cautious as it may worsen CNS depression.

Metipranolol: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring Parameters:

Monitor intraocular pressure.

How to administer Metipranolol (Betanol)?

For ophthalmic use only. Avoid dropper contact with skin/ cornea. Remove contact lenses before instilling drops and wait 15 minutes before inserting again.

Mechanism of action of Metipranolol (Betanol):

• Although its mechanism of action is not clear, it is believed to decrease blood flow to the cerebellum, which in turn reduces the production of aqueous humor and thus lowers intraocular pressure.
• Beta blocking agent, but with no intrinsic sympathomimetic or membrane-stabilizing activity and no synaptic activity.

Onset of action:

• • =30 minutes

Peak effect:

• Maximum: ~2 hours

Duration:

• Intraocular pressure reduction: Up to 24 hours

Metabolism:

• Rapid and complete to deacetyl metipranolol, an active metabolite

Half-life elimination:

• ~3 hours

International Brand Names of Metipranolol:

• Beta Ophtiole
• Betamana
• Betamann
• Betanol
• Disorat
• Glauline
• Minims Metipranolol
• Normoglaucon
• Trimepranol
• Turoptin

Metipranolol Brand Names in Pakistan:

No Brands Available in Pakistan.