How does this medication work? What will it do for me?

Levobunolol belongs to the class of medications known as beta-blockers. Levobunolol is used to control intraocular (eye) pressure in people with chronic open-angle glaucoma or mild-to-moderate ocular hypertension (increased pressure within the eye).

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each mL of sterile eye solution contains levobunolol 5 mg. Nonmedicinal ingredients: benzalkonium chloride (as a preservative), dibasic sodium phosphate, edetate disodium, polyvinyl alcohol, potassium phosphate, purified water, sodium chloride, and sodium hydroxide or hydrochloric acid (to adjust pH), and sodium metabisulfite.

How should I use this medication?

The recommended starting dose of levobunolol eye drops is 1 drop of levobunolol 0.25% twice a day in the affected eye(s). The dose may be increased to 1 drop of levobunolol 0.5% twice a day if necessary. Doses greater than this have not been found to be any more effective.

Ask your doctor or pharmacist to show you the correct way to instill the eye drops. This medication is for external use only. Do not touch the dropper tip to any surface, since this may contaminate the solution. Protect the medication from light and excessive heat. Discard any unused solution after the end of the treatment period.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication regularly and exactly as prescribed by your doctor. If you miss a dose, use it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to levobunolol or any ingredients of this medication
  • have asthma or a history of asthma or severe chronic obstructive pulmonary disease (e.g., chronic bronchitis or emphysema)
  • have certain abnormal heart rhythms associated with slowing down of the heart rate
  • have overt heart failure
  • suffer from cardiogenic shock

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • acid or sour stomach
  • belching
  • blurred vision (temporary)
  • brow ache
  • constipation
  • crusting of eyelashes
  • decreased night vision
  • dry eyes
  • dry skin
  • feeling like you have something in your eye
  • heartburn
  • increased sensitivity of eye to light
  • indigestion
  • itching, stinging, burning, or watering of eye or other eye irritation
  • pain, redness, warmth, or swelling of muscles
  • stinging of eye or other eye irritation (when medication is applied)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blurred vision or other change in vision
  • discoloration of the eyeball
  • droopy upper eyelid
  • eye pain
  • pupils of different sizes
  • redness of the eyes or inside of the eyelids
  • redness or irritation of the tongue
  • seeing "double"
  • swelling, irritation, or inflammation of eye or eyelid

Signs of too much medication being absorbed into the body:

  • ankle, knee, or big toe joint pain or swelling
  • anxiety or nervousness
  • bloody or cloudy urine
  • breast pain
  • burning or prickling feeling on body
  • change in taste sensation
  • chest pain
  • chills
  • clumsiness or unsteadiness
  • confusion or depression
  • coughing, wheezing, or troubled breathing
  • decreased sexual ability
  • diarrhea
  • difficult, burning, or painful urination
  • dizziness or feeling faint
  • drowsiness
  • dryness or soreness of throat
  • ear pain
  • feeling of constant movement
  • fever
  • hair loss
  • hallucinations
  • headache
  • hoarseness
  • irregular, fast, slow, or pounding heartbeat
  • lightheadedness
  • lower back or side pain
  • muscle or joint aches or pain
  • muscle tightness or stiffness
  • nausea or vomiting
  • raw, red, blistering, scaly, or crusted areas of the skin
  • ringing or buzzing in the ears
  • runny, stuffy, or bleeding nose
  • skin rash, hives, or itching
  • swelling of feet, ankles, or lower legs
  • trouble sleeping
  • unusual tiredness or weakness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergies: This medication should be used with caution by anyone with a known allergy to other beta-blockers (e.g., metoprolol, atenolol).

Medical conditions: This medication belongs to the family of medications known as beta-blockers. Although levobunolol is given as an eye drop, small amounts may be absorbed into the bloodstream. For this reason, it should not be used by anyone who must avoid internal use of beta-blockers. This includes those with abnormally low heart rate, certain abnormal heart rhythms, uncontrolled congestive heart failure, asthma, or severe chronic obstructive pulmonary disease.

Sulfites: This product contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylaxis, in certain susceptible people. Sulfite sensitivity is seen more frequently in those with asthma.

Pregnancy: This medication has not been studied for use by pregnant women. It should be used during pregnancy only if the potential benefits outweigh the potential risks.

Breast-feeding: It is not known if levobunolol passes into breast milk. Related medications have been shown to pass into breast milk. Talk to your doctor about breast-feeding while using levobunolol.

Children: The safety and effectiveness of this medication have not been established for use by children.

What other drugs could interact with this medication?

There may be an interaction between levobunolol and any of the following:

  • medications that reduce blood pressure
  • other beta-blockers
  • other eye drops

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.