Betaxolol Hydrochloride

It is a long-acting cardioselective beta-blocker that is used orally (once a day) in the treatment of hypertension and angina pectoris and, as eye drops (twice a day), to treat glaucoma.

Betaxolol was excreted in the colostrum in an amount that could represent a relative dose of 5 to 10%. ^{(Morselli 1990)}

Its low percentage of plasma protein binding and long half-life make it likely that it would pass into breast milk in amounts which could be significant ^{(Riant 1986)}, although its very wide volume of distribution would make it difficult.

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.

OPHTHALMIC USE:

Following ophthalmic administration of betaxolol 0.5% for 1 week, peak betaxolol plasma concentrations were ≤ 1 ng/mL (nanograms/milliliter). ^{(AEMPS 2019)}

Systemic absorption should be minimized by pressing the tear duct (inner corner of the eye) with the finger for 1 to 2 minutes and administering the dose immediately after breastfeeding. ^{(Belkin 2020, Blumen 2020, Méndez 2012)}

The small dose and poor plasma absorption of most topical ophthalmological preparations make it unlikely that significant amounts will transfer into breastmilk. Topical use of Betaxolol in the form of eye drops is compatible with breastfeeding.