Adrenaline
Severe
Textbook
Marked rise in BP.
Adrenaline should not be given to patients receiving β blockers.
Source: KDT 7e · p133
Drug reference
Levobunolol
Beta Blocker · Ocular Hypotensive
Also known as Levobunolol hydrochloride
Beta BlockerOcular HypotensiveATC S01ED02
CDSCO approvedSchedule HATC S01ED02
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
- AdrenalineSevereTextbookKDT 7e · p133
- AmilorideSevereTextbookKDT 7e
- SofosbuvirSevereTextbookHarrison 22e · unknown
- AminophyllineSevereDatabaseDDInter
Mechanism
Levobunolol is a beta-adrenoceptor blocker. Beta-adrenoceptor blockers may produce benefit by blocking sympathetic activity.
Indications
GlaucomaOcular hypertensionChronic open-angle glaucomaGlaucoma (topical)
Dosing
- Adult
- 1 drop OD (0.5% ophthalmic solution)
- Geriatric
- Potentially inappropriate in combination with verapamil or diltiazem (risk of heart block); with bradycardia (heart rate less than 50 beats per minute), type II heart block or complete heart block.
Contraindications
- Asthma
- Cardiogenic shock
- Hypotension
- Marked bradycardia
- Metabolic acidosis
- Phaeochromocytoma (apart from specific use with alpha-blockers)
- Prinzmetal’s angina
- Second-degree AV block
- Severe peripheral arterial disease
- Sick sinus syndrome
- Third-degree AV block
- Uncontrolled heart failure
- Bronchospasm (including history of asthma or obstructive airways disease)
Side effects
Common
Symptoms of hypoglycaemia may be maskedSymptoms of thyrotoxicosis may be maskedbradycardiadepressionimpotence
Serious
- Torsade de pointes (in susceptible patients)
- Deterioration in liver function (in patients with portal hypertension)
- exacerbation of respiratory problems (asthma and chronic obstructive pulmonary disease)
Drug interactions
Amiloride
Severe
Textbook
Hyperkalaemia more likely.
Source: KDT 7e
Sofosbuvir
Severe
Textbook
Severe bradycardia.
Extreme caution advised if amiodarone is co-administered with sofosbuvir and a beta blocker.
Source: Harrison 22e · unknown
Aminophylline
Severe
Database
Drug interaction classified as: antagonism
Source: DDInter
Arformoterol
Severe
Database
Drug interaction classified as: antagonism
Source: DDInter
Ceritinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Clonidine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Diltiazem
Severe
Database
Increased propensity for AV block, severe bradycardia, and decreased left ventricular function.
Avoid concurrent administration. The concurrent administration of diltiazem with a beta blocker is contraindicated.
Source: DDInter
Dyphylline
Severe
Database
Clinical effect not specified
Source: DDInter
Epinephrine
Severe
Database
Severe hypertension and cerebral hemorrhage.
The use of epinephrine generally is contraindicated in patients who are receiving nonselective β receptor antagonists.
Source: DDInter
Formoterol
Severe
Database
Clinical effect not specified
Source: DDInter
Indacaterol
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Other Beta Blocker drugs
Ask House about Levobunolol
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team