Since studies on the efficacy and tolerability of betaxolol in children not conducted, its use in pediatrics is not recommended.
When taking the drug should be monitored heart rate and blood pressure - at the beginning of treatment daily and then 1 time in 3 - 4 months, blood glucose in patients with diabetes mellitus (1 time in 4-5 months.) In elderly patients should be monitored kidney function (1 every 4-5 months).
It is necessary to teach the patient how to calculate heart rate and instruct about the need for medical consultation at a heart rate of less than 50 beats per minute.
In elderly patients, if there is an increasing bradycardia (less than 50 beats / min), arterial hypotension (BP below 100 mmHg), atrioventricular blockade, bronchospasm, ventricular arrhythmias, severe liver and kidney function, it is necessary to lower the dose or stop treatment.
Treatment should not be stopped abruptly, especially in patients with ischemic heart disease. The dose should be reduced gradually, that is, within 1-2 weeks and, if necessary, it is possible to simultaneously start substitution therapy to avoid the progression of angina pectoris.
When used simultaneously with insulin and oral hypoglycemic agents betaxolol can mask symptoms of hypoglycemia (eg, tachycardia).
Drugs that reduce catecholamine stocks (eg, reserpine), can enhance the action of beta-blockers. Patients taking such drugs should be under constant medical supervision for arterial hypotension or bradycardia.
Patients with bronchopulmonary diseases can be prescribed cardioselective beta-blockers in case of intolerance and / or ineffectiveness of other antihypertensive drugs, but you should strictly follow the dosage, because Overdose is dangerous by the development of bronchospasm.
Bronchial asthma and chronic obstructive pulmonary disease: beta-blockers may be prescribed only to patients with moderate disease severity, with the choice of a selective beta-adrenoblocker in a low initial dose.Before the start of treatment it is recommended to perform an evaluation of the function of breathing. When developing seizures during treatment, bronchodilators - β2-adrenomimetics.
Patients using contact lenses, should take into account that against the background of treatment may reduce the production of tear fluid.
With the development of depression, caused by the use of beta-blockers, it is recommended to stop therapy. When discontinuing therapy, the dose of the drug is recommended to be reduced gradually (by 1/4 every 3-4 days) for 1-2 weeks to avoid the occurrence of the "withdrawal" syndrome.
In case of need for planned surgical treatment the drug is withdrawn 48 hours before the start of the general anesthesia. An anesthesiologist should be informed that the patient was receiving beta-blocker therapy. If the patient has taken the drug before surgery, he should choose a drug for general anesthesia with minimal negative inotropic effect.
With thyrotoxicosis betaxolol can mask certain clinical signs of the disease (for example, tachycardia). Abrupt withdrawal of the drug in such patients can lead to increased symptoms.
With diabetes mellitus admission betaxolol and can mask tachycardia caused by hypoglycemia. In contrast to non-selective beta-blockers, betaxolol practically does not increase insulin-induced hypoglycemia and does not delay the restoration of the glucose concentration in the blood to a normal level.
When taken concomitantly with clonidine The abolition of clonidine should be carried out a few days after Betak's withdrawal.
With a weighed allergic anamnesis it is possible to increase the severity of the reaction of hypersensitivity and the lack of effect from the usually recommended doses of epinephrine.
It is necessary to cancel Betak before the study of the blood and urine content of catecholamines, normetanephrine and vanillin-mandelic acid, antinuclear antibody titers.
For the duration of treatment, exclude the use of ethanol.
In "smokers" the effectiveness of beta-blockers is lower.
In newborns, whose mothers were treated with beta-blockers, the effect of the latter persists for several days after birth. Although this residual effect may not have clinical consequences, nevertheless, it is possible to develop a heart defect requiring intensive care for a newborn (see section "Overdose").In such a situation, the introduction of blood volume-increasing solutions (the risk of developing pulmonary edema) should be avoided.
There are also reports of bradycardia, respiratory distress syndrome and hypoglycemia, therefore careful monitoring of newborns under specialized conditions (HR control, blood glucose levels during the first 3-5 days of life) is recommended.
Athletes must take into account that the drug contains an active substance, which can give a positive reaction when conducting tests of doping control.