Beta-blockers: issues of drug interactions in local and systemic delivery

Glaucoma currently ranks first among the causes of irreversible blindness and low vision. Stabilization of the glaucomatous process, especially at its initial stages, can be achieved by using drug therapy to affect the proven risk factor — the level of intraocular pressure. Taking into account the elderly and senile age of patients with glaucoma and the presence of comorbid somatic pathologies, most common being cardiovascular system diseases, the issues of interaction between local and systemic therapy in this group of patients become especially relevant. This article reviews the role of β-blockers, which are often prescribed by both ophthalmologists and therapeutic specialists, the features of their use and interaction, the decrease in intraocular pressure provided by systemic therapy, their bioavailability, and the possible undesirable side effects as a result of mixed delivery. Raising the awareness among ophthalmologists, cardiologists and general practitioners on the potential problems of co-prescribing should encourage more careful approach to reviewing patients’ history of previously prescribed topical and systemic β-blockers.