Teoptic eye drops (Carteolol)

How does it work?

Teoptic eye drops contain the active ingredient carteolol, which is a type of medicine called a beta-blocker. It works by blocking beta-receptors in the eye.

The pressure within the eyeball is naturally maintained by a continuous flow of liquid called aqueous humour through the eyeball. Aqueous humour is produced by a part of the eye called the ciliary body, and it drains out of the eyeball through channels called the trabecular meshwork. If the outflow of aqueous humour is blocked, the aqueous humour builds up inside the eye, increasing the pressure within the eyeball. This pressure needs to be reduced, as otherwise it can damage the optic nerve and impair vision as a result.

Carteolol blocks beta-receptors that are found on the ciliary body. This reduces the amount of aqueous humour secreted into the eyeball by the ciliary body. Carteolol also blocks beta-receptors found on the blood vessels that supply the ciliary body. This causes these blood vessels to constrict, and reduces the amount of watery fluid that filters out of the blood vessels to form aqueous humour.

Carteolol therefore reduces the inflow of aqueous humour into the eyeball, which decreases the pressure within the eye. It is used to treat conditions where there is raised pressure in the eye, such as glaucoma.

Sufficient carteolol may be absorbed from the eye into the bloodstream to cause side effects on other parts of the body, or to react with other medicines being taken by mouth, injection or suppository. You can minimise the amount of medicine that is absorbed into your bloodstream and increase the local action in the eye by pressing on your tear duct (the corner of the eye closest to the nose), or closing your eyelids after putting in the drops. It is recommended that you do this for five minutes after you have administered the drops.

What is it used for?

• Raised pressure within the eye (ocular hypertension).
• Open angle glaucoma.
• Glaucoma caused by another disease of the eye (secondary glaucoma).

Warning!

• This medicine is not to be taken by mouth.
• When using these eye drops you should take care to not touch the dropper tip to any surface, or to your eye, in order to avoid contaminating the eye drops.
• Teoptic eye drops contain the preservative benzalkonium chloride, which can be absorbed by soft contact lenses and cause eye irritation. If you wear soft contact lenses, you should remove them before putting in these eye drops. You should wait at least 15 minutes after using the drops before putting your contact lenses back in.
• This medicine may cause temporary blurred vision after you have applied it into the eye(s). If affected, do not drive or operate machinary until this has worn off. You should also take into account that this medicine can sometimes cause other visual disturbances and dizziness or fatigue, all of which may affect your ability to drive or operate machinary.
• While using these eye drops you will need to have regular eye examinations.
• Teoptic eye drops are sterile until opened. The bottles contain a preservative that helps keep the eye drops sterile while in use. Any remaining medicine in the bottle should be carefully disposed of four weeks after the first opening, as after this time it is likely to be contaminated with germs. You may find it helpful to write the date of first opening on the packet. Dispose of carefully, preferably by returning to your pharmacy.

Use with caution in

• History of severe heart disease.
• Heart failure.
• A problem common in the elderly, related to poor control of the working of the heart (sick sinus syndrome).
• A severe form of angina pectoris, not caused by exertion (Prinzmetal's or variant angina).
• Low blood pressure (hypotension).
• Severe problems with blood circulation in the hands or feet, eg Raynaud's disease.
• Untreated tumour of the adrenal gland (phaeochromocytoma).
• Overactive thyroid gland (hyperthyroidism).
• Diabetes (this medicine may mask the symptoms of low blood sugar, such as increased heart rate and tremor, and the dose of your diabetes medicine may need adjusting).
• Increased acidity in the blood (metabolic acidosis).
• Abnormal muscle weakness (myasthenia gravis).
• History of allergies.
• Psoriasis.

Not to be used in

• Uncontrolled heart failure.
• Very slow heart rate caused by the pacemaker of the heart (sinus bradycardia).
• Serious defect in the heart's electrical message pathways resulting in decreased function of the heart (2nd or 3rd degree heart block).
• Failure of the heart to maintain adequate circulation of blood around the body (cardiogenic shock).
• History of asthma.
• History of chronic obstructive pulmonary disease (COPD).
• Pregnancy.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• The safety of this medicine for use during pregnancy has not been established. It should not be used by pregnant women. Seek medical advice from your doctor if you think you could be pregnant, or want to have a baby, while you are using these eye drops.
• This medicine may pass into breast milk after application to the eyes. It should be used with caution in breastfeeding mothers and only if the expected benefit to the mother is greater than any possible risk to the nursing infant. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

• Burning, itching, stinging or painful sensations in the eye.
• Sensation of something being in the eye.
• Red eye.
• Dry eyes.
• Blurred vision.
• Inflammation of the membrane that lines the inside of the eyelids and outside of the eyeball, causing redness and discharge (conjunctivitis).
• Inflammation of the eyelids (blepharitis).
• Inflammation of the cornea (keratitis).
• Increased sensitivity of the eyes to light (photophobia).
• Headache.
• Dizziness.
• Feeling weak.
• Nausea and bitter taste.
• Shortness of breath or asthma attacks.
• Slow heart rate (bradycardia).
• Palpitations.
• Chest pain.
• Fainting.
• Allergic skin rashes.
• Worsening of psoriasis.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

The carteolol in these eye drops can be absorbed into the bloodstream after application to the eye and it may therefore interact with other medicines that you are taking. It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to ensure that the combination is safe.

If you are using more than one type of eye drop you should administer them at least five minutes apart, to prevent the second drop washing away the first. Use eye gels or ointments last.

If you are already taking any beta-blocker medicines by mouth, for example propranolol, atenolol, metoprolol, these eye drops may increase the chance of experiencing side effects from the oral beta-blocker.

If this medicine is used by people taking calcium channel blockers, such as nifedipine, verapamil or diltiazem, there may be an increased risk of slow heart rate, low blood pressure or heart failure.

If this medicine is used by people taking digoxin or medicines for an abnormal heart rhythm (antiarrhythmics such as amiodarone, quinidine or disopyramide) there may be an increased risk of slow heart rate.

If you go into hospital or to the dentist to have an operation you should tell the person treating you that you are using these eye drops. This is because your blood pressure may fall too low if you are given certain types of anaesthetics while using this medicine.

This medicine may reduce the blood sugar lowering effect of some medicines used to treat diabetes. People with diabetes should carefully monitor their blood sugar while using this medicine, as the eye drops may also mask some of the signs of low blood sugar, such as increased heart rate and tremor.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain carteolol as the active ingredient.