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Levobunolol ophthalmic Side Effects

Not all side effects for levobunolol ophthalmic may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to levobunolol ophthalmic: ophthalmic solution

In addition to its needed effects, some unwanted effects may be caused by levobunolol ophthalmic. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking levobunolol ophthalmic:

More common
  • Burning or stinging in eye
  • drainage from the eye
  • redness, swelling, and/or itching of eye and eyelid
Less common
  • Blurred vision
  • chest pain or discomfort
  • confusion
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • shortness of breath
  • slow or irregular heartbeat
  • sweating
  • unusual tiredness or weakness
  • Eye pain
  • headache
  • hives or welts
  • itching skin
  • redness of skin
  • shakiness and unsteady walk
  • skin rash
  • tearing
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • unusual drowsiness, dullness, or feeling of sluggishness
Incidence not determined
  • Blistering, peeling, loosening of skin
  • blue lips, fingernails, or skin
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chills
  • cough
  • decreased urine output
  • diarrhea
  • difficult or labored breathing
  • difficulty in chewing, swallowing, or talking
  • dilated neck veins
  • disturbed color perception
  • double vision
  • drooping eyelids
  • extreme fatigue
  • fast, pounding, or racing heartbeat or pulse
  • fever
  • halos around lights
  • hoarseness
  • inability to speak
  • irregular, fast or slow, or shallow breathing
  • irritation
  • joint pain, stiffness, or swelling
  • muscle pain
  • muscle weakness
  • night blindness
  • no blood pressure or pulse
  • noisy breathing
  • overbright appearance of lights
  • red skin lesions, often with a purple center
  • seeing double
  • seizures
  • severe numbness, especially on one side of the face or body
  • severe or sudden headache
  • severe tiredness
  • slurred speech
  • sore throat
  • sores, ulcers, or white spots in mouth or on lips
  • stopping of heart
  • swelling of eyelids, face, lips, hands, fingers, feet, or lower legs
  • temporary blindness
  • tightness in chest
  • troubled breathing
  • tunnel vision
  • unconsciousness
  • weakness in arm and/or leg on one side of the body, sudden and severe
  • weight gain
  • wheezing

Some of the side effects that can occur with levobunolol ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not determined
  • Decreased interest in sexual intercourse
  • discouragement
  • feeling sad or empty
  • inability to have or keep an erection
  • irritability
  • lack of appetite
  • lack or loss of strength
  • loss in sexual ability, desire, drive, or performance
  • loss of interest or pleasure
  • nausea
  • stuffy nose
  • tiredness
  • trouble concentrating
  • trouble sleeping

For Healthcare Professionals

Applies to levobunolol ophthalmic: ophthalmic solution


The safety of levobunolol in over 2,000 patients has been reported in a multicenter trial. Eighty-five percent of the patients completed 3 months of therapy with well-controlled intraocular pressure. Treatment was discontinued in 7% due to adverse drug events.[Ref]


There is a possibility of decreased corneal sensitivity after prolonged use despite the minimal activity levobunolol has on membrane-stabilizing.[Ref]

Ocular side effects have frequently included transient ocular discomfort, stinging, or burning in up to 33% of patients. Blepharoconjunctivitis has been reported in 5%, and blepharitis, decreased visual acuity, conjunctivitis, band keratopathy, erythema, tearing, and pruritus have each been reported in approximately 4% of patients. Iridocyclitis and corneal sensitivity have been reported rarely.

Ocular side effects associated with levobunolol and/or other ophthalmic beta blockers have included signs and symptoms of keratitis, blepharoptosis, visual disturbances (including refractive changes), diplopia, and ptosis.[Ref]


Levobunolol and timolol appear more likely to produce clinically important decreases in airflow than betaxolol when administered to patients with reactive airways disease.[Ref]

Respiratory side effects associated with levobunolol and/or other ophthalmic beta blockers have included bronchospasm, respiratory failure, dyspnea, and nasal congestion.[Ref]


Cardiovascular side effects have included decreased heart rate and blood pressure.

Cardiovascular side effects associated with levobunolol and/or other ophthalmic beta blockers have included bradycardia, arrhythmia, hypotension, syncope, heart block, cerebral vascular accident, cerebral ischemia, congestive heart failure, palpitation, and cardiac arrest.[Ref]

In one case, an 82-year-old man with glaucoma, first degree AV heart block, and peptic ulcer disease developed episodes of dizziness at rest and one episode of syncope associated with sinus bradycardia (42 beats/min) with first degree AV heart block soon after levobunolol eyedrops were added to his medical regimen. He responded to atropine, but reverted to sinus bradycardia (in the 40's) during his subsequent hospitalization. An electrophysiologic study revealed a prolonged AH interval at 240 msec and a slightly prolonged HV interval at 60 msec and intermittent left bundle branch block with atrial pacing. Neither supraventricular nor ventricular tachycardia could be induced. Pilocarpine was substituted, and the patient's ambulatory ECG revealed fewer episodes of bradycardia and AV heart block. The patient had no further episodes of syncope or dizziness.

Heart rate and blood pressure changes are rarely clinically relevant, and usually consist of reductions of resting heart rate of 2 to 10 beats/min and decreased systolic and diastolic blood pressures of 3 to 20 and 1 to 10 mm Hg, respectively.

Levobunolol can blunt the heart rate response to exercise.[Ref]


Hypersensitivity side effects have included urticaria, pruritus, contact dermatitis, alopecia, and Stevens-Johnson syndrome.

Hypersensitivity side effects associated with levobunolol and/or other ophthalmic beta blockers have included localized and generalized rash.[Ref]

Nervous system

Nervous system side effects have included headache, transient ataxia, dizziness, depression, and lethargy,

Nervous system side effects associated with levobunolol and/or other ophthalmic beta blockers have included paresthesia, headache, and asthenia.[Ref]


Gastrointestinal side effects associated with levobunolol and/or other ophthalmic beta blockers have included nausea and diarrhea.[Ref]


Endocrine side effects associated with levobunolol and/or other ophthalmic beta blockers have included masking of the signs of hyperthyroidism/thyroid storm or hypoglycemia.[Ref]


Genitourinary side effects have included impotence.[Ref]


Musculoskeletal side effects have included ataxia.

Musculoskeletal side effects associated with levobunolol and/or other ophthalmic beta blockers have included exacerbation of myasthenia gravis.[Ref]


Psychiatric side effects have included depression and confusion.[Ref]


Other side effects associated with levobunolol and/or other ophthalmic beta blockers have included chest pain.[Ref]


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14. Gonzalez JP, Clissold SP "Ocular levobunolol. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy." Drugs 34 (1987): 648-61

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16. van der Meeren HL, Meurs PJ "Sensitization to levobunolol eyedrops." Contact Dermatitis 28 (1993): 41-2

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18. Charap AD, Shin DH, Petursson G, Cinotti D, Wortham E 4th, Brown RH, Silverstone DE, Atkins JM, Eto CY, Lue JC, et al "Effect of varying drop size on the efficacy and safety of a topical beta blocker." Ann Ophthalmol 21 (1989): 351-7

19. Chun JG, Brodsky MA, Allen BJ "Syncope, bradycardia, and atrioventricular block associated with topical ophthalmic levobunolol." Am Heart J 127 (1994): 689-90

20. Dilernia V, Albertini G, Bisighini G "Allergic contact dermatitis from levobunolol eyedrops." Contact Dermatitis 33 (1995): 57

21. Zucchelli V, Silvani S, Vezzani C, Lorenzi S, Tosti A "Contact dermatitis from levobunolol and befunolol." Contact Dermatitis 33 (1995): 66-7

22. Koch P "Allergic contact dermatitis due to timolol and levobunolol in eyedrops, with no cross-sensitivity to other ophthalmic beta-blockers." Contact Dermatitis 33 (1995): 140-1

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