No specific information on emergency treatment of overdosage with Kerlone is available. The most common effects expected are bradycardia, congestive heart failure, hypotension, bronchospasm, and hypoglycemia. In one acute overdosage of betaxolol, a 16-year-old female recovered fully after ingesting 460 mg.

Oral LD_50s are 350 to 400 mg betaxolol/kg in mice and 860 to 980 mg/kg in rats.

In the case of overdosage, treatment with Kerlone should be stopped and the patient carefully observed. Hemodialysis or peritoneal dialysis does not remove substantial amounts of the drug. In addition to gastric lavage, the following therapeutic measures are suggested if warranted:

Hypotension: Use sympathomimetic pressor drug therapy, such as dopamine, dobutamine, or norepinephrine. In refractory cases of overdosage of other beta-blockers, the use of glucagon hydrochloride has been reported to be useful.

Bradycardia: Atropine should be administered. If there is no response to vagal blockade, isoproterenol should be administered cautiously. In refractory cases the use of a transvenous cardiac pacemaker may be considered.

Acute Cardiac Failure: Conventional therapy including digitalis, diuretics, and oxygen should be instituted immediately.

Bronchospasm: Use a ß₂-agonist. Additional therapy with aminophylline may be considered.

Heart Block (2nd-or 3rd-degree): Use isoproterenol or a transvenous cardiac pacemaker.

Contraindications include hypersensitivity to betaxolol or any component of the formulation; sinus bradycardia; heart block greater than first-degree (except in patients with a functioning artificial pacemaker); cardiogenic shock; uncompensated cardiac failure; pulmonary edema; pregnancy (2nd or 3rd trimester).

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