The following adverse reactions have been reported in clinical trials with Ocupress Ophthalmic Solution:

Ocular: Transient eye irritation, burning, tearing, conjunctival hyperemia and edema occurred in about 1 of 4 patients. Ocular symptoms including blurred and cloudy vision, photophobia, decreased night vision, and ptosis and ocular signs including blepharoconjunctivitis, abnormal corneal staining, and corneal sensitivity occurred occasionally.

Systemic: As is characteristic of nonselective adrenergic blocking agents, Ocupress may cause bradycardia and decreased blood pressure (see WARNINGS). The following systemic events have occasionally been reported with the use of Ocupress: cardiac arrhythmia, heart palpitation, dyspnea, asthenia, headache, dizziness, insomnia, sinusitis, and taste perversion.

The following additional adverse reactions have been reported with ophthalmic use of beta-1 and beta-2 (nonselective) adrenergic receptor blocking agents:

Body As a Whole: Headache

Cardiovascular: Arrhythmia, syncope, heart block, cerebral vascular accident, cerebral ischemia, congestive heart failure, palpitation (see WARNINGS).

Digestive: Nausea

Psychiatric: Depression

Skin: Hypersensitivity, including localized and generalized rash

Respiratory: Bronchospasm (predominantly in patients with pre-existing bronchospastic disease), respiratory failure (see WARNINGS)

Endocrine: Masked symptoms of hypoglycemia in insulin-dependent diabetics (see WARNINGS)

Special Senses: Signs and symptoms of keratitis, blepharoptosis, visual disturbances including refractive changes (due to withdrawal of miotic therapy in some cases), diplopia, ptosis.

Other reactions associated with the oral use of nonselective adrenergic receptor blocking agents should be considered potential effects with ophthalmic use of these agents.

Ocupress should be used with caution in patients who are receiving a beta-adrenergic blocking agent orally because of the potential for additive effects on systemic beta-blockade.

Close observation of the patient is recommended when a beta-blocker is administered to patients receiving catecholamine-depleting drugs such as reserpine, because of possible additive effects and the production of hypotension and/or marked bradycardia, which may produce vertigo, syncope, or postural hypotension.

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