Caution with history of severe anaphylaxis to allergens. In general, patients with bronchospastic disease should not receive β-blockers, but betaxolol, with β~1~ selectivity, has been used cautiously with close monitoring (caution in reactive airway disease on pulmonary function testing or excessive restriction of pulmonary function). Caution in history of cardiac failure or heart block. Caution in patients on concurrent verapamil or diltiazem (bradycardia or heart block can occur). Caution in cerebrovascular insufficiency (hypotension and decreased heart rate may reduce cerebral blood flow). Caution in diabetes mellitus (may potentiate and/or mask signs and symptoms of hypoglycemia). May mask signs of hyperthyroidism (e.g. tachycardia). Caution in myasthenia gravis and myasthenic symptoms (may potentiate myasthenia-related muscle weakness, including diplopia and ptosis). May precipitate or aggravate symptoms of arterial insufficiency in peripheral vascular disease and Raynaud’s disease. In case of pheochromocytoma adequate α-blockade is required prior to use of any β-blocker. Caution in history of psychiatric illness (may cause or exacerbate CNS depression). Caution in renal impairment. Caution in patients receiving anesthetic agents which decrease myocardial function due to decreased ability of the heart to respond to reflex β-adrenergic stimuli. β-Blocker therapy should not be withdrawn abruptly (particularly in coronary artery disease). Ophthalmic suspension contains benzalkonium chloride, which may be absorbed by contact lenses. Should not be used alone in angle-closure glaucoma (has no effect on pupillary constriction). Choroidal detachment reported with aqueous suppressant therapy after filtration procedures. Oral betaxolol may interfere with glaucoma screening tests. May be absorbed systemically following topical application to the eye, especially in excessive restriction of pulmonary function. Severe respiratory and cardiac reactions, including death resulting from bronchospasm in asthma and, rarely, death associated with cardiac failure, reported following topical (ocular) β-adrenergic blocking agents. In addition, topical betaxolol and a systemic β-adrenergic blocking agent may add effects on intraocular pressure and/or systemic effects of β-adrenergic blockade. Ophthalmic betaxolol should also be used with caution in patients subject to spontaneous hypoglycemia or with diabetes mellitus. Patients having or suspected of developing thyrotoxicosis should be monitored closely during ophthalmic betaxolol therapy.