Drug Interaction Report

Oxymetazoline and Levobunolol Ophthalmic: Interaction Details

A pharmacist-reviewed analysis of the Oxymetazoline and Levobunolol Ophthalmic interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Levobunolol Ophthalmic

AKBeta® Betagan Betagan®
+

Oxymetazoline

Afrin Allerest 12 Hour Nasal Spray Dristan 12-Hour Nasal Spray Duramist Plus Neo-Synephrine 12 Hour Nostrilla Qlearquil Nasal Decongestant Rhofade
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
LinkedIn
Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 8 documented Oxymetazoline interactions, 8 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased blood pressure

Interaction Deep Dive

Avoid concomitant use of oxymetazoline and a nonselective beta adrenergic antagonist as this may result in hypertension. Choose an alternative to oxymetazoline if use of the beta antagonist cannot be discontinued1.

Why it happens (mechanism)

Increased sympathomimetic activity

Common questions

Can I take Oxymetazoline and Levobunolol Ophthalmic together?

Increased blood pressure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Oxymetazoline and Levobunolol Ophthalmic interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Oxymetazoline or Levobunolol Ophthalmic need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: KOVANAZE(TM) nasal spray, tetracaine HCl oxymetazoline HCl nasal spray. St. Renatus, LLC (per FDA), Fort Collins, CO, 2016. DailyMed
Was this write-up helpful?
Levobunolol Ophthalmic

Keep reading about Levobunolol Ophthalmic

All Levobunolol Ophthalmic interactions (160) Levobunolol Ophthalmic drug information
Also serious with: Albuterol Ceritinib Clonidine Crizotinib
Oxymetazoline

Keep reading about Oxymetazoline

All Oxymetazoline interactions (8) Oxymetazoline drug information
Also serious with: Amitriptyline Fentanyl Transdermal Patch Labetalol Linezolid Injection

Check another combination

Our instant two-drug interaction checker is almost here.

Coming soon

The instant two-drug checker is on its way.

In the meantime, browse the directory below to look up any drug and see its documented interactions.

Still have questions about this combination?

Every question gets a real answer from a licensed pharmacist — free, and usually within a day.

Ask the pharmacist
This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.