brimonidine, (Alphagan, Alphagan P - Discontinued in the US)

DRUG CLASS AND MECHANISM: Brimonidine is is an ophthalmic solution used for the treatment of one type of glaucoma, open-angle glaucoma. In this type of glaucoma, too much fluid (aqueous humor) is made within the eye and causes high pressures within the eye. The pressure damages the nerves in the eye responsible for vision, and this ultimately causes blindness. Brimonidine reduces the body's production of aqueous humor and increases the flow of aqueous humor out of the eye, resulting in a decrease in pressure. It accomplishes this by stimulating alpha type 2 receptors selectively in the eye with less effect on alpha type 2 receptors elsewhere in the body. It is the first drug of its class to be used for glaucoma. Brimonidine was approved by the FDA in 1996.

GENERIC AVAILABLE: Yes

PRESCRIPTION: Yes

PREPARATIONS: Ophthalmic solution: 0.1%, 0.15%, 0.2%, and 0.5%

STORAGE: Brimonidine should be kept at room temperature, 15 C to30 C (59 F to 86 F) and protected for direct light.

PRESCRIBED FOR: Brimonidine is used for the reduction of intraocular pressure in patients with open-angle glaucoma. DOSING: The usual dose is one drop into each affected eye three times daily with each application approximately 8 hours apart.

DRUG INTERACTIONS: In theory, monoamine oxidase Inhibitors (for example, tranylcypromine, selegiline, linezolid) may interfere with the metabolism of brimonidine, increasing the occurrence of low blood pressure.

PREGNANCY: It is not known if brimonidine passes from the mother into the fetus.

NURSING MOTHERS: It is not known if brimonidine is secreted in breast milk.

SIDE EFFECTS: Common side effects include dry eyes, red eyes, irritation of the eyes, headache, blurred vision, a sensation of a foreign body in the eye, and drowsiness. Less common side effects include corneal staining, increased sensitivity to light, eyelid redness, eye pain, tearing, and eyelid swelling. Low blood pressure also may occur.

Reference: FDA Prescribing Information

Last Editorial Review: 11/15/2012

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