Brimonidine Tartrate

Pronunciation: bri-MOE-ni-deen TAR-trate
Class: Alpha adrenergic agonist

Trade Names

Alphagan P
- Solution 0.15%

Apo-Brimonidine (Canada)
PMS-Brimonidine Tartrate (Canada)
ratio-Brimonidine (Canada)

Pharmacology

Reduces aqueous humor production and increases uveoscleral outflow.

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Indications and Usage

Lowers IOP in open-angle glaucoma or ocular hypertension.

Contraindications

Coadministration of MAOIs.

Dosage and Administration

Adults and children 2 yr of age and older

Ophthalmic Instill 1 drop into affected eye(s) 3 times daily (approximately 8 h apart). If using other topical ophthalmic drugs, separate each medication by at least 5 min.

Storage/Stability

Store at controlled room temperature (59° to 77°F). Keep container tightly closed.

Drug Interactions

Antihypertensives, beta blockers, cardiac glycosides

Brimonidine may reduce pulse and BP; use with caution.

CNS depressants (eg, alcohol, anesthetics, barbiturates, opiates, sedative)

Additive or potentiating CNS depressant effect.

MAOIs

Concurrent use contraindicated; discontinue MAOIs at least 14 days before initiating therapy.

Tricyclic antidepressants

May decrease the effect of brimonidine by altering the metabolism and uptake of circulating amines.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Hypertension; palpitations.

CNS

Headache; fatigue; drowsiness; dizziness; depression; anxiety; syncope.

EENT

Dry mouth; ocular hyperemia, burning, and stinging; blurred vision; foreign body sensation; conjunctival follicles; ocular allergy; ocular pruritus; corneal staining and erosion; photophobia; eyelid erythema and edema; ocular aching and pain; ocular dryness; tearing; conjunctival edema; blepharitis; ocular irritation; conjunctival blanching; abnormal vision; lid crusting; conjunctival hemorrhage; abnormal taste; conjunctival discharge; nasal dryness.

GI

GI symptoms.

Respiratory

Upper respiratory tract symptoms.

Miscellaneous

Asthenia; muscle pain.

Precautions

Monitor

Ensure that IOPs have been measured and documented in the patient's record.


Pregnancy

Category B .

Lactation

Undetermined.

Children

Safety and efficacy not established in children younger than 2 yr of age.

Renal Function

Use with caution.

Hepatic Function

Use with caution.

Soft contact lenses

Wait at least 15 min after instilling brimonidine before inserting contact lenses.

Patient Information

  • Advise patient that usual dose is 1 drop in the affected eye(s) 3 times daily, approximately 8 h apart.
  • Teach patient the following proper technique for instilling eye drops: wash hands; do not allow dropper to touch eye. Tilt head back, look up; pull lower eyelid down; instill prescribed number of drops.
  • Close eye for 1 to 2 min and apply gentle pressure to bridge of nose. Do not rub eye.
  • Advise patients who wear contact lenses to remove lenses before instilling this medicine and to wait at least 15 min after instilling eye drop before inserting lenses.
  • Advise patient that if more than 1 topical ophthalmic drug is being used, administer the drugs at least 5 min apart.
  • Advise patient that drug may cause drowsiness or fatigue and to use caution while driving or performing other activities requiring mental alertness.
  • Advise patient to contact eye care physician if eye or eyelid inflammation, irritation, or itching is noted.
  • Remind patient that eye examinations and measurement of IOP will be necessary while using this medication and make sure to keep appointments.

Copyright © 2009 Wolters Kluwer Health.

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