Simbrinza Side Effects

Generic Name: brimonidine / brinzolamide ophthalmic

Note: This document contains side effect information about brimonidine / brinzolamide ophthalmic. Some of the dosage forms listed on this page may not apply to the brand name Simbrinza.

Some side effects of Simbrinza may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to brimonidine / brinzolamide ophthalmic: ophthalmic suspension

Along with its needed effects, brimonidine / brinzolamide ophthalmic may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking brimonidine / brinzolamide ophthalmic:

More common
  • Blurred vision
  • discoloration of the white part of the eye
  • eye irritation or redness
Less common
  • Decreased vision
  • eye pain
  • eyes sensitive to light
  • red, sore eyes
  • Burning, dry, or itching eyes
  • discharge or excessive tearing
  • hives or welts
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • skin rash
Incidence not known
  • Chest pain or discomfort
  • constricted, pinpoint, or small pupils (black part of the eye)
  • fast, pounding, or irregular heartbeat or pulse
  • fever
  • hoarseness
  • irritation
  • itching
  • joint pain, stiffness, or swelling
  • lightheadedness, dizziness, or fainting
  • redness of the skin
  • shortness of breath
  • slow or irregular heartbeat
  • swelling of the eyelids, face, lips, hands, or feet
  • tearing
  • throbbing pain
  • tightness in the chest
  • troubled breathing or swallowing
  • unusual tiredness

Get emergency help immediately if any of the following symptoms of overdose occur while taking brimonidine / brinzolamide ophthalmic:

Symptoms of overdose
  • Confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • muscle cramps or pain
  • numbness, tingling, pain, or weakness in the hands or feet
  • seizures
  • sweating
  • trembling
  • weakness and heaviness of the legs

Some side effects of brimonidine / brinzolamide ophthalmic may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Burning and stinging sensation
  • change in color vision
  • change in taste
  • difficulty seeing at night
  • drowsiness
  • feeling of having something in the eye
  • headache
  • increase in blood flow to the whites of the eyes
  • increased sensitivity of the eyes to sunlight
  • lack or loss of strength
  • loss of taste
  • paleness of the eye or inner lining of the eyelid
  • redness and tiny bumps on the lining of the eyelid
Less common
  • Dry eyes
  • dry mouth
  • muscle pain
  • runny nose
  • sneezing
  • stuffy nose
  • trouble sleeping
  • Acid or sour stomach
  • belching
  • body aches or pain
  • congestion
  • cough
  • crusting in the corner of the eye
  • diarrhea
  • double vision
  • dryness or soreness of the throat
  • excessive muscle tone
  • hair loss or thinning of the hair
  • heartburn
  • hoarseness
  • indigestion
  • muscle stiffness
  • muscle tension or tightness
  • nausea
  • stomach discomfort, upset, or pain
  • tender, swollen glands in the neck
  • tightness in the chest
  • voice changes

For Healthcare Professionals

Applies to brimonidine / brinzolamide ophthalmic: ophthalmic suspension


Common (1% to 10%): Hyperemia
Uncommon (0.1% to 1%): Chest pain

Frequency not reported: Hypertension, palpitations/arrhythmias
Postmarketing reports: Bradycardia, tachycardia


Common (1% to 10%): Dermatitis

Postmarketing reports: Skin reactions (erythema, eyelid pruritus, rash, and vasodilation)


Common (1% to 10%): Bitter, sour or unusual taste
Uncommon (less than 1%): Diarrhea, dry mouth, dyspepsia, nausea

Very common (10% or more): Oral dryness
Common (1% to 10%): Gastrointestinal symptoms
Frequency not reported: Abnormal taste
Postmarketing reports: Nausea


The most frequently reported side effects included blurred vision, eye irritation, dysgeusia, dry mouth, eye allergy

Postmarketing reactions reported in infants receiving brimonidine ophthalmic solutions include apnea, bradycardia, coma, hypotension, hypothermia, hypotonia, lethargy, pallor, respiratory depression, somnolence. Brimonidine caused somnolence (50% to 83%) and decreased alertness in patients 2 to 6 years old.


Uncommon (less than 1%): Allergic reactions

Postmarketing reports: Hypersensitivity


Common (1% to 10%): Muscular pain

Nervous system

Common (1% to 10%): Headache
Uncommon (less than 1%): Dizziness, hypertonia

Very common (10% or more): Headache, drowsiness
Common (1% to 10%): Dizziness
Frequency not reported: Insomnia, syncope


Common (1% to 10%): Blurred vision, blepharitis, dry eye, foreign body sensation, ocular discharge, ocular discomfort, ocular keratitis, ocular pain, ocular pruritus
Uncommon (less than 1%): Conjunctivitis, diplopia, eye fatigue, keratoconjunctivitis, keratopathy, lid margin crusting or sticky sensation, tearing

Very common (10% or more): Ocular hyperemia, burning and stinging, blurring, foreign body sensation, conjunctival follicles, ocular allergic reactions, ocular pruritus
Common (1% to 10%): Corneal staining/erosion, photophobia, eyelid erythema, ocular ache/pain, ocular dryness, tearing, eyelid edema, conjunctival edema, blepharitis, ocular irritation, conjunctival blanching, abnormal vision
Frequency not reported: Lid crusting, conjunctival hemorrhage, conjunctival discharge
Postmarketing reports: Iritis, keratoconjunctivitis sicca, miosis


Common (1% to 10%): Asthenia, fatigue


Frequency not reported: Depression, anxiety


Uncommon (less than 1%): Kidney pain


Uncommon (less than 1%): Dyspnea, pharyngitis

Common (1% to 10%): Upper respiratory symptoms
Frequency not reported: Nasal dryness

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