Brimonidine use while Breastfeeding
Drugs containing Brimonidine: Combigan, Alphagan, Simbrinza, Mirvaso, Alphagan P, Qoliana
Brimonidine Levels and Effects while Breastfeeding
Summary of Use during Lactation
Limited information indicates that maternal use of brimonidine 0.2% ophthalmic drops do not adversely affect their nursing infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
Topical brimonidine gel used to treat rosacea has not been studied during breastfeeding. It is unlikely that the topical gel would affect the breastfed infant, but the manufacturer states that it should not be used during nursing. Until more data are available, an alternative topical agent might be preferred
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
A woman used brimonidine 0.2%, timolol gel-forming solution 0.5%, dipiverin 0.2%, and dorzolamide 0.5% drops for glaucoma while nursing a newborn. The frequency of medication use and extent of nursing were not stated. All medications were given immediately after nursing with punctal occlusion of the tear duct. The infant's vital signs were closely monitored with no signs of bradycardia or apnea.
A woman was using ophthalmic drops containing 0.5% timolol and 0.2% brimonidine twice daily in the right eye for 6 months. During this time, she breastfed her infant (extent not stated) apparently without harm to her infant.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
(Topical for Rosacea) Azeleic Acid, Metronidazole
1. Johnson SM, Martinez M, Freedman S. Management of glaucoma in pregnancy and lactation. Surv Ophthalmol. 2001;45:449-54. PMID: 11274697
2. Madadi P, Koren G, Freeman DJ et al. Timolol concentrations in breast milk of a woman treated for glaucoma: calculation of neonatal exposure. J Glaucoma. 2008;17:329-31. PMID: 18552619
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Adrenergic alpha-2 Receptor Agonists
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Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
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- Drug class: ophthalmic glaucoma agents