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Brimonidine / brinzolamide ophthalmic Side Effects

For the Consumer

Applies to brimonidine / brinzolamide ophthalmic: ophthalmic suspension

In addition to its needed effects, some unwanted effects may be caused by brimonidine / brinzolamide ophthalmic. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when 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

If any of the following symptoms of overdose occur while taking brimonidine / brinzolamide ophthalmic, get emergency help immediately:

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

Minor Side Effects

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

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


Uncommon (0.1% to 1%): Cardio-respiratory distress, angina pectoris, arrhythmia, palpitations, irregular heart rate, bradycardia, tachycardia, hypotension, chest discomfort
Very rare (less than 0.01%): Hypertension
Frequency not reported: Chest pain
Postmarketing reports: Pallor[Ref]


Uncommon (0.1% to 1%): Contact dermatitis, urticaria, rash, maculo-papular rash, generalized pruritus, alopecia, skin tightness
Frequency not reported: Dermatitis, erythema[Ref]


Common (1% to 10%): Dry mouth
Uncommon (0.1% to 1%): Dyspepsia, esophagitis, abdominal discomfort, diarrhea, vomiting, nausea, frequent bowel movements, flatulence, oral hypoesthesia, oral paresthesia[Ref]


The most commonly reported side effects were blurred vision, ocular hyperemia, eye allergy, dry mouth, and dysgeusia.[Ref]


Uncommon (0.1% to 1%): Hypersensitivity[Ref]


Uncommon (0.1% to 1%): Back pain, muscle spasms, myalgia
Frequency not reported: Arthralgia, pain in extremity[Ref]

Nervous system

Common (1% to 10%): Somnolence, dizziness, dysgeusia
Uncommon (0.1% to 1%): Headache, motor dysfunction, amnesia, memory impairment, paresthesia, vertigo, tinnitus, feeling jittery
Very rare (less than 0.01%): Syncope
Frequency not reported: Tremor, hypoesthesia, ageusia
Postmarketing reports: Coma, lethargy[Ref]


Common (1% to 10%): Eye allergy, keratitis, eye pain, ocular discomfort, blurred vision, abnormal vision, ocular hyperemia, conjunctival blanching
Uncommon (0.1% to 1%): Corneal erosion, corneal edema, blepharitis, corneal deposits (keratic precipitates), conjunctival disorder (papilla) , photophobia, photopsia, eye swelling, eyelid edema, conjunctival edema, dry eye, eye discharge, reduced visual acuity, increased lacrimation, pterygium, erythema of eyelid, meibomianitis, diplopia, glare, eye hypoesthesia, scleral pigmentation, subconjunctival cyst, abnormal sensation in eye, asthenopia
Very rare (less than 0.01%): Uveitis, miosis
Frequency not reported: Visual disturbances, madarosis
Postmarketing reports: Iritis, keratoconjunctivitis sicca[Ref]


Uncommon (0.1% to 1%): Pain, feeling abnormal, irritability
Frequency not reported: Face edema, peripheral edema
Postmarketing reports: Hypothermia[Ref]


Uncommon (0.1% to 1%): Apathy, depression, insomnia, nightmare, nervousness[Ref]


Uncommon (0.1% to 1%): Renal pain
Frequency not reported: Pollakiuria[Ref]


Uncommon (0.1% to 1%): Nasopharyngitis, pharyngitis, sinusitis, dyspnea, bronchial hyperactivity, pharyngolaryngeal pain, dry throat, cough, epistaxis, upper respiratory tract congestion, nasal congestion, rhinorrhea, throat irritation, nasal dryness, postnasal drip, sneezing
Frequency not reported: Rhinitis, asthma
Postmarketing reports: Apnea, respiratory depression[Ref]


Uncommon (0.1% to 1%): Decreased libido, erectile dysfunction[Ref]


Uncommon (0.1% to 1%): Decreased red blood cell, increased blood chloride[Ref]


Frequency not reported: Abnormal liver function[Ref]


1. "Product Information. Simbrinza (brimonidine-brinzolamide ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. Cerner Multum, Inc. "Australian Product Information." O 0

Not all side effects for brimonidine / brinzolamide ophthalmic may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.