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Brimonidine ophthalmic Side Effects

For the Consumer

Applies to brimonidine ophthalmic: ophthalmic solution

Along with its needed effects, brimonidine 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 ophthalmic:

More common
  • Blurred or loss of vision
  • burning, dry, or itching eyes
  • discharge or excessive tearing
  • disturbed color perception
  • double vision
  • halos around lights
  • headache
  • itching of the eye
  • night blindness
  • overbright appearance of lights
  • redness of the eye or inner lining of the eyelid
  • swelling of the eyelid
  • tearing of the eye
  • tunnel vision
Less common
  • Ache or pain in the eye
  • blindness
  • bloody eye
  • blurred vision or other change in vision
  • change in color vision
  • confusion
  • decreased vision
  • difficult or labored breathing
  • difficulty seeing at night
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drainage from the eye
  • fainting
  • fast heartbeat
  • feeling of something in the eye
  • gradual blurring or loss of vision
  • increased blood pressure
  • increased sensitivity of the eye to light
  • mental depression
  • muscle pain
  • nausea or vomiting
  • oozing in the eye
  • redness, swelling, or itching of the eye or eyelid
  • runny or stuffy nose
  • seeing flashes or sparks of light
  • seeing floating dark spots or material before eyes
  • seeing floating spots before the eyes or a veil or curtain appearing across part of vision
  • shortness of breath
  • skin rash
  • sneezing
  • sweating
  • swelling of the eye
  • tightness in the chest
  • unusual tiredness or weakness
  • watery eyes
  • wheezing
Incidence not known
  • Bluish lips or skin
  • chest pain or discomfort
  • confusion
  • fast, pounding, or irregular heartbeat or pulse
  • feeling of warmth or heat
  • flushing or redness of the skin, especially on the face and neck
  • irregular, fast, slow, or shallow breathing
  • low body temperature
  • muscle aches or weakness
  • shivering
  • slow or irregular heartbeat
  • weak or feeble pulse
  • weight gain

Some side effects of brimonidine 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, stinging, or tearing of the eye
  • drowsiness or tiredness
  • dryness of the mouth
Less common
  • Acid or sour stomach
  • anxiety
  • bad, unusual, or unpleasant (after) taste
  • belching
  • body aches or pain
  • change in taste
  • chills
  • congestion
  • cough
  • cough producing mucus
  • crusting on eyelid or corner of eye
  • diarrhea
  • difficulty breathing
  • discoloration of white part of the eye
  • dryness of the eye
  • dryness or soreness of the throat
  • fever
  • general feeling of discomfort or illness
  • hoarseness
  • indigestion
  • joint pain
  • lack or loss of strength
  • large amounts of cholesterol in the blood
  • lid disorder
  • loss of appetite
  • muscle aches and pains
  • pain or tenderness around the eyes and cheekbones
  • paleness of the eye or inner lining of the eyelid
  • passing of gas
  • pounding heartbeat
  • rash
  • shivering
  • sleepiness or unusual drowsiness
  • sleeplessness
  • sneezing
  • sore throat
  • stomach discomfort, fullness, upset, or pain
  • tender, swollen glands in the neck
  • trouble with sleeping
  • trouble with swallowing
  • troubled breathing
  • unable to sleep
  • voice changes
Incidence not known
  • Constricted, pinpoint, or small pupils (black part of the eye)
  • redness of the skin
  • sensitivity to light
  • throbbing pain
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • unusual weak feeling
  • unusually warm skin

For Healthcare Professionals

Applies to brimonidine ophthalmic: ophthalmic solution, topical gel


The most commonly reported side effects were oral dryness, ocular hyperemia, burning/stinging, headache, blurring, and foreign body sensation.[Ref]


Very common (10% or more): Ocular hyperemia (20%), burning/stinging (19%), foreign body sensation (12%), ocular pruritus, blurred vision (12%), allergic blepharitis, allergic blepharoconjunctivitis, allergic conjunctivitis, ocular allergic reaction, follicular conjunctivitis
Common (1% to 10%): Local irritation (eyelid hyperemia/edema, blepharitis, conjunctival edema/discharge, ocular pain /tearing), photophobia, corneal erosion/staining, ocular dryness, conjunctival blanching, abnormal vision, conjunctivitis, epiphora, superficial punctate keratitis, visual disturbance, worsening of visual acuity, cataract, vitreous detachment, vitreous disorder, vitreous floaters
Uncommon (0.1% to 1%): Conjunctival papilla, papillary hypertrophy, iritis, hordeolum
Very rare (less than 0.01%): Miosis
Frequency not reported: Lid crusting
Postmarketing reports: Iridocyclitis (anterior uveitis), eyelid pruritus, keratoconjunctivitis sicca[Ref]


Very common (10% or more): Oral dryness
Common (1% to 10%): Gastrointestinal symptoms[Ref]


Uncommon (0.1% to 1%): Palpitations/arrhythmias (including bradycardia and tachycardia)
Very rare (less than 0.01%): Hypertension, hypotension
Postmarketing reports: Pallor[Ref]

Nervous system

Very common (10% or more): Headache, drowsiness
Common (1% to 10%): Dizziness, abnormal taste
Uncommon (0.1% to 1%): Somnolence
Very rare (less than 0.01%): Syncope
Postmarketing reports: Coma, lethargy[Ref]


Common (1% to 10%): Upper respiratory symptoms, rhinitis, bronchitis, cough, flu syndrome
Uncommon (0.1% to 1%): Nasal dryness, pharyngitis
Rare (less than 0.1%): Dyspnea
Postmarketing reports: Respiratory depression[Ref]


Common (1% to 10%): Depression
Very rare (less than 0.01%): Insomnia
Frequency not reported: Anxiety[Ref]


Common (1% to 10%): Muscular pain[Ref]


Postmarketing reports: Skin reactions including erythema, pruritus, rash, vasodilatation[Ref]


Uncommon (0.1% to 1%): Systemic allergic reactions[Ref]


Common (1% to 10%): Hypercholesterolemia[Ref]


Very common (10% or more): Fatigue[Ref]


1. "Product Information. Alphagan (brimonidine ophthalmic)." Allergan Inc, Irvine, CA.

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

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

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

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.