brimonidine (Rx, OTC)

Brand and Other Names:Alphagan P, Qoliana, more...Lumify
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution (Rx)

  • 0.1% (Alphagan P)
  • 0.15% (Alphagan P, Qoliana)

ophthalmic solution (OTC)

  • 0.025% (Lumify)

Elevated Intraocular Pressure

Indicated to reduce elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension

Alphagan P, Qoliana: 1 gtt in affected eye(s) q8hr

Ocular Redness

Indicated to relieve ocular redness caused by minor eye irritations

Lumify: Instill 1 gtt in affected eye(s) q6-8hr

Optic Neuropathy (Orphan)

Treatment of anterior ischemic optic neuropathy

Orphan indication sponsor

  • Allergan, Inc; 2525 Dupont Drive, P.O. Box 19534; Irvine, CA 92713

Graft vs Host Disease (Orphan)

Orphan designation for ocular GVHD

Sponsor

  • Ocugen, Inc; 5 Great Valley Parkway, Suite 160; Malvern, Pennsylvania 19355

Dosage Forms & Strengths

ophthalmic solution (Rx)

  • 0.1% (Alphagan P)
  • 0.15% (Alphagan P, Qoliana)

ophthalmic solution (OTC)

  • 0.025% (Lumify)

Elevated Intraocular Pressure

Indicated to reduce elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension

<2 years: Contraindicated

≥2 years: Alphagan P, Qoliana: 1 gtt in affected eye(s) q8hr

Ocular Redness

Indicated to relieve ocular redness caused by minor eye irritations in adults and children aged ≥5 yr

<5 years (Lumify): Safety and efficacy not established

≥5 years (Lumify): Instill 1 gtt in affected eye(s) q6-8hr

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Interactions

Interaction Checker

and brimonidine

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (8)

            • isocarboxazid

              isocarboxazid, brimonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • linezolid

              linezolid, brimonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • phenelzine

              phenelzine, brimonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • procarbazine

              procarbazine, brimonidine. Mechanism: unknown. Contraindicated.

            • rasagiline

              rasagiline, brimonidine. Mechanism: unknown. Contraindicated. Brimonidine should not be used in patients receiving MAO inhibitors.

            • selegiline

              selegiline, brimonidine. Mechanism: unknown. Contraindicated. Coadministration is contraindicated.

            • selegiline transdermal

              selegiline transdermal, brimonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            • tranylcypromine

              tranylcypromine, brimonidine. Mechanism: unknown. Contraindicated. Contraindicated in mfr prescribing info.

            Serious - Use Alternative (0)

              Monitor Closely (15)

              • amifostine

                amifostine, brimonidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

              • candesartan

                brimonidine increases effects of candesartan by pharmacodynamic synergism. Use Caution/Monitor.

              • digoxin

                brimonidine increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor.

              • eprosartan

                brimonidine increases effects of eprosartan by pharmacodynamic synergism. Use Caution/Monitor.

              • esketamine intranasal

                esketamine intranasal, brimonidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

              • irbesartan

                brimonidine increases effects of irbesartan by pharmacodynamic synergism. Use Caution/Monitor.

              • lasmiditan

                lasmiditan, brimonidine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

              • losartan

                brimonidine increases effects of losartan by pharmacodynamic synergism. Use Caution/Monitor.

              • lurasidone

                lurasidone, brimonidine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased sedation.

              • nitroglycerin rectal

                nitroglycerin rectal, brimonidine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .

              • olmesartan

                brimonidine increases effects of olmesartan by pharmacodynamic synergism. Use Caution/Monitor.

              • sacubitril/valsartan

                brimonidine increases effects of sacubitril/valsartan by pharmacodynamic synergism. Use Caution/Monitor.

              • stiripentol

                stiripentol, brimonidine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

              • telmisartan

                brimonidine increases effects of telmisartan by pharmacodynamic synergism. Use Caution/Monitor.

              • valsartan

                brimonidine increases effects of valsartan by pharmacodynamic synergism. Use Caution/Monitor.

              Minor (177)

              • acebutolol

                brimonidine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • alfentanil

                brimonidine increases effects of alfentanil by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • alfuzosin

                brimonidine increases effects of alfuzosin by pharmacodynamic synergism. Minor/Significance Unknown.

              • alprazolam

                brimonidine increases effects of alprazolam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • amiloride

                brimonidine increases effects of amiloride by pharmacodynamic synergism. Minor/Significance Unknown.

              • amitriptyline

                amitriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • amlodipine

                brimonidine increases effects of amlodipine by pharmacodynamic synergism. Minor/Significance Unknown.

              • amobarbital

                brimonidine increases effects of amobarbital by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • amoxapine

                amoxapine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • aripiprazole

                brimonidine increases effects of aripiprazole by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • asenapine

                brimonidine increases effects of asenapine by pharmacodynamic synergism. Minor/Significance Unknown.

              • atenolol

                brimonidine increases effects of atenolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • azelastine

                brimonidine increases effects of azelastine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • belladonna and opium

                brimonidine increases effects of belladonna and opium by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • benazepril

                brimonidine increases effects of benazepril by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

              • bendroflumethiazide

                brimonidine increases effects of bendroflumethiazide by pharmacodynamic synergism. Minor/Significance Unknown.

              • benperidol

                brimonidine increases effects of benperidol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • betaxolol

                brimonidine increases effects of betaxolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • bisoprolol

                brimonidine increases effects of bisoprolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • bosentan

                brimonidine increases effects of bosentan by pharmacodynamic synergism. Minor/Significance Unknown.

              • brompheniramine

                brimonidine increases effects of brompheniramine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • bumetanide

                brimonidine increases effects of bumetanide by pharmacodynamic synergism. Minor/Significance Unknown.

              • buprenorphine

                brimonidine increases effects of buprenorphine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • buprenorphine buccal

                brimonidine increases effects of buprenorphine buccal by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • butabarbital

                brimonidine increases effects of butabarbital by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • butalbital

                brimonidine increases effects of butalbital by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • butorphanol

                brimonidine increases effects of butorphanol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • captopril

                brimonidine increases effects of captopril by pharmacodynamic synergism. Minor/Significance Unknown. Both drugs lower blood pressure. Monitor blood pressure.

              • carbinoxamine

                brimonidine increases effects of carbinoxamine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • carvedilol

                brimonidine increases effects of carvedilol by pharmacodynamic synergism. Minor/Significance Unknown.

              • celiprolol

                brimonidine increases effects of celiprolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • chloral hydrate

                brimonidine increases effects of chloral hydrate by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • chlordiazepoxide

                brimonidine increases effects of chlordiazepoxide by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • chlorothiazide

                brimonidine increases effects of chlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.

              • chlorpheniramine

                brimonidine increases effects of chlorpheniramine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • chlorpromazine

                brimonidine increases effects of chlorpromazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • chlorthalidone

                brimonidine increases effects of chlorthalidone by pharmacodynamic synergism. Minor/Significance Unknown.

              • cinnarizine

                brimonidine increases effects of cinnarizine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • clemastine

                brimonidine increases effects of clemastine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • clevidipine

                brimonidine increases effects of clevidipine by pharmacodynamic synergism. Minor/Significance Unknown.

              • clomipramine

                clomipramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • clonazepam

                brimonidine increases effects of clonazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • clonidine

                brimonidine increases effects of clonidine by pharmacodynamic synergism. Minor/Significance Unknown.

              • clorazepate

                brimonidine increases effects of clorazepate by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • clozapine

                brimonidine increases effects of clozapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • codeine

                brimonidine increases effects of codeine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • cyclizine

                brimonidine increases effects of cyclizine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • cyclopenthiazide

                brimonidine increases effects of cyclopenthiazide by pharmacodynamic synergism. Minor/Significance Unknown.

              • cyproheptadine

                brimonidine increases effects of cyproheptadine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • desipramine

                desipramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • dexchlorpheniramine

                brimonidine increases effects of dexchlorpheniramine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • dexmedetomidine

                brimonidine increases effects of dexmedetomidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • dextromoramide

                brimonidine increases effects of dextromoramide by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • diamorphine

                brimonidine increases effects of diamorphine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • diazepam

                brimonidine increases effects of diazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • difenoxin hcl

                brimonidine increases effects of difenoxin hcl by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • diltiazem

                brimonidine increases effects of diltiazem by pharmacodynamic synergism. Minor/Significance Unknown.

              • dimenhydrinate

                brimonidine increases effects of dimenhydrinate by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • diphenhydramine

                brimonidine increases effects of diphenhydramine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • diphenoxylate hcl

                brimonidine increases effects of diphenoxylate hcl by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • dipipanone

                brimonidine increases effects of dipipanone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • doxazosin

                brimonidine increases effects of doxazosin by pharmacodynamic synergism. Minor/Significance Unknown.

              • doxepin

                doxepin decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • doxylamine

                brimonidine increases effects of doxylamine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • droperidol

                brimonidine increases effects of droperidol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • drospirenone

                brimonidine increases effects of drospirenone by pharmacodynamic synergism. Minor/Significance Unknown.

              • enalapril

                brimonidine increases effects of enalapril by pharmacodynamic synergism. Minor/Significance Unknown.

              • eplerenone

                brimonidine increases effects of eplerenone by pharmacodynamic synergism. Minor/Significance Unknown.

              • epoprostenol

                brimonidine increases effects of epoprostenol by pharmacodynamic synergism. Minor/Significance Unknown.

              • esmolol

                brimonidine increases effects of esmolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • estazolam

                brimonidine increases effects of estazolam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • ethacrynic acid

                brimonidine increases effects of ethacrynic acid by pharmacodynamic synergism. Minor/Significance Unknown.

              • ethanol

                brimonidine increases effects of ethanol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • etomidate

                brimonidine increases effects of etomidate by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • felodipine

                brimonidine increases effects of felodipine by pharmacodynamic synergism. Minor/Significance Unknown.

              • fenoldopam

                brimonidine increases effects of fenoldopam by pharmacodynamic synergism. Minor/Significance Unknown.

              • fluphenazine

                brimonidine increases effects of fluphenazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • flurazepam

                brimonidine increases effects of flurazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • fosinopril

                brimonidine increases effects of fosinopril by pharmacodynamic synergism. Minor/Significance Unknown.

              • furosemide

                brimonidine increases effects of furosemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • guanfacine

                brimonidine increases effects of guanfacine by pharmacodynamic synergism. Minor/Significance Unknown.

              • haloperidol

                brimonidine increases effects of haloperidol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • hydralazine

                brimonidine increases effects of hydralazine by pharmacodynamic synergism. Minor/Significance Unknown.

              • hydrochlorothiazide

                brimonidine increases effects of hydrochlorothiazide by pharmacodynamic synergism. Minor/Significance Unknown.

              • hydromorphone

                brimonidine increases effects of hydromorphone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • hydroxyzine

                brimonidine increases effects of hydroxyzine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • iloperidone

                brimonidine increases effects of iloperidone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • iloprost

                brimonidine increases effects of iloprost by pharmacodynamic synergism. Minor/Significance Unknown.

              • imidapril

                brimonidine increases effects of imidapril by pharmacodynamic synergism. Minor/Significance Unknown.

              • imipramine

                imipramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • indapamide

                brimonidine increases effects of indapamide by pharmacodynamic synergism. Minor/Significance Unknown.

              • isradipine

                brimonidine increases effects of isradipine by pharmacodynamic synergism. Minor/Significance Unknown.

              • ketanserin

                brimonidine increases effects of ketanserin by pharmacodynamic synergism. Minor/Significance Unknown.

              • labetalol

                brimonidine increases effects of labetalol by pharmacodynamic synergism. Minor/Significance Unknown.

              • levorphanol

                brimonidine increases effects of levorphanol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • lisinopril

                brimonidine increases effects of lisinopril by pharmacodynamic synergism. Minor/Significance Unknown.

              • lofepramine

                lofepramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • loprazolam

                brimonidine increases effects of loprazolam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • lorazepam

                brimonidine increases effects of lorazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • lormetazepam

                brimonidine increases effects of lormetazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • loxapine

                brimonidine increases effects of loxapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • loxapine inhaled

                brimonidine increases effects of loxapine inhaled by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • maprotiline

                maprotiline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • mecamylamine

                brimonidine increases effects of mecamylamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • meperidine

                brimonidine increases effects of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • meprobamate

                brimonidine increases effects of meprobamate by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • methadone

                brimonidine increases effects of methadone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • methyclothiazide

                brimonidine increases effects of methyclothiazide by pharmacodynamic synergism. Minor/Significance Unknown.

              • metolazone

                brimonidine increases effects of metolazone by pharmacodynamic synergism. Minor/Significance Unknown.

              • metoprolol

                brimonidine increases effects of metoprolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • metyrosine

                brimonidine increases effects of metyrosine by pharmacodynamic synergism. Minor/Significance Unknown.

              • midazolam

                brimonidine increases effects of midazolam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • minoxidil

                brimonidine increases effects of minoxidil by pharmacodynamic synergism. Minor/Significance Unknown.

              • moexipril

                brimonidine increases effects of moexipril by pharmacodynamic synergism. Minor/Significance Unknown.

              • morphine

                brimonidine increases effects of morphine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • moxisylyte

                brimonidine increases effects of moxisylyte by pharmacodynamic synergism. Minor/Significance Unknown.

              • moxonidine

                brimonidine increases effects of moxonidine by pharmacodynamic synergism. Minor/Significance Unknown.

              • nadolol

                brimonidine increases effects of nadolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • nalbuphine

                brimonidine increases effects of nalbuphine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • nebivolol

                brimonidine increases effects of nebivolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • nicardipine

                brimonidine increases effects of nicardipine by pharmacodynamic synergism. Minor/Significance Unknown.

              • nifedipine

                brimonidine increases effects of nifedipine by pharmacodynamic synergism. Minor/Significance Unknown.

              • nisoldipine

                brimonidine increases effects of nisoldipine by pharmacodynamic synergism. Minor/Significance Unknown.

              • nortriptyline

                nortriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • olanzapine

                brimonidine increases effects of olanzapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • opium tincture

                brimonidine increases effects of opium tincture by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • oxazepam

                brimonidine increases effects of oxazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • oxycodone

                brimonidine increases effects of oxycodone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • oxymorphone

                brimonidine increases effects of oxymorphone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • paliperidone

                brimonidine increases effects of paliperidone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • papaveretum

                brimonidine increases effects of papaveretum by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • penbutolol

                brimonidine increases effects of penbutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • pentazocine

                brimonidine increases effects of pentazocine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • pentobarbital

                brimonidine increases effects of pentobarbital by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • perindopril

                brimonidine increases effects of perindopril by pharmacodynamic synergism. Minor/Significance Unknown.

              • perphenazine

                brimonidine increases effects of perphenazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • phenobarbital

                brimonidine increases effects of phenobarbital by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • phenoxybenzamine

                brimonidine increases effects of phenoxybenzamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • phentolamine

                brimonidine increases effects of phentolamine by pharmacodynamic synergism. Minor/Significance Unknown.

              • pimozide

                brimonidine increases effects of pimozide by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • pindolol

                brimonidine increases effects of pindolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • prazosin

                brimonidine increases effects of prazosin by pharmacodynamic synergism. Minor/Significance Unknown.

              • primidone

                brimonidine increases effects of primidone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • prochlorperazine

                brimonidine increases effects of prochlorperazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • promethazine

                brimonidine increases effects of promethazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • propranolol

                brimonidine increases effects of propranolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • protriptyline

                protriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • quazepam

                brimonidine increases effects of quazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • quetiapine

                brimonidine increases effects of quetiapine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • quinapril

                brimonidine increases effects of quinapril by pharmacodynamic synergism. Minor/Significance Unknown.

              • ramipril

                brimonidine increases effects of ramipril by pharmacodynamic synergism. Minor/Significance Unknown.

              • risperidone

                brimonidine increases effects of risperidone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • secobarbital

                brimonidine increases effects of secobarbital by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • silodosin

                brimonidine increases effects of silodosin by pharmacodynamic synergism. Minor/Significance Unknown.

              • sotalol

                brimonidine increases effects of sotalol by pharmacodynamic synergism. Minor/Significance Unknown.

              • spironolactone

                brimonidine increases effects of spironolactone by pharmacodynamic synergism. Minor/Significance Unknown.

              • sufentanil

                brimonidine increases effects of sufentanil by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • tapentadol

                brimonidine increases effects of tapentadol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • temazepam

                brimonidine increases effects of temazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • terazosin

                brimonidine increases effects of terazosin by pharmacodynamic synergism. Minor/Significance Unknown.

              • thioridazine

                brimonidine increases effects of thioridazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • thiothixene

                brimonidine increases effects of thiothixene by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • timolol

                brimonidine increases effects of timolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • torsemide

                brimonidine increases effects of torsemide by pharmacodynamic synergism. Minor/Significance Unknown.

              • tramadol

                brimonidine increases effects of tramadol by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • trandolapril

                brimonidine increases effects of trandolapril by pharmacodynamic synergism. Minor/Significance Unknown.

              • trazodone

                trazodone decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • treprostinil

                brimonidine increases effects of treprostinil by pharmacodynamic synergism. Minor/Significance Unknown.

              • triamterene

                brimonidine increases effects of triamterene by pharmacodynamic synergism. Minor/Significance Unknown.

              • triazolam

                brimonidine increases effects of triazolam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • triclofos

                brimonidine increases effects of triclofos by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • trifluoperazine

                brimonidine increases effects of trifluoperazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • trimipramine

                trimipramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • triprolidine

                brimonidine increases effects of triprolidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • verapamil

                brimonidine increases effects of verapamil by pharmacodynamic synergism. Minor/Significance Unknown.

              • ziprasidone

                brimonidine increases effects of ziprasidone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • zotepine

                brimonidine increases effects of zotepine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

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              Adverse Effects

              Frequency Not Defined

              Oral dryness

              Conjunctival hyperemia

              Allergic conjunctivitis

              Eye pruritus

              Rash

              Photophobia

              Headache

              Fatigue

              Dizziness

              Dyspepsia

              Blepharitis

              Eye discharge

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              Warnings

              Contraindications

              Hypersensitivity to product or components

              Children <2 years (0.1-0.15% ophthalmic solution)

              Cautions

              Remove contact lenses before instilling eye drops; wait 15 min before reinserting contact lenses

              If >1 ophthalmic product is being administered, wait 5 minutes between instilling eye drops

              May potentiate syndromes associated with vascular insufficiency; caution with depression, cerebral or coronary insufficiency, Raynaud phenomenon, orthostatic hypotension, or thromboangiitis obliterans

              Although brimonidine ophthalmic had minimal effect on the blood pressure of patients in clinical studies, caution with severe cardiovascular disease

              Bacterial keratitis associated with the use of multiple-dose containers of topical ophthalmic products; instruct patients on how to avoid contamination

              Drug interaction overview

              • Because brimonidine ophthalmic may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with advised
              • Although specific drug interaction studies have not been conducted with brimonidine ophthalmic, the possibility of an additive or potentiating effect with CNS depressants (alcohol, barbiturates, opiates, sedatives, or anesthetics) should be considered
              • Tricyclic antidepressants (TCAs) have been reported to blunt the hypotensive effect of systemic clonidine; unknown whether the concurrent use TCAs with brimonidine ophthalmic can interfere with IOP lowering effect
              • MAOIs may theoretically interfere with the metabolism of brimonidine and potentially result in increased systemic effects (eg, hypotension); advise caution to patients taking MAO inhibitors
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              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: It is not known whether this drug is excreted in milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Open-Angle Glaucoma or Ocular Hypertension

              • Alpha-2 adrenergic receptor agonist; decreases aqueous humor secretion, increases uveoscleral outflow

              Ocular Redness

              • Dilutes alpha-2 receptor agonist; rapidly eliminates redness along the bulbar conjunctival microvasculature

              Pharmacokinetics

              Onset of action: 2hr (peak effect)

              Half-Life: 2 hr

              Peak plasma time: 0.5-2.5 hr

              Metabolism: Liver

              Excretion: urine (74%)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Mirvaso topical
              -
              0.33 % gel
              Mirvaso topical
              -
              0.33 % gel
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.15 % drops
              brimonidine ophthalmic (eye)
              -
              0.15 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.15 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              brimonidine ophthalmic (eye)
              -
              0.2 % drops
              Alphagan P ophthalmic (eye)
              -
              0.1 % drops
              Alphagan P ophthalmic (eye)
              -
              0.1 % drops
              Alphagan P ophthalmic (eye)
              -
              0.1 % drops
              Alphagan P ophthalmic (eye)
              -
              0.15 % drops
              Alphagan P ophthalmic (eye)
              -
              0.15 % drops
              Alphagan P ophthalmic (eye)
              -
              0.15 % drops

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

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              Patient Education
              brimonidine topical

              BRIMONIDINE GEL - TOPICAL

              (bri-MON-i-deen)

              COMMON BRAND NAME(S): Mirvaso

              USES: This medication is used to treat a certain skin disorder called rosacea. It works by narrowing blood vessels to reduce redness. Brimonidine belongs to a class of drugs known as alpha agonists.

              HOW TO USE: Read the Patient Information Leaflet and Instructions for Use if available from your pharmacist before you start using this drug and each time you get a refill. If you have any questions, ask your doctor or pharmacist.This medication is for use on the skin only. Avoid getting this medication into your eyes or mouth, on your lips, on any areas of broken/irritated skin including after laser treatment, or in and around the vaginal area.Wash your hands before and after applying this medication. Clean and dry the affected area before applying the medication. Apply a pea-sized amount of the medication to the affected area(s) (such as the forehead, chin, nose, and each cheek) and gently spread a thin layer of the medication over that area as directed by your doctor, usually once daily.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.To reduce your risk of side effects, your doctor may direct you to apply a smaller amount of medication at first and gradually increase your dose. Follow your doctor's instructions carefully.Tell your doctor if your condition does not improve or if it worsens.Keep this medicine in a safe place to prevent accidental use or misuse. Children who have accidentally swallowed this medication have had serious side effects, including trouble breathing, weakness, slow heartbeat, confusion, sweating. If a child swallows this drug, get medical help right away.

              SIDE EFFECTS: Flushing and redness/burning of the skin may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: slow heartbeat, dizziness, fainting, pale/whitening skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using brimonidine, tell your doctor or pharmacist if you are allergic to it; or to apraclonidine; or if you have any other allergies. This product may contain inactive ingredients (such as phenoxyethanol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood vessel diseases (thromboangiitis obliterans), blood circulation disorders (cerebral or coronary insufficiency), heart disease, depression, Raynaud's disease, low blood pressure upon standing (orthostatic hypotension), a certain immune system disorder (Sjogren's syndrome), a certain skin/connective tissue disease (scleroderma).Avoid certain triggers that may worsen rosacea such as wind, hot beverages, spicy foods, alcohol, and extreme cold. Discuss with your doctor.Sun exposure can worsen rosacea. Limit exposure to the sun by wearing a wide-brimmed hat and using a sunscreen that is SPF 15 or greater.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Avoid the use of skin care products that can cause further irritation (such as cleaners that contain alcohol, tinctures, astringents, abrasives, and peeling agents). Consult your doctor or pharmacist for details.

              OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another condition unless your doctor directs you to do so. A different medication may be necessary in that case.

              MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.