Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Frequency Not Defined
Oral dryness
Conjunctival hyperemia
Allergic conjunctivitis
Eye pruritus
Rash
Photophobia
Headache
Fatigue
Dizziness
Dyspepsia
Blepharitis
Eye discharge
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
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.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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Formulary
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