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

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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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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            Formulary

            FormularyPatient Discounts

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            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.