How does brimonidine work

Clinical efficacy of brimonidine in reducing IOP In its 1-year pivotal trials for drug approval, twice-daily brimonidine 0. Clinical comparison of brimonidine-Purite 0. Open in a separate window. Figure 1. Figure 2. Abbreviations: IOP, intraocular pressure. Safety and tolerability Brimonidine has a favorable safety and tolerability profile. Patient acceptance and compliance with brimonidine treatment Brimonidine treatment is usually well received by patients.

Clinical trials of neuroprotection with brimonidine An initial trial evaluating potential neuroprotection by brimonidine in patients with acute angle-closure glaucoma found no difference between the number of patients who progressed during treatment with brimonidine or timolol Aung et al Fixed combination of brimonidine and timolol A fixed combination of brimonidine 0.

Place of brimonidine in therapy for glaucoma and OHT Brimonidine can be used as monotherapy in glaucoma and OHT, but it is more commonly used as adjunctive therapy. Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures.

Am J Ophthalmol. The relationship between control of intraocular pressure and visual field deterioration.

Distribution of brimonidine into anterior and posterior tissues of monkey, rabbit, and rat eyes. Drug Metab Dispos. Comparative ocular pharmacokinetics of brimonidine after a single dose application to the eyes of albino and pigmented rabbits. Randomised controlled trial comparing the effect of brimonidine and timolol on visual field loss after acute primary angle closure.

Br J Ophthalmol. Ophthalmic drops causing coma in an infant. J Pediatr. The evolving pharmacotherapeutic profile of brimonidine, an alpha 2-adrenergic agonist, after four years of continuous use. Expert Opin Pharmacother. A comparison of dorzolamide-timolol combination versus the concomitant drugs. Brimonidine and timolol fixed-combination therapy versus monotherapy: a 3-month randomized trial in patients with glaucoma or ocular hypertension.

J Ocul Pharmacol Ther. Ocular surface changes induced by topical antiglaucoma monotherapy. Brimonidine Alphagan : a clinical profile four years after launch. Eur J Ophthalmol. J Pharmacol Exp Ther. Effects of the preservative purite on the bioavailability of brimonidine in the aqueous humor of rabbits. Glaucoma: a look beyond intraocular pressure. Fixed combinations of topical glaucoma medications. Curr Opin Ophthalmol.

Topical brimonidine reduces collateral damage caused by laser photocoagulation for choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol. Salt water or high tech? A look at two new rinsing solutions for contact lenses. A pooled-data analysis of three randomized, double-masked, six-month clinical studies comparing the intraocular pressure reducing effect of latanoprost and timolol.

Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. One-year, randomized study comparing bimatoprost and timolol in glaucoma and ocular hypertension.

The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma.

Brimonidine tartrate 0. J Glaucoma. Vitreous concentration of topically applied brimonidine tartrate 0.

Prevalence of glaucoma. The Beaver Dam Eye Study. Twelve-month results of an ongoing randomized trial comparing brimonidine tartrate 0. The effectiveness and safety of brimonidine as mono-, combination, or replacement therapy for patients with primary open-angle glaucoma or ocular hypertension: a post hoc analysis of an open-label community trial. Effectiveness and safety of brimonidine as adjunctive therapy for patients with elevated intraocular pressure in a large, open-label community trial.

Glaucoma and its treatment: a review. Am J Health Syst Pharm. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery. Ischemia results 3 months later in altered ERG, degeneration of inner layers, and deafferented tectum: neuroprotection with brimonidine.

Invest Ophthalmol Vis Sci. Ongoing clinical assessment of the safety profile and efficacy of brimonidine compared with timolol: year-three results. Brimonidine Study Group II. Clin Ther. Elevated intraocular pressure and optic nerve injury models in the rat. Travoprost compared with latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension. Brimonidine Purite and bimatoprost compared with timolol and latanoprost in patients with glaucoma and ocular hypertension.

Adv Ther. Effects of common ophthalmic preservatives on ocular health. Corneal and conjunctival changes caused by commonly used glaucoma medications. Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension. An evidence-based review. Optic nerve and neuroprotection strategies. A day old with episodic lethargy, hypotonia, and apnea: the eyes have it. Curr Opin Pediatr.

Primate glaucoma models. Effects of systemic beta-blocker therapy on the efficacy and safety of topical brimonidine and timolol. A 1-year study of brimonidine twice daily in glaucoma and ocular hypertension. A controlled, randomized, multicenter clinical trial.

Brimonidine purite 0. Efficacy of brimonidine 0. Three-month comparison of brimonidine and latanoprost as adjunctive therapy in glaucoma and ocular hypertension patients uncontrolled on beta-blockers: tolerance and peak intraocular pressure lowering.

Surv Ophthalmol. Patient-reported behavior and problems in using glaucoma medications. Brimonidine 0. Causes of non-compliance with drug regimens in glaucoma patients: a qualitative study.

Acute versus chronic effects of brimonidine on aqueous humor dynamics in ocular hypertensive patients. Effects of brimonidine on aqueous humor dynamics in human eyes. Comparison of the effects of brimonidine 0. Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies. Is neuroprotection a viable therapy for glaucoma? Efficacy and tolerability of 0. A study of the causes of non-compliance by patients prescribed eyedrops.

Neuroprotection of retinal ganglion cells by brimonidine in rats with laser-induced chronic ocular hypertension. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals.

For non-prescription products, read the label or package ingredients carefully. Because of brimonidine's toxicity, use in children younger than 2 years of age is not recommended. Safety and efficacy have not been established.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of brimonidine eye drops in the elderly. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below.

The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:. Use this medicine only as directed by your doctor.

Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. If your doctor ordered two different eye drops to be used together, wait at least 5 minutes after you put the first medicine in your eye to use the second medicine. You should not use the eye drops if you have contact lenses in your eyes. Remove your contact lenses before you use this medicine. It is usually instilled in the affected eye s three times a day.

Use brimonidine eye drops at around the same times every day, and try to space your 3 daily doses about 8 hours apart. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use brimonidine eye drops exactly as directed. Do not use more or less of them or use them more often than prescribed by your doctor.

Brimonidine eye drops may control your condition, but will not cure it. Continue to use brimonidine eye drops even if you feel well. Do not stop using brimonidine eye drops without talking to your doctor. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Instill the missed dose as soon as you remember it.

However, if is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not instill a double dose to make up for a missed one. Keep this medication in the container it came in, tightly closed, and out of reach of children.

Store it at room temperature and away from excess heat and moisture not in the bathroom. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.

However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.

To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.