Top 300 Pharmacy Drug Cards

BRIMONIDINE: Alphagan P, Various

Class: Adrenergic Agonist; Antiglaucoma Agent

Dosage Forms. Ophthalmic Solution: 0.1%, 0.15%, 0.2%

Common FDA Label Indication, Dosing, and Titration.

1. Ocular hypertension: 1 drop in affected eye(s) q8h, strength chosen based on therapeutic effect

2. Open-angle glaucoma: 1 drop in affected eye(s) q8h, strength chosen based on therapeutic effect

Off-Label Uses.

1. Capsulotomy of posterior lens capsule: 1 drop of 0.2% solution in operative eye 1 h prior to surgery, then 1 drop in operative eye immediately following procedure

MOA. Brimonidine, a relatively selective α-adrenergic agonist, reduces aqueous humor production and increases uveoscleral outflow. It is used to lower intraocular pressure in open-angle glaucoma or ocular hypertension.

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Drug Characteristics: Brimonidine

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Medication Safety Issues: Brimonidine

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Drug Interactions: Brimonidine

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Adverse Reactions: Brimonidine

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Efficacy Monitoring Parameters. Reduction in intraocular pressure.

Toxicity Monitoring Parameters. Seek medical attention if syncope occurs, or if symptoms of ocular irritation are severe.

Key Patient Counseling Points. Wash your hands and remove contact lenses before using the medicine. For administration, lie down or tilt head back. With index finger, pull down the lower lid of eye to form a pocket. Hold the dropper close to eye with the other hand. Drop the correct number of drops into the pocket made between lower lid and eyeball. Gently close eyes. Place index finger over the inner corner of your eye for 1 min. Do not rinse or wipe the dropper or allow it to touch anything, including eye. Put the cap on bottle right away.

Clinical Pearls. This agent has no specific advantage over other similar products for the reduction in intraocular pressure in chronic ocular hypertension or in the treatment of glaucoma.