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Brimonidine

    DEA Class; Rx, OTC

    Common Brand Names; Alphagan P, Qoliana, Lumify, Mirvaso

    • Antiglaucoma, Alpha Agonists
    • Acne Agents, Topical; 
    • Alpha Agonists, Topical

    Selective alpha-2 adrenergic agonist
    Used ophthalmically to reduce intraocular pressure in open-angle glaucoma and ocular hypertension and to relieve ocular redness due to irritation and topically to reduce persistent facial erythema of rosacea
    Minimal cardiopulmonary effects

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

    Indicated to relieve ocular redness caused by minor eye irritations

    Treatment of anterior ischemic optic neuropathy

    Indicated for persistent facial erythema of rosacea

    Hypersensitivity to product or components

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

    • Oral dryness
    • Conjunctival hyperemia
    • Allergic conjunctivitis
    • Eye pruritus
    • Rash
    • Photophobia
    • Headache
    • Fatigue
    • Dizziness
    • Dyspepsia
    • Blepharitis
    • Eye discharge

    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

    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.

    Adults

    Do not apply to more than 100 cm2 in total area.

    Geriatric

    Do not apply to more than 100 cm2 in total area.

    Adolescents

    Do not apply to more than 2% total body surface area.

    Children

    Do not apply to more than 2% total body surface area.

    Infants

    9 to 11 months: Do not apply to more than 2% total body surface area.
    1 to 9 months: Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Brimonidine tartrate

    ophthalmic solution (Rx)

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

    ophthalmic solution (OTC)

    • 0.025% (Lumify)

    topical gel

    • 0.33%