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brimonidine

S01EA05

Forms & Strengths

Ophthalmic solution: 0.1%, 0.15%, 0.2%
Topical gel (rosacea): 0.33%

Adult Dosing

Open-angle glaucoma or ocular hypertension: 1 drop in affected eye(s) TID approximately 8 hours apart (0.1%, 0.15%, or 0.2% solution)
Erythema of rosacea: Apply a pea-sized amount once daily to each of the five areas of the face (forehead, chin, nose, each cheek)

Pediatric Dosing

Children < 2 years: Contraindicated due to risk of CNS depression and severe hypotensive episodes
Pediatric glaucoma (if > 2 years): Safety and efficacy established in older children; 1 drop TID (off-label or specific specialist guidance)

Indications

Reduction of elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension
Treatment of persistent facial erythema associated with rosacea in adults

Mechanism of Action

Selective alpha-2 adrenergic agonist
Reduces intraocular pressure by decreasing aqueous humor production and increasing uveoscleral outflow
Reduces facial erythema via direct vasoconstriction of cutaneous blood vessels

Contraindications

Hypersensitivity to brimonidine tartrate or any component
Neonates and infants under 2 years of age
Concurrent use with monoamine oxidase (MAO) inhibitor therapy

Adverse Reactions

Ocular: Allergic conjunctivitis, conjunctival hyperemia, burning/stinging, pruritus, blurred vision, ocular dryness
Systemic: Dry mouth, fatigue, drowsiness, headache, dizziness, hypotension

Drug Interactions

MAO inhibitors: May theoretically affect catecholamine uptake and metabolism, potentially exacerbating conditions like depression
CNS depressants (alcohol, barbiturates, opioids, sedatives, anesthetics): Potential additive CNS depression
Antihypertensives / cardiac glycosides: May result in additive effects such as lowering blood pressure or heart rate

Curated Content: Needs Vetting Before Put to Clinical Use