Brimonidine (Ophthalmic)

Mechanism :

It acts on the alpha adrenergic receptors present in the eye. By activating G protein coupled receptors and cAMP, it decreases the production of aqueous humour by the ciliary body. Additionally, it increases the uveoscleral outflow of aqueous humour, thus achieving a reduction in IOP.

Indication :

Open angle glaucoma due to raised IOP
Redness in the eye

Contraindications :

• Hypersensitivity

• Patients younger than 2 years

• Caution in case of severe cardiovascular associated with severe vascular insufficiency disorder/cerebrovascular disease, orthostatic hypotension, Raynaud phenomenon, thromboangitis obliterans, depression

• Minimal data available regarding safety in pregnant and lactating women. Based on data available, may use the drug as no risk to fetus/production of milk is known. Decision regarding use should be made based on importance of the drug to the mother

Dosing :

Ophthalmic solution:

0.1% (Alphagan P) .

0.15% (Alphagan P, Qoliana, generic).

0.025% (Lumify) .

For raised IOP/open angle glaucoma:

<2 years: contraindicated.

≥2 years: 0.15% solution 1 drop in the eye(s) that is affected to be repeated every 8 hours.

For redness in the eye:

<5 years: safety and efficacy is not established.

≥5 years: 0.025% solution 1 drop in the eye(s) that is affected to be repeated every 6-8 hours.

Lumify: Relives ocular redness caused by minnor eye irritatations.

Adverse Effect :

Dry eyes, conjuctival hyperemia, itching in the eye, photophobia, allergic conjunctivitis, discharge from the eyes, inflammation of the eyelids, rash, headache, tiredness, dizziness, indigestion

Interaction :

• Contraindicated: isocarboxazid, linezolid, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine

• Requiring close monitoring: amifostine, digoxin, angiotensin II receptor blockers, intranasal esketamine, lurasidone, rectal nitroglycerin, stiripentol

• Minor: