Dosing and uses of Alphagan (brimonidine)
Adult dosage forms and strengths
ophthalmic solution
- 0.1%
- 0.15%
- 0.2%
Open-Angle Glaucoma or Ocular Hypertension
1 gtt in affected eye(s) q8hr
Optic Neuropathy (Orphan)
Treatment of anterior ischemic optic neuropathy
Orphan indication sponsor
- Allergan, Inc; 2525 Dupont Drive, P.O. Box 19534; Irvine, CA 92713
Pediatric dosage forms and strengths
ophthalmic solution
- 0.1%
- 0.15%
- 0.2%
Open-Angle Glaucoma or Ocular Hypertension
<2 years
- Contraindicated
>2 years
- 1 gtt in affected eye(s) q8hr
Alphagan (brimonidine) adverse (side) effects
Frequency not defined
Oral dryness
Conjunctival hyperemia
Allergic conjunctivitis
Eye pruritus
Rash
Photophobia
Headache
Fatigue
Dizziness
Dyspepsia
Blepharitis
Eye discharge
Postmarketing Reports
Skin and subcutaneous disorders: Pallor
Immune system disorders: Angioedema, hypersensitivity, lip swelling, swollen tongue, throat tightness, urticaria
Cardiovascular disorders: bradycardia, hypotension (including orthostatic hypotension)
Warnings
Contraindications
Hypersensitivity to product or components
Children <2 years
Concurrent MAO inhibitors
Cautions
Wait 15 min before inserting soft contact lenses
Use caution in severe cardiovascular disease, cerebral insufficiency, depression, hepatic impairment, orthostatic hypotension, renal impairment, thromboangiitis obliterans
May cause CNS depression, which may impair mental abilities
Children are at higher risk of adverse effects
Bradycardia, hypotension (including orthostatic hypotension) and dizziness reported
Avoid applying topical gel to skin or open wounds
Some patients have experienced erythema involving areas of face that were previously not affected by erythema and in areas (e.g., neck and chest) outside of treatment sites
Some patients have experienced increased frequency of flushing and/or increased depth of erythema with flushing; some patients reported new onset of flushing
Some patients have experienced pallor or excessive whitening at or outside application site following therapy
Allergic contact dermatitis was reported for topical geL
Adverse events reported for topical gel include angioedema, throat tightening, tongue swelling, and urticarial; institute appropriate therapy and discontinue therapy, if clinically significant hypersensitivity reaction occurs
Pregnancy and lactation
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.
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Alphagan (brimonidine)
Mechanism of action
Alpha-2 adrenergic receptor agonist; decreases aqueous humor secretion, increases uveoscleral outflow
Pharmacokinetics
Onset of action: 2hr (peak effect)
Half-Life: 2 hr
Peak plasma time: 0.5-2.5 hr
Metabolism: Liver
Excretion: urine (74%)
