Brimonidine Tartrate

Brimonidine P Eye Drops 

Brimonidine P Eye Drops 0.15% is an alpha-2 (α2) adrenergic receptor agonist that has gained FDA approval to reduce intraocular pressure (fluid pressure in the eye) in patients suffering from open-angle glaucoma or ocular hypertension (a type of eye disease). The medication works by reducing the amount of fluid in the eyes. Available as eye drops, it should be used three times daily as directed by the medical professional, in a gap of 8 hours. The medication is not advised to be used in children less than 2 years of age. It is important to consult with your healthcare provider for any guidance or concerns.

Product Overview 

Brimonidine P Eye Drops (0.15%) contain Brimonidine tartrate as their primary active ingredient. This medication is effectively used to lower high intraocular pressure in people with ocular conditions such as open-angle glaucoma or ocular hypertension. These eye drops are available in a 0.15% strength, ensuring an accurate dosage crucial for managing eye conditions related to high intraocular pressure. It is recommended to take one drop into the affected eye three times daily, approximately eight hours apart. 

Suitable for adults, this medication is designed for those diagnosed with glaucoma or ocular hypertension and functions by decreasing fluid production in the eye and improving fluid drainage. These eye drops are usually well-tolerated, but they may cause some side effects, including eye irritation, dry mouth, and occasional dizziness. Patients experiencing these or any other unusual symptoms should seek advice from their healthcare provider. In case a dose is missed, take precautions. 

However, if it’s almost time for your next medication, skip the missed dose to prevent an overdose. Always stick to the prescribed dosage. Store the eye drops in a cool, dry place, away from light and out of the reach of children. Regular check-ups with a medical professional are recommended to monitor eye health and adjust the treatment plan as needed.

Uses of Brimonidine P Eye Drops

These eye drops are prescribed for:

• Treating open-angle glaucoma or high fluid pressure in the eye.
• Reducing the chances of vision loss, nerve damage, or blindness.

How to Use?

Dosage

The solution comes in two strengths:

• Brimonidine tartrate 1 mg/mL
• Brimonidine tartrate 1.5 mg/mL

Recommended Dosage for Different Patients

For Glaucoma

• Adults & Children Above 2 Years: For this age group, only one drop of Brimonidine in the affected eye, 3 times a day. The duration should be 8 hours apart. 
• Children Younger Than 2 Years: It is not recommended.

For Redness of the Eye

• Adults & Children Above 5 Years: One drop every 6 to 8 hours in the infected eye.
• Children Below 5 Years: Consult your physician to determine the appropriate use and dosage.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your healthcare professional, and they’ll customize your dosage accordingly.]

How to Take It?

The prescribed dosage is one drop of Brimonidine P eye drops in the affected eye 3 times a day, each with a gap of 8 hours. For properly using Brimonidine P Eye Drops:

• Thoroughly wash your hands before and after using the eye drops to avoid any inflammation or infection.
• Make sure to shake the eye drops well just before each use.
• To apply the drops, tilt your head back and use your finger to gently pull down the lower eyelid, creating a small space. Carefully drop the medicine into this space. Release the eyelid and close your eyes gently, without blinking. Keep your eyes closed for a few minutes. This helps the medicine absorb properly.
• If the drops did not properly get into the eyes, repeat the process with a second drop.
• To maintain the sterility of the medicine, avoid touching the applicator tip to any surface, including the eye. Always keep the container tightly closed when not in use.
• If bacteria contaminate the bottle, it could lead to a serious eye infection, potentially causing blindness.
• The eye drops should appear as a clear liquid with a greenish-yellow color. If you notice a change in color or the liquid turns cloudy, stop using it and get a new bottle from the pharmacy.

[Note: Your healthcare provider will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Brimonidine P Eye Drop Work?

Brimonidine Tartrate works by targeting specific receptors like alpha-2 adrenergic in the eyes. When this eye drop is used in the affected eye, it connects to these receptors, thus reducing the fluid amount (aqueous humor) produced in the eye. Additionally, the medication affects the blood vessels in the eye, causing them to narrow down. This process helps in managing the pressure inside the eye. 

With long-term use, Brimonidine also increases the drainage of fluid from the eye through a pathway called the uveoscleral outflow. This dual action of reducing fluid production and increasing fluid outflow effectively lowers intraocular pressure (IOP) in the eye. As a result, these eye drops help prevent damage to the optic nerve, which is important for maintaining clear vision and preventing the progression of glaucoma. 

Important Safety Information

Side Effects

Common side effects of Brimonidine may include:

• Itching or irritated eyes
• Blurred vision
• Excessive tearing
• Headache
• Tiredness
• Halos around lights
• Redness on the inner lining of the eyelid
• Eyelid swelling

Mild side effects of Brimonidine may include:

• Vision changing
• Loss of eyesight
• Bloody eye
• Severe eye pain
• Change in color vision
• Difficulty in breathing
• Dizziness when getting up suddenly
• Increased heartbeats
• Vomiting
• Watery eyes

[Note: Remember, the above list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

• Vascular Insufficiency: Sold under the brand name of Alphagan P Brimonidine may increase the risk of conditions that are linked to poor blood flow. It should be used cautiously in patients with brain problems, Raynaud’s phenomenon, and orthostatic hypotension.
• Risk with Severe Heart Conditions: Although Brimonidine tartrate eye drops generally have a minimal impact on blood pressure, care should be taken when using it by patients with serious heart diseases.
• Risk of Contamination in Eye Drops: Reports indicate a risk of bacterial keratitis from the use of multi-dose eye drop containers. Contamination typically occurs when used by patients with existing corneal diseases or damage to the eye’s surface layer.
• Ophthalmologic: If a person wears contact lenses, ensure to remove them before using your medication. Moreover, wait for 15 min before wearing contact lenses again.
• Multiple Eye Drops Users: When using more than one type of ophthalmic product, allow a 5-minute interval between each application.

Precautions

• If symptoms like itching, redness, swelling, or other irritations occur in your eyes, connect with your doctor immediately.
• If you or your child has an eye injury, develops an infection, or needs eye surgery, discuss it with a medical expert immediately. In such cases, discontinuation and modification of medication are required.
• Brimonidine P eye drops may cause some people to feel lightheaded, dizzy, drowsy, or fatigued. Avoid engaging in any potentially dangerous activities until you know how the medication affects you.
• These eye drops can increase the effects of alcohol and other CNS or central nervous system depressants, which include antihistamines, sedatives, pain relievers, seizure medications, muscle relaxants, and certain anesthetics. Consult your healthcare provider before using such antidepressants in combination with your eye drops.
• Brimonidine may increase your sensitivity to light. Wearing sunglasses and minimizing exposure to bright light may reduce discomfort.
• Pregnant ladies or those who are planning should not use these eye drops. Additionally, if you become pregnant while using these eye drops, stop using them and do not breastfeed.
• If you are using additional topical eye medications, apply them either 5 minutes before or 5 minutes after using Brimonidine eye drops.

Contraindications

• Neonates and Infants: Brimonidine P is not recommended for use in newborns and infants under the age of 2 years.
• Hypersensitivity Reactions: It is not suitable for people who have previously shown an allergic reaction to any component of the medication.
• Patients on Monoamine Oxidase Inhibitors: Those undergoing treatment with MAO inhibitors are contraindicated from using Brimonidine P eye drops.

Missed Dose

• If you forget the application of Brimonidine P eye drops, instill the missed dose when you remember. 
• If it is time for your next dose, you can continue your usual dosing schedule. 
• Remember to not take double doses just to make up for the previous one. 

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult an expert or pharmacist.]

Overdose

There is limited information about accidental ingestion of Brimonidine in adults. The only side effect reported to date was hypotension. There are even treatments for an oral overdose, which include- supportive and symptomatic therapy. These treatments involve the evacuation of the stomach during the first few hours of overdosage. Moreover, there are certain cases of overdoses that have been reported in infants and children using Brimonidine P eye drops. These symptoms include apnea, bradycardia, coma, lethargy, pallor, respiratory depression, and somnolence. 

[Note: If you consumed more than the recommended dose, get medical help right away or contact the Poison Help line at 1-800-222-1222.]

Storage

• Keep the medication in the container it came in and store it at a temperature between 15-25 °C in a dry place. Make sure that the container is out of reach of children and away from heat or moisture.
• Avoid disposing of the medicine by flushing it down in the toilet. 
• Always place safety lock caps to protect your children from poisoning. Ensure that the medication is in a safe location. 
• Check the packaging of your specific brand for storage instructions.
• You can also ask a medical expert for recommendations on how to store the medication.
• Discard the dropper when it is past its expiration date or is no longer required.

[Note: Discuss with your medical professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Brimonidine P Interactions

Like every other medication, Brimonidine P can have several interactions when combined with other drugs. Let’s take a look at these adverse interactions:

• Cardiac Glycosides: Since this drug is used to lower blood pressure, combining it with antihypertensives or cardiac glycosides should be done with caution.
• CNS Depressants: While specific interaction studies with Brimonidine P and CNS depressants (such as alcohol, barbiturates, opiates, sedatives, or anesthetics) have not been conducted, the risk for an additive effect in patients should be considered.
• Tricyclic Antidepressants: Tricyclic antidepressants are known to reduce the blood pressure-lowering effect of systemic clonidine. It is not known if the simultaneous use of these antidepressants with Brimonidine P affects its ability to lower intraocular pressure (IOP). Therefore, caution is recommended for patients using tricyclic antidepressants.
• Monoamine Oxidase Inhibitors: MAO inhibitors could theoretically impact the metabolism of Brimonidine, causing increased systemic effects, such as low blood pressure. Caution is advised for patients on MAO inhibitors due to these potential interactions.

[Note: This isn’t a complete list, and there could be other medications that interact with Brimonidine P. Ensure to tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

Brimonidine P Alternatives of Glaucoma

• Brimonidine ophthalmic
• Latanoprost ophthalmic
• Lumigan (bimatoprost)
• Timolol ophthalmic
• Xalatan

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

What is the response time of Brimonidine P?

Alphagan P (Brimonidine) usually reduces eye pressure within 2 to 3 days as soon as you apply it. It works best when the medication is instilled 3 times a day. However, it is important to note that you are not taking an overdose of eye drops for effective results. Use it as prescribed by the healthcare provider.  

Why are Brimonidine P eye drops not recommended for children?

Due to their capacity to pass through the blood-brain barrier, causing central nervous system toxicity, these eye drops are not prescribed to children. As per the clinical reports of the National Library of Medicine, the medication may have severe side effects in infants, including bradycardia (slowed heart rate), hypotension (low blood pressure), and apnea (temporary cessation of breathing). Given these risks, the use of Brimonidine in pediatric patients is generally avoided, as its safety and effectiveness in young children have not been studied yet.

What is the best time to take Brimonidine P in adults?

While it is advised to take your eye drops at the same times each day, it is necessary to consult with your eye care professional. However, it is commonly recommended to use the drops 3 times a day, about 8 hours apart, such as in the morning, evening, and at night. This scheduled regimen helps you maintain consistent levels of the medication in the eye, thus effectively managing intraocular pressure throughout the day and night. 

Is Brimonidine P and beta blockers the same thing?

No, they are not the same. Brimonidine is an alpha-2 (α2) adrenergic receptor agonist that works by lowering the fluid production in the eye and increasing fluid outflow. Whereas beta blockers block lowers blood pressure, thus helping in reduced risk of heart risks. However, a combination of both drugs, Brimonidine and a beta-blocker (timolol), is used to manage elevated IOP in patients with glaucoma.

Does Brimonidine P cause eyelash growth? 

Brimonidine does not make eyelashes grow. However, a different glaucoma medication called Bimatoprost, also known as Lumigan, is known to cause eyelash growth as a side effect. Lumigan is also marketed under the name Latisse, which is used specifically to improve the thickness, length, and darkness of eyelashes.

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