Brinzolamide / Brimonidine tartrate

Simbrinza

Simbrinza, composed of brinzolamide and brimonidine tartrate, is an FDA-approved medication for managing increased eye pressure associated with conditions like ocular hypertension and open-angle glaucoma. Suitable for adults and children over 2 years, it comes in a dropper bottle as a liquid solution. The standard dosage is one drop into the affected eye(s) three times daily. Simbrinza reduces eye pressure by decreasing fluid production and increasing fluid drainage in the eye. Key side effects include dry mouth and eye irritation, with severe reactions being rare. Usage precautions involve avoiding contact with the dropper tip to prevent infections and discussing other medications with healthcare providers to avoid adverse interactions.

Product Overview

Simbrinza, containing 1% brinzolamide and 0.2% brimonidine tartrate, is an ophthalmic solution designed to treat increased eye pressure in individuals diagnosed with ocular hypertension or open-angle glaucoma, the most prevalent form of glaucoma. This medication is approved for use in adults and children aged two years and older. Packaged in a dropper bottle, the recommended administration involves one drop in the affected eye(s) thrice daily.

The active ingredients in Simbrinza, brinzolamide and brimonidine tartrate, function by reducing intraocular pressure through different mechanisms. Brinzolamide, a carbonic anhydrase inhibitor, decreases fluid production inside the eye. In contrast, brimonidine tartrate, an alpha-2 adrenergic receptor agonist, reduces fluid production and enhances fluid drainage from the eye. Patients using Simbrinza should ensure that the dropper tip does not contact the eye or other surfaces to avoid contamination and potential infections. If using other eye medications, a gap of at least five minutes should be maintained between different products. 

The solution should be shaken well before use, and contact lens wearers should remove their lenses before application and wait 15 minutes before reinsertion. Common side effects include dry mouth, eye allergy, blurry vision, and eye irritation, with serious adverse effects like decreased blood pressure and severe allergic reactions being less frequent. Individuals with specific health conditions such as severe kidney disease, heart disease, liver issues, or a history of allergic reactions to similar medications may need alternative treatments.

Discussing all health conditions and current medications with a healthcare provider to tailor the treatment plan and monitor for potential drug interactions and side effects is crucial. Continuous medical oversight is advised to adjust dosages and ensure the medication’s efficacy and safety.

What Are the Uses of Simbrinza?

This medication is approved to treat elevated eye pressure in individuals with the following conditions:

• Ocular Hypertension
• Open-Angle Glaucoma

Simbrinza is suitable for use in adults and children aged 2 years and older.

What Are the Forms & Strengths of Simbrinza?

The forms and strengths of Simbrinza are as follows:

• Form: Simbrinza is a liquid solution in a dropper bottle. The bottle has a tip designed for placing drops into your eye.
• Strength: Simbrinza is available in a single strength: 1% brinzolamide and 0.2% brimonidine tartrate.

What Are the Recommended Dosage of Simbrinza?

Dosage for Increased Eye Pressure

Here’s how to use Simbrinza to treat increased eye pressure caused by ocular hypertension or open-angle glaucoma properly:

• Recommended Dosage:
  • Apply one drop into the affected eye (or eyes) three times a day.
• Application Instructions:
  • Avoid touching the tip of the Simbrinza bottle to your eye or any surface to prevent the risk of serious eye infections.
• Using Other Eye Drops:
  • If you need to use other eye drops, consult your doctor to ensure they are safe to use with Simbrinza.
  • If approved, wait at least 5 minutes between applying different eye drops.

Pediatric Dosage

• Children Under 2 Years Old:
  • Simbrinza should not be used in children younger than 2 years old.
• Children 2 Years and Older:
  • For children aged 2 years and older, the recommended dosage is the same as for adults: one drop into the affected eye (or eyes) three times a day.

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

How to Use Simbrinza? 

To ensure effective and safe use of Simbrinza, follow your doctor’s or healthcare provider’s instructions carefully. Here are the key steps:

1. Preparation:
   • Shake the Simbrinza bottle well before each use.
   • Remove contact lenses before applying the drops.
2. Application:
   • Simbrinza comes in a liquid solution with a dropper bottle. Use the tip to place the drops into your eye.
   • Be careful not to touch the tip of the bottle to your eye or any other surface to avoid contamination and infection.
3. After Use:
   • Immediately place the cap back on the bottle after using the drops.
   • If you wear contact lenses, wait at least 15 minutes before reinserting them.
4. Dosage:
   • Apply Simbrinza three times daily, roughly every 8 hours. To help remember, you might use it at mealtimes.
   • If you are using other eye drops, wait at least 5 minutes between applying each product.
5. Medication Reminders:
   • To avoid missing a dose, use a reminder tool such as an alarm on your phone, a reminder app, or a kitchen timer.

[Note: Your doctor 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 Simbrinza Work?

Simbrinza works to lower the pressure inside your eye by reducing the amount of fluid your eye produces and increasing the fluid drainage. It contains two active ingredients that function differently: brinzolamide and brimonidine tartrate. Brinzolamide, a carbonic anhydrase inhibitor, decreases eye pressure by reducing the production of fluid inside the eye. Brimonidine tartrate, an alpha-2 adrenergic receptor agonist, also reduces the amount of fluid the eye makes and increases fluid drainage from the eye. Combining these two mechanisms, Simbrinza effectively helps manage conditions like ocular hypertension and open-angle glaucoma.

Important Safety Information for Using Simbrinza

What Are the Side Effects of Simbrinza?

Most mild side effects of Simbrinza may resolve independently within a few days to a few weeks. However, if these side effects persist or become more severe, it is important to consult your doctor or pharmacist. Mild side effects of Simbrinza can include:

• Dry mouth
• Eye side effects, such as:
  • Eye allergy
  • Blurry vision
  • Eye irritation
• Changes in how things taste

Serious side effects from Simbrinza are uncommon, but they can occur. If you experience any of the following symptoms, contact your doctor immediately. If you believe your symptoms are life-threatening or you think you are having a medical emergency, call 911 or your local emergency number right away. Serious Simbrinza side effects may include:

• Decreased blood pressure. Symptoms can include:
  • Fainting
  • Dizziness
  • Allergic reaction
  • Nausea 
  • Blurry vision

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

Are There Any Warnings for Simbrinza? 

No specific warnings have been issued for Simbrinza. However, you must consult your doctor immediately if you experience any unusual symptoms or adverse effects while using this medication.

What Are the Simbrinza Precautions?

Before starting treatment with Simbrinza, discussing your complete health history with your doctor is important. Simbrinza may be unsuitable if you have certain medical conditions or other health factors. Key precautions include:

• Severe Kidney Disease: The effects of Simbrinza on individuals with severe kidney disease are poorly understood. One of Simbrinza’s active ingredients, brinzolamide, is processed by the kidneys. If you have significant kidney issues, it’s generally recommended not to use Simbrinza. Your doctor can suggest alternative treatments that are safer for your condition.
• Heart Disease (for example, Heart Failure): One of Simbrinza’s active ingredients, brimonidine tartrate, can lower blood pressure, potentially causing serious issues for individuals with heart disease. If you have a history of heart disease or heart failure, your doctor might suggest an alternative medication.
• Sudden Angle-Closure Glaucoma: Simbrinza may not be effective for treating sudden angle-closure glaucoma, which can lead to permanent vision damage. Symptoms of this condition include severe eye pain, sudden blurry vision, seeing rainbow-colored rings, and feeling nauseous or vomiting. If you experience these symptoms, seek immediate medical attention.
• Liver Disease (for example, Hepatitis): The safety of Simbrinza in individuals with liver conditions is not well established. If you have liver disease, such as hepatitis, your doctor may monitor you more closely for side effects during treatment with Simbrinza. Discuss any liver-related concerns with your doctor before starting the medication.
• Allergic Reactions: Do not use Simbrinza or its ingredients if you are allergic to it. Additionally, avoid Simbrinza if you have a sulfa allergy. If you are unsure about your medication allergies, consult your doctor.
• Low Number of Cells in the Cornea: If you have a reduced number of corneal cells, using Simbrinza may increase the risk of corneal swelling. The cornea is the clear covering at the front of your eye. Your doctor might monitor your eyes more frequently to check for signs of swelling while you are using Simbrinza. Discuss any concerns about corneal health with your doctor before starting treatment.
• Vascular Diseases (for example, Orthostatic Hypotension): If you have a history of vascular conditions, using Simbrinza might worsen your symptoms. One example is orthostatic hypotension, characterized by low blood pressure upon changing body positions. Be sure to inform your doctor about any vascular diseases before using Simbrinza.
• Simbrinza and Pregnancy: The safety of Simbrinza during pregnancy is not well established. It is recommended to use Simbrinza during pregnancy only if the potential benefits outweigh the risks, as the drug can cross the placenta and may affect the developing fetus. While animal studies have been conducted, their results do not always predict effects in humans. Discuss with your doctor to weigh the benefits and risks.
• Simbrinza and Breastfeeding: The safety of Simbrinza during breastfeeding is not known. It is possible that the drug could pass into breast milk and affect the nursing child. Therefore, you should either stop breastfeeding while using Simbrinza or discontinue the medication. Consult your doctor to determine the best action and safe options for feeding your child.
• Simbrinza and Birth Control: If you are sexually active and there is a possibility of pregnancy, discuss your birth control needs with your doctor while using Simbrinza to ensure you are adequately protected.

What Are the Contraindications of Simbrinza?

Simbrinza has specific contraindications that must be considered before use to ensure safety. It should not be used by:

1. People with Allergies to Simbrinza or Its Ingredients
2. Infants and Children Under 2 Years Old

What If You Missed a Dose of Simbrinza?

If you miss a dose of Simbrinza, it’s important to handle the situation correctly to maintain the effectiveness of the treatment. Here’s what you should do:

• Consider how much time has passed since the dose was missed. If it’s close to the time for your next dose, it might be better to skip the missed dose and continue with your regular dosing schedule.
• Never take a double dose to make up for a missed one unless specifically instructed by your healthcare provider.
• To prevent missing doses in the future, consider setting reminders. You can use an alarm on your phone, a reminder app, or even a simple kitchen timer. These tools can help keep you on track with your medication schedule.

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

What Happens If You Take Too Much of Simbrinza?

Taking more Simbrinza than recommended by your doctor can result in serious side effects. Overuse of this medication can potentially exacerbate its common side effects and may introduce more severe complications. If you accidentally administer too much Simbrinza, it’s important to seek medical attention promptly.

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

How to Store a Simbrinza?

• Simbrinza eye drops should be stored at a temperature of 36°F to 77°F (2°C to 25°C). This can be done at room temperature or in a refrigerator.
• Avoid storing Simbrinza in areas where it could get damp or wet, such as bathrooms.
• If you no longer need to use Simbrinza and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

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

What Medications Interact with Simbrinza?

Simbrinza can interact with various medications, potentially affecting how well it works or increasing the risk of side effects. While it is not known to interact with supplements or foods, interactions with other medications can vary in their impact.

Interaction of Simbrinza with Other Medications

Here are the drugs that can interact with Simbrinza mentioned below:

• Simbrinza and Salicylates: When taking Simbrinza in conjunction with salicylate medications, there is a potential risk of experiencing changes in your blood chemistry, such as abnormal electrolyte levels and altered acid levels. Salicylates are found in various common medications, including:
  • Doan’s (magnesium salicylate)
  • Aspirin (aspirin)
  • Pepto Bismol (bismuth subsalicylate)
• Simbrinza and Oral Carbonic Anhydrase Inhibitors: Simbrinza contains brinzolamide, part of a group of medications known as carbonic anhydrase inhibitors. It’s important not to use Simbrinza in conjunction with any carbonic anhydrase inhibitors that are administered orally. Carbonic anhydrase inhibitors are used in various forms. When applied as eye drops, such as in Simbrinza, they help lower the pressure inside your eye, which is beneficial for conditions like glaucoma. Examples of oral carbonic anhydrase inhibitors include:
  • Methazolamide – Typically prescribed for certain eye conditions like glaucoma.
  • Acetazolamide – Often used to manage mountain sickness, glaucoma, and other conditions.
  • Keveyis (dichlorphenamide) – Used for treating a type of paralysis.
• Simbrinza and Central Nervous System Depressants: When using Simbrinza alongside central nervous system (CNS) depressants, caution is advised due to the potential for exacerbated side effects. Although the exact interactions are not fully understood, it’s known that both Simbrinza and CNS depressants can slow down bodily functions such as breathing and heart rate. This combination could lead to dangerously low levels of respiratory or cardiac activity. Examples of central nervous system depressants include:
  • Opiates such as Roxicodone (oxycodone) are commonly used for pain relief.
  • Barbiturates, such as phenobarbital, are used to control seizures.
  • Sedatives such as Xanax (alprazolam) are used to manage panic disorders and anxiety.
• Simbrinza and Digoxin: Using Simbrinza with digoxin, a medication used to treat certain heart conditions, could increase the risk of a low heart rate or lower blood pressure. This is an important consideration if treated with digoxin (Lanoxin). Before starting Simbrinza, inform your doctor if you are taking digoxin. They may need to monitor your heart function more frequently to manage and mitigate potential risks during your treatment effectively.
• Simbrinza and Blood Pressure Drugs: When using Simbrinza alongside medications that lower blood pressure, it’s important to be cautious due to potential interactions, particularly because one of Simbrinza’s active components, brimonidine tartrate, can also decrease blood pressure. Combining Simbrinza with other blood pressure-lowering drugs might lead to excessively low blood pressure, resulting in symptoms like dizziness and blurry vision. Examples of common blood pressure medications include:
  • Norvasc (amlodipine)
  • Toprol XL, Lopressor (metoprolol)
  • Cozaar (losartan)
• Simbrinza and Monoamine Oxidase Inhibitors: Using Simbrinza in conjunction with monoamine oxidase inhibitors (MAOIs), a class of medications primarily used to treat depression, may affect how your body metabolizes Simbrinza. This interaction could heighten the risk of experiencing side effects from the MAOI and Simbrinza. Examples of MAOIs include:
  • Nardil (phenelzine)
  • Emsam (selegiline)
  • Parnate (tranylcypromine)
• Simbrinza and Certain Antidepressants: When taking tricyclic antidepressants (TCAs) with Simbrinza, there may be a potential interaction that could affect the effectiveness of Simbrinza in reducing eye pressure. Although this interaction has not been definitively proven, it is theorized that TCAs could potentially diminish Simbrinza’s ability to effectively manage eye conditions such as ocular hypertension or open-angle glaucoma. Examples of TCAs include:
  • Imipramine
  • Silenor (doxepin)
  • Amitriptyline
  • Pamelor (nortriptyline)

What Are the Other Simbrinza Interactions?

Regarding interactions with other substances, Simbrinza generally does not have specific known interactions with herbs, supplements, foods, or beverages. However, it’s always wise to proceed with caution:

• Foods and Beverages: Similarly, there are no known food or beverage interactions with Simbrinza. Still, if you have any concerns about your diet or specific foods and how they might affect your treatment with Simbrinza, it’s best to consult your doctor.
• Herbs and Supplements: While no interactions between Simbrinza and herbal or dietary supplements have been specifically reported, it’s important to inform your doctor or pharmacist about all supplements you are taking. This ensures that all aspects of your health regimen are considered together, avoiding potential adverse effects.
• Simbrinza and Alcohol: While there are no documented interactions between Simbrinza and alcohol, caution is advised when consuming alcohol during treatment. Both Simbrinza and alcohol can potentially slow your breathing and heart rate. This combination could enhance these effects, leading to potential health risks. 

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

What Are the Simbrinza Alternatives?

If Simbrinza isn’t suitable for your needs, there are several alternative medications available for treating increased eye pressure associated with conditions like ocular hypertension or open-angle glaucoma. 

Alternatives for treating increased eye pressure

If Simbrinza isn’t suitable for you, there are several other medications that can help manage increased eye pressure associated with ocular hypertension or open-angle glaucoma. Here are some alternatives:

• Travatan-Z (travoprost)
• Betoptic (betaxolol)
• Cosopt (dorzolamide/timolol)
• Alphagan-P (brimonidine)
• Xalatan (latanoprost)
• Lumigan (bimatoprost)
• Azopt (brinzolamide)
• Combigan (brimonidine/timolol)
• Timoptic-XE (timolol)
• Trusopt (dorzolamide)
• Carteolol (carteolol)
• Timoptic in Ocudose (timolol)
• Timoptic (timolol)

[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.]

Simbrinza Cost & Coupons

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Frequently Asked Questions

Will I need to use this drug long-term?

Simbrinza is generally prescribed as a long-term treatment option. If your doctor finds that Simbrinza is safe and effective for your condition, you will likely need to use it continuously over an extended period. This ongoing treatment helps manage your eye pressure effectively to prevent potential damage. If you have any concerns or questions about the duration of your treatment with Simbrinza, it’s important to discuss them with your doctor.

How long does it take to work?

Simbrinza starts to work immediately after you apply the eye drops. Its effectiveness in lowering eye pressure peaks around 2 hours after each dose. Although you might not physically feel the drug working, it’s important to continue using it as directed by your doctor. Consistent use is key to managing your condition effectively. If you have questions about how Simbrinza works or what to expect during treatment, it’s best to consult your doctor for detailed information.

Can I use Simbrinza while wearing contacts?

Yes, you can use contact lenses while being treated with Simbrinza, but there are specific steps you need to follow. Before applying Simbrinza drops, you must remove your contact lenses because some ingredients in the drops can be absorbed by the lenses. After administering the drops, wait at least 15 minutes before reinserting your contact lenses. This waiting period helps prevent any potential medication absorption by the lenses. If you have any questions about using contact lenses with Simbrinza, it’s advisable to consult your doctor for more detailed guidance.

Can I use Simbrinza with other eye drops or eye ointments?

You can use Simbrinza with other eye drops or ointments if your doctor advises. However, waiting at least 5 minutes between applying each type of eye medication is important. This gap ensures that your eye absorbs each drug effectively. If you have any questions about using Simbrinza with other eye products, it’s a good idea to consult with your doctor or pharmacist for guidance.

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