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Brimonidine (ophthalmic): Drug information

Brimonidine (ophthalmic): Drug information
(For additional information see "Brimonidine (ophthalmic): Patient drug information" and see "Brimonidine (ophthalmic): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Alphagan P;
  • Lumify [OTC]
Brand Names: Canada
  • Alphagan;
  • Alphagan P;
  • APO-Brimonidine;
  • Brimonidine P;
  • JAMP-Brimonidine;
  • MED-Brimonidine;
  • PMS-Brimonidine [DSC];
  • RIVA-Brimonidine;
  • SANDOZ Brimonidine
Pharmacologic Category
  • Alpha2 Agonist, Ophthalmic;
  • Ophthalmic Agent, Antiglaucoma
Dosing: Adult
Elevated intraocular pressure

Elevated intraocular pressure:

US labeling: Ophthalmic: 0.1%, 0.15%, 0.2% solution: Instill 1 drop in affected eye(s) 3 times/day (approximately every 8 hours).

Canadian labeling: Ophthalmic:

Solution 0.15%: Instill 1 drop in affected eye(s) 3 times/day (approximately every 8 hours).

Solution 0.2%: Instill 1 drop in affected eye(s) 2 times/day (approximately every 12 hours).

Miosis

Miosis (following laser refractive surgery) (off-label use): Ophthalmic: 0.15%, 0.2% solution: Instill 1 drop in each eye 30 to 60 minutes before scotopic condition (Ref).

Ocular redness

Ocular redness (OTC): Ophthalmic (0.025% solution): Instill 1 drop in affected eye(s) every 6 to 8 hours up to 4 times daily.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Brimonidine (ophthalmic): Pediatric drug information")

Glaucoma, ocular hypertension

Glaucoma, ocular hypertension: Children ≥2 years and Adolescents: Ophthalmic solution (0.1%, 0.15%, or 0.2%): Ophthalmic: Instill 1 drop into lower conjunctival sac of affected eye(s) 3 times daily (approximately every 8 hours)

Ocular redness

Ocular redness: Children ≥5 years: Ophthalmic solution (0.025%): Ophthalmic: Instill 1 drop info affected eye(s) every 6 to 8 hours as needed up to 4 times daily

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Actual frequency of adverse reactions may be formulation dependent; percentages reported with Alphagan P:

>10%:

Central nervous system: Drowsiness (children 25% to 83%; adults 1% to 4%)

Ophthalmic: Allergic conjunctivitis, conjunctival hyperemia, eye pruritus

1% to 10% (unless otherwise noted 1% to 4%):

Cardiovascular: Hypertension (5% to 9%), hypotension

Central nervous system: Dizziness, fatigue, foreign body sensation of eye, headache, impaired consciousness (children), insomnia

Dermatologic: Erythema of eyelid, skin rash

Endocrine & metabolic: Hypercholesterolemia

Gastrointestinal: Xerostomia (5% to 9%), dyspepsia

Hypersensitivity: Local ocular hypersensitivity reaction (5% to 9%), hypersensitivity reaction

Infection: Infection

Neuromuscular & skeletal: Weakness

Ophthalmic: Burning sensation of eyes (5% to 9%), follicular conjunctivitis (5% to 9%), visual disturbance (5% to 9%), blepharitis, blepharoconjunctivitis, blurred vision, cataract, conjunctival edema, conjunctival hemorrhage, conjunctivitis, decreased visual acuity, dry eye syndrome, epiphora, eye discharge, eye irritation, eyelid disease, eyelid edema, eye pain, keratitis, photophobia, stinging of eyes, superficial punctate keratitis, visual field defect, vitreous detachment, vitreous opacity, watery eyes

Respiratory: Bronchitis, cough, dyspnea, flu-like symptoms, pharyngitis, rhinitis, sinus infection, sinusitis

<1%, postmarketing, and/or case reports: Anterior uveitis, apnea (infants), bradycardia, corneal erosion, depression, dermatological reaction (erythema, eyelid pruritus, vasodilation), dry nose, dysgeusia, hordeolum, hypothermia (infants), hypotonia (infants), iritis, miosis, nausea, tachycardia

Contraindications

Hypersensitivity to brimonidine or any component of the formulation; neonates and infants <2 years; concomitant MAO inhibitor therapy

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Warnings/Precautions

Concerns related to adverse effects:

• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions has caused bacterial keratitis.

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with severe cardiovascular disease or coronary insufficiency.

• Cerebrovascular insufficiency: Use with caution in patients with cerebral insufficiency.

• Hepatic impairment: Use with caution in patients with hepatic impairment (has not been studied).

• Orthostatic hypotension: Use with caution in patients with orthostatic hypotension.

• Raynaud phenomenon: Use with caution in patients with Raynaud phenomenon.

• Renal impairment: Use with caution in patients with renal impairment (has not been studied).

• Thromboangiitis obliterans: Use with caution in patients with thromboangiitis obliterans.

Special populations:

• Contact lens wearers: Some formulations may contain benzalkonium chloride which may be adsorbed by soft contact lenses; remove contacts prior to administration and wait 15 minutes before reinserting.

• Pediatric: Systemic absorption has been reported; children are at higher risk of systemic adverse events (Levy, 2004). Use is contraindicated in children <2 years of age.

Other warnings/precautions:

• Self-medication (OTC use): Discontinue use and contact health care provider if eye pain or changes in vision occur; redness or irritation of the eye continues, or condition worsens or persists for >3 days. Do not use if solution changes color or becomes cloudy.

Warnings: Additional Pediatric Considerations

May cause CNS depression, particularly in young children; not recommended for use in infants or children <2 years. The most common adverse effects reported in a study of pediatric glaucoma patients were somnolence and decreased alertness (50% to 83% in children 2 to 6 years of age); these effects resulted in a 16% discontinuation of treatment rate; children >7 years (>20 kg) had a much lower rate of somnolence (25%); apnea, bradycardia, hypotension, hypothermia, hypotonia, and somnolence have been reported in infants receiving brimonidine.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic, as tartrate:

Alphagan P: 0.1% (5 mL, 10 mL, 15 mL); 0.15% (5 mL, 10 mL, 15 mL)

Lumify: 0.025% (2.5 mL, 7.5 mL) [contains benzalkonium chloride]

Generic: 0.1% (5 mL, 10 mL, 15 mL); 0.15% (5 mL, 10 mL, 15 mL); 0.2% (5 mL, 10 mL, 15 mL)

Generic Equivalent Available: US

Yes

Pricing: US

Solution (Alphagan P Ophthalmic)

0.1% (per mL): $46.64

0.15% (per mL): $49.74

Solution (Brimonidine Tartrate Ophthalmic)

0.1% (per mL): $44.31

0.15% (per mL): $38.33

0.2% (per mL): $0.84 - $6.52

Solution (Lumify Ophthalmic)

0.025% (per mL): $3.77

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic, as tartrate:

Alphagan: 0.2% (5 mL, 10 mL) [contains benzalkonium chloride]

Alphagan P: 0.15% (5 mL, 10 mL)

Generic: 0.15% (5 mL, 10 mL); 0.2% (5 mL, 10 mL)

Administration: Adult

Ophthalmic: For topical ophthalmic use only. Remove contact lenses prior to administration; wait 15 minutes before reinserting if using products containing benzalkonium chloride. Separate administration of other ophthalmic agents by at least 5 minutes. Do not touch tip of container to any surface, the eyelids, or the surrounding area.

Administration: Pediatric

Ophthalmic: Wash hands prior to use. Instill into conjunctival sac avoiding contact of bottle tip with skin or eye. Apply gentle pressure to lacrimal sac during and immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration, to decrease systemic absorption of ophthalmic drops (Ref). Administer other topical ophthalmic medications at least 5 minutes apart; generic formulation contains benzalkonium chloride which may be absorbed by soft contact lenses; wait at least 10 to 15 minutes after administration to insert soft contact lenses.

Use: Labeled Indications

Elevated intraocular pressure: Reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension

Ocular redness (OTC only): Relief of redness of the eye due to minor eye irritations

Use: Off-Label: Adult

Miosis (following laser refractive surgery)

Medication Safety Issues
Sound-alike/look-alike issues:

Brimonidine may be confused with bromocriptine

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alcohol (Ethyl): CNS Depressants may enhance the CNS depressant effect of Alcohol (Ethyl). Risk C: Monitor therapy

Alizapride: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Azelastine (Nasal): May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Beta-Blockers: Alpha2-Agonists may enhance the AV-blocking effect of Beta-Blockers. Sinus node dysfunction may also be enhanced. Beta-Blockers may enhance the rebound hypertensive effect of Alpha2-Agonists. This effect can occur when the Alpha2-Agonist is abruptly withdrawn. Management: Closely monitor heart rate during treatment with a beta blocker and clonidine. Withdraw beta blockers several days before clonidine withdrawal when possible, and monitor blood pressure closely. Recommendations for other alpha2-agonists are unavailable. Risk D: Consider therapy modification

Blonanserin: CNS Depressants may enhance the CNS depressant effect of Blonanserin. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Strong CNS depressants should not be coadministered with blonanserin. Risk D: Consider therapy modification

Brexanolone: CNS Depressants may enhance the CNS depressant effect of Brexanolone. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Bromopride: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Bromperidol: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Buprenorphine: CNS Depressants may enhance the CNS depressant effect of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Risk D: Consider therapy modification

Cannabinoid-Containing Products: CNS Depressants may enhance the CNS depressant effect of Cannabinoid-Containing Products. Risk C: Monitor therapy

Chlormethiazole: May enhance the CNS depressant effect of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Risk D: Consider therapy modification

Chlorphenesin Carbamate: May enhance the adverse/toxic effect of CNS Depressants. Risk C: Monitor therapy

CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants. Risk C: Monitor therapy

Daridorexant: May enhance the CNS depressant effect of CNS Depressants. Management: Dose reduction of daridorexant and/or any other CNS depressant may be necessary. Use of daridorexant with alcohol is not recommended, and the use of daridorexant with any other drug to treat insomnia is not recommended. Risk D: Consider therapy modification

DexmedeTOMIDine: CNS Depressants may enhance the CNS depressant effect of DexmedeTOMIDine. Management: Monitor for increased CNS depression during coadministration of dexmedetomidine and CNS depressants, and consider dose reductions of either agent to avoid excessive CNS depression. Risk D: Consider therapy modification

Difelikefalin: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Dimethindene (Topical): May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Doxylamine: CNS Depressants may enhance the CNS depressant effect of Doxylamine. Risk C: Monitor therapy

DroPERidol: May enhance the CNS depressant effect of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Risk D: Consider therapy modification

Esketamine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Flunarizine: CNS Depressants may enhance the CNS depressant effect of Flunarizine. Risk X: Avoid combination

Flunitrazepam: CNS Depressants may enhance the CNS depressant effect of Flunitrazepam. Management: Reduce the dose of CNS depressants when combined with flunitrazepam and monitor patients for evidence of CNS depression (eg, sedation, respiratory depression). Use non-CNS depressant alternatives when available. Risk D: Consider therapy modification

HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants. Management: Consider a decrease in the CNS depressant dose, as appropriate, when used together with hydroxyzine. Increase monitoring of signs/symptoms of CNS depression in any patient receiving hydroxyzine together with another CNS depressant. Risk D: Consider therapy modification

Ixabepilone: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Kava Kava: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Kratom: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Lemborexant: May enhance the CNS depressant effect of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Risk D: Consider therapy modification

Lisuride: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Lofexidine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Magnesium Sulfate: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Methotrimeprazine: CNS Depressants may enhance the CNS depressant effect of Methotrimeprazine. Methotrimeprazine may enhance the CNS depressant effect of CNS Depressants. Management: Reduce the usual dose of CNS depressants by 50% if starting methotrimeprazine until the dose of methotrimeprazine is stable. Monitor patient closely for evidence of CNS depression. Risk D: Consider therapy modification

Metoclopramide: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

MetyroSINE: CNS Depressants may enhance the sedative effect of MetyroSINE. Risk C: Monitor therapy

Mianserin: May diminish the therapeutic effect of Alpha2-Agonists (Ophthalmic). Risk X: Avoid combination

Minocycline (Systemic): May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Mirtazapine: May diminish the antihypertensive effect of Alpha2-Agonists. Management: Consider avoiding concurrent use. If the combination cannot be avoided, monitor for decreased effects of alpha2-agonists if mirtazapine is initiated/dose increased, or increased effects if mirtazapine is discontinued/dose decreased. Risk D: Consider therapy modification

Monoamine Oxidase Inhibitors: May enhance the adverse/toxic effect of Brimonidine (Ophthalmic). Monoamine Oxidase Inhibitors may increase the serum concentration of Brimonidine (Ophthalmic). Risk C: Monitor therapy

Nabilone: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Olopatadine (Nasal): May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Opioid Agonists: CNS Depressants may enhance the CNS depressant effect of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider therapy modification

Orphenadrine: CNS Depressants may enhance the CNS depressant effect of Orphenadrine. Risk X: Avoid combination

Oxomemazine: May enhance the CNS depressant effect of CNS Depressants. Risk X: Avoid combination

Oxybate Salt Products: CNS Depressants may enhance the CNS depressant effect of Oxybate Salt Products. Management: Consider alternatives to this combination when possible. If combined, dose reduction or discontinuation of one or more CNS depressants (including the oxybate salt product) should be considered. Interrupt oxybate salt treatment during short-term opioid use Risk D: Consider therapy modification

OxyCODONE: CNS Depressants may enhance the CNS depressant effect of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider therapy modification

Paraldehyde: CNS Depressants may enhance the CNS depressant effect of Paraldehyde. Risk X: Avoid combination

Perampanel: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Piribedil: CNS Depressants may enhance the CNS depressant effect of Piribedil. Risk C: Monitor therapy

Pramipexole: CNS Depressants may enhance the sedative effect of Pramipexole. Risk C: Monitor therapy

Procarbazine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Ropeginterferon Alfa-2b: CNS Depressants may enhance the adverse/toxic effect of Ropeginterferon Alfa-2b. Specifically, the risk of neuropsychiatric adverse effects may be increased. Management: Avoid coadministration of ropeginterferon alfa-2b and other CNS depressants. If this combination cannot be avoided, monitor patients for neuropsychiatric adverse effects (eg, depression, suicidal ideation, aggression, mania). Risk D: Consider therapy modification

ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole. Risk C: Monitor therapy

Rotigotine: CNS Depressants may enhance the sedative effect of Rotigotine. Risk C: Monitor therapy

Rufinamide: May enhance the adverse/toxic effect of CNS Depressants. Specifically, sleepiness and dizziness may be enhanced. Risk C: Monitor therapy

Serotonin/Norepinephrine Reuptake Inhibitors: May diminish the therapeutic effect of Alpha2-Agonists. Risk C: Monitor therapy

Suvorexant: CNS Depressants may enhance the CNS depressant effect of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Risk D: Consider therapy modification

Thalidomide: CNS Depressants may enhance the CNS depressant effect of Thalidomide. Risk X: Avoid combination

Tricyclic Antidepressants: May diminish the therapeutic effect of Alpha2-Agonists (Ophthalmic). Risk C: Monitor therapy

Trimeprazine: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Valerian: May enhance the CNS depressant effect of CNS Depressants. Risk C: Monitor therapy

Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Risk D: Consider therapy modification

Zuranolone: May enhance the CNS depressant effect of CNS Depressants. Management: Consider alternatives to the use of zuranolone with other CNS depressants or alcohol. If combined, consider a zuranolone dose reduction and monitor patients closely for increased CNS depressant effects. Risk D: Consider therapy modification

Pregnancy Considerations

Teratogenic effects were not observed in animal reproduction studies.

Breastfeeding Considerations

It is not known if brimonidine is excreted in breast milk. Due to the potential for serious adverse reactions in the nursing infant, the manufacturer recommends a decision be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of treatment to the mother.

Monitoring Parameters

IOP routinely (first month of therapy may not reflect long-term level of IOP reduction)

Mechanism of Action

A relatively selective alpha-2 adrenergic agonist; causes reduction of aqueous humor formation and increased uveoscleral outflow

Pharmacokinetics (Adult Data Unless Noted)

Metabolism: Hepatic (extensive)

Half-life elimination: ~3 hours

Time to peak, plasma: 1 to 4 hours

Excretion: Urine (74%)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Alphagan | Brimo | Brimonidine | Lumify;
  • (AR) Argentina: Alphagan | Alphagan p | Brimopress | Oftalmotonil;
  • (AT) Austria: Alphagan | Brimogen | Brimonidin Arcana;
  • (AU) Australia: Alphagan | Alphagan p | Enidin;
  • (BD) Bangladesh: Alphagan | Alphaten | Bricoma | Brimodin | Eyelia | Luminor;
  • (BE) Belgium: Alphagan | Brimonidine Mylan;
  • (BF) Burkina Faso: Brimodin;
  • (BG) Bulgaria: Brimogen | Brimonidine tartrate teva | Luxfen | Rimonal;
  • (BR) Brazil: Alphabrin | Alphagan | Alphagan p | Alphagan z | Alphagan-p | Glaub | Glaub md | Tartarato de brimonidina;
  • (CH) Switzerland: Alphagan | Brimonidin Mepha | Brimonidin Teva;
  • (CI) Côte d'Ivoire: Bglau;
  • (CL) Chile: Agglad ofteno | Alphagan | Alphagan p | Brimof | Brimokem | Brimonidina tartrato | Brimopress;
  • (CN) China: Alphagan | Brimocon;
  • (CO) Colombia: Agglad ofteno | Alphagan | Alphagan p | Alphagan-p | Brimodelt | Brimoftal | Brimoftal p | Brimoftal z | Brimonidina tartrato | Glaucodina | Pressoftalm soft | Tartrato de brimonidina;
  • (CZ) Czech Republic: Alphagan | Brimonidin olikla | Brimonidine Polpharma | Glabrin | Luxfen;
  • (DE) Germany: Alphagan | Brimo Ophtal | Brimo vision | Brimogen | Brimonidin 1 a pharma | Brimonidin AL | Brimonidin axunio | Brimonidin bluefish | Brimonidin Dura | Brimonidin micro labs | Brimonidin ratiopharm | Brimonidin Stada | Brimonidin stulln | Brimonidintartrat AbZ;
  • (DO) Dominican Republic: Agglad ofteno | Alphagan | Alphagan p | Bridomol | Brimogot | Brimoni;
  • (EC) Ecuador: Agglad | Agglad ofteno | Alphagan | Alphagan p | Brimof | Citol brim;
  • (EE) Estonia: Alphagan | Alphagen;
  • (EG) Egypt: Alfabrimo | Alphagan | Alphagan p | Alphanova | Brimillergy | Brimocoma | Brimonidine | Brimonocond | Brimosalm | Pharmapress;
  • (ES) Spain: Alfadina | Alphagan | Brimonidina cinfa | Brimonidina Colirteva | Brimonidina kern pharma | Brimonidina Mylan | Brimonidina vir;
  • (ET) Ethiopia: Bglau;
  • (FI) Finland: Alphagan | Brimonidin Sandoz | Brimonidine Teva | Glaudin;
  • (FR) France: Alphagan | Brimonidine biogaran | Brimonidine Chauvin | Brimonidine EG | Brimonidine Mylan | Brimonidine Ratiopharm | Brimonidine sandoz | Brimonidine Teva;
  • (GB) United Kingdom: Alphagan | Brimonidine | Brimonidine Teva | Brymont;
  • (GR) Greece: Alphagan | Benil | Brimodine | Brimogan | Brimontal | Brinidin | Corneax | Glaucoval | Pharmexin;
  • (HK) Hong Kong: Alphagan | Brimogan;
  • (HR) Croatia: Alphagan | Bimanox | Brimot | Luxfen;
  • (HU) Hungary: Alphagan;
  • (IE) Ireland: Alphagan;
  • (IL) Israel: Alphagan | Alphagan p;
  • (IN) India: Albrim | Alphagan | Alphagan-p | Alphagan-z | Apbidin P | Arobrim | Bidin ls | Brimed | Brimo | Brimochek | Brimodin | Brimodin-p | Brimonid | Brimopress | Brimosun ls | Brimosun p | Cibrim z | Glaucom | Globrim | Iobrim | Kaibrim | Rimoflo soft | Rimonid;
  • (IT) Italy: Alphagan | Brimoftal | Brimonidina Bausch & Lomb | Brimonidina EG | Brimonidina Mylan | Brimonidina Ratiopharm | Brimonidina San | Brimonidina Tub | Brimostill | Brimoton | Glaubrim;
  • (JO) Jordan: Alphagan | Alphagan p | Brimo | Lumify;
  • (JP) Japan: Aiphagan | Brimonidine tartrate ts;
  • (KE) Kenya: Alphagan purite;
  • (KR) Korea, Republic of: Alphagam p ophthalmic solution 0.15% | Alphagan | Alphagan-p | Alphamon p | Bridin T | Bridine t | Brimonin | Monigan | Optigreen;
  • (KW) Kuwait: Alphagan | Alphagan p;
  • (LB) Lebanon: Alphagan p | Bglau | Brimo | Brimogan | Brimonidine biogaran;
  • (LT) Lithuania: Alphagan | Brimonal | Brimonidine | Luxfen | Rivotra;
  • (LU) Luxembourg: Alphagan;
  • (LV) Latvia: Alphagan | Briglafre | Brimonidine tartrate elvim | Luxfen;
  • (MA) Morocco: Alphagan | Ibrimo;
  • (MX) Mexico: Agglad | Agglad ofteno | Alphagan | Alphagan-p | Brimonidina 3m | Briop | Nor tenz;
  • (MY) Malaysia: Alphagan | Alphagan p | Brimonidine;
  • (NG) Nigeria: Alphaten | Brimogan | Druphagan;
  • (NL) Netherlands: Alphagan | Brimonidinetartraat Mylan | Brimonidinetartraat PCH | Brimonidinetartraat Sandoz;
  • (NO) Norway: Alphagan | Brimoratio | Brymont;
  • (NZ) New Zealand: Alphagan | Alphagan p | Arrow brimonidine | Brimonidine aft;
  • (PE) Peru: Agglad ofteno | Alphagan | Alphagan p | Brimodual | Citol brim | Nor tenz;
  • (PH) Philippines: Alcon Brimonidine | Alphagan | Alphagan p | Brimochek;
  • (PK) Pakistan: Alphagan | Alzagan | Brimo | Brimo T | Brimod | Brimodine | Brimotar | Brimson | Onidin;
  • (PL) Poland: Alphagan | Biprolast | Briglau free | Briglau Pph | Brimogen | Brimoteva | Brymont | Luxfen | Oculobrim;
  • (PR) Puerto Rico: Alphagan | Alphagan p | Lumify;
  • (PT) Portugal: Alphagan | Bglau | Brimonidina bluepharma;
  • (PY) Paraguay: Brimof | Brimopress | Citol brim | Oftalmol b | Oftalmotonil;
  • (QA) Qatar: Alphagan P | Brimo | Brimochek;
  • (RO) Romania: Brimonal;
  • (RU) Russian Federation: Alfabrim | Alphagan p | Brim aniglau eco | Luxfen;
  • (SA) Saudi Arabia: Alphagan | Alphagan p | Brimo | Brimodin;
  • (SE) Sweden: Alphagan | Brimonidin 2care4 | Brimonidin bluefish | Brimonidin hexal | Brimoratio | Brymont | Glaudin;
  • (SG) Singapore: Alphagan | Alphagan p;
  • (SI) Slovenia: Bimanox | Brimonidin medops;
  • (SK) Slovakia: Alphagan | Brimonal | Brimonidin olikla | Luxfen;
  • (TH) Thailand: Alphagan | Alphagan p;
  • (TN) Tunisia: Alphacol free | Alphagan;
  • (TR) Turkey: Alphagan | Bremon | Brimogut | Brimolix | Gloger | Rimonal;
  • (TW) Taiwan: Almidine | Alphagan | Alphagan p;
  • (UA) Ukraine: Alphagan p | Bimanox | Briglau eco | Brimogen | Brimonal | Brimonidin farmax | Brirosa | Luxfen;
  • (UY) Uruguay: Agglad ofteno | Alphagan | Brimopress | Oftamotonil;
  • (VE) Venezuela, Bolivarian Republic of: Agglad ofteno | Alphagan | Alphagan p | Brimolag | Brimopress;
  • (ZA) South Africa: Alphagan | Alphagan purite | Brimoct
  1. Alphagan (brimonidine tartrate) [prescribing information]. Irvine, CA: Allergan Inc; September 2013.
  2. Alphagan (brimonidine tartrate) [product monograph]. St-Laurent, Quebec, Canada: AbbVie Corp; September 2022.
  3. Alphagan P (brimonidine tartrate) [product monograph]. Markham, Ontario, Canada: Allergan Inc; August 2015.
  4. Berlin RJ, Lee UT, Samples JR, et al. Ophthalmic Drops Causing Coma in an Infant. J Pediatr. 2001;138(3):441-443. [PubMed 11241061]
  5. Brimonidine P (brimonidine tartrate) ophthalmic solution 0.15% [product monograph]. Vaughan, Ontario, Canada: AA Pharma Inc; July 2019.
  6. Brimonidine Tartrate Ophthalmic Solution 0.2% [prescribing information]. Boca Raton, FL: Florida Pharmaceutical Products LLC; November 2021.
  7. Byles DB, Frith P, Salmon JF. Anterior Uveitis as a Side Effect of Topical Brimonidine. Am J Ophthalmol. 2000;130(3):287-291. [PubMed 11020406]
  8. Carlsen JO, Zabriskie NA, Kwon YH, et al. Apparent Central Nervous System Depression in Infants After the Use of Topical Brimonidine. Am J Ophthalmol. 1999;128(2):255-256. [PubMed 10458196]
  9. Edwards JD, Burka JM, Bower KS, Stutzman RD, Sediq DA, Rabin JC. Effect of brimonidine tartrate 0.15% on night-vision difficulty and contrast testing after refractive surgery. J Cataract Refract Surg. 2008;34(9):1538-1541. doi:10.1016/j.jcrs.2008.05.029 [PubMed 18721716]
  10. Enyedi LB, Freedman SF. Safety and efficacy of brimonidine in children with glaucoma. J AAPOS. 2001;5(5):281-284. [PubMed 11641636]
  11. Lee JH, You YS, Choe CM, Lee ES. Efficacy of brimonidine tartrate 0.2% ophthalmic solution in reducing halos after laser in situ keratomileusis. J Cataract Refract Surg. 2008;34(6):963-967. doi:10.1016/j.jcrs.2008.01.028 [PubMed 18499002]
  12. Levy Y, Zadok D. Systemic side effects of ophthalmic drops. Clin Pediatr (Phila). 2004;43(1):99-101. [PubMed 14968900]
  13. Lumify (brimonidine tartrate) [prescribing information]. Bridgewater, NJ: Bausch + Lomb; received May 2023.
  14. McDonald JE 2nd, El-Moatassem Kotb AM, Decker BB. Effect of brimonidine tartrate ophthalmic solution 0.2% on pupil size in normal eyes under different luminance conditions. J Cataract Refract Surg. 2001;27(4):560-564. doi:10.1016/s0886-3350(01)00769-6 [PubMed 11311624]
  15. Thordsen JE, Bower KS, Warren BB, Stutzman R. Miotic effect of brimonidine tartrate 0.15% ophthalmic solution in normal eyes. J Cataract Refract Surg. 2004;30(8):1702-1706. doi:10.1016/j.jcrs.2003.12.037 [PubMed 15313293]
  16. Urtti A, Salminen L. Minimizing systemic absorption of topically administered ophthalmic drugs. Surv Ophthalmol. 1993;37(6):435-456. [PubMed 8100087]
  17. Zimmerman TJ, Kooner KS, Kandarakis AS, Ziegler LP. Improving the therapeutic index of topically applied ocular drugs. Arch Ophthalmol. 1984;102(4):551-553. [PubMed 6704011]
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