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Brimonidine tartrate ocular


Eye drop solution containing brimonidine tartrate.

Drugs List

  • ALPHAGAN 0.2% eye drops
  • brimonidine 0.2% eye drops
  • Therapeutic Indications


    Elevated IOP in ocular hypertension - adjunctive therapy
    Elevated IOP in ocular hypertension - alternative to beta-blockers
    Elevated IOP in open-angle glaucoma - adjunctive therapy
    Elevated IOP in open-angle glaucoma - alternative to beta-blockers



    Instil one drop in the affected eye(s) twice daily approximately 12 hours apart.


    Instil one drop in the affected eye(s) twice daily approximately 12 hours apart.


    Brimonidine tartrate eye drops are contraindicated in infants under 2 years.

    Safety and efficacy have not been established in children aged 2-12 years. Systemic side effects, including increased risk of drowsiness, have been reported in this age group, particularly in the 2-7 year age group and those weighing less than 20kg. No dose recommendations are given by the manufacturer.


    Children under 2 years

    Precautions and Warnings

    Children aged 2 to 18 years
    Soft contact lenses
    Cerebrovascular insufficiency
    Hepatic impairment
    Postural hypotension
    Raynaud's syndrome
    Renal impairment
    Severe cardiovascular disorder
    Thromboangiitis obliterans

    Advise patient blurred vision may affect ability to drive/operate machinery
    Advise patient drowsiness may affect ability to drive or operate machinery
    Contains benzalkonium chloride
    In combined therapy, administer eye products at least five minutes apart
    To reduce systemic absorption compress lacrimal sac during administration
    Discontinue if allergic reaction occurs
    Advise patient to avoid touching the eye/other surfaces with container tip
    Discolours soft contact lenses
    If soft contact lenses worn,insert them 15 minutes after using eye drops

    Pregnancy and Lactation


    Caution is advised in pregnancy.

    In animal studies, no teratogenic effects were seen, however pre-implantation loss and postnatal growth reduction were seen in rabbits when brimonidine tartrate was present at plasma levels higher than those achieved during human treatment.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    This medication is contraindicated in breastfeeding.

    It is not known if brimonidine is excreted in human milk; it is known to be excreted in the milk of lactating rats.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at


    Advise patient to remove soft contact lenses before instillation of the eye drops and re-insert them after 15 minutes.

    Advise patient that brimonidine tartrate is known to discolour soft contact lenses.

    Advise patient to leave an interval of at least 5 minutes before instilling another ophthalmic medication.

    Advise patient to avoid contact of the container with eye or other surfaces as contamination may occur.

    Advise patient to compress the lacrimal sac during administration and for one minute afterwards, to reduce systemic absorption.

    Advise patient that eye drops may cause fatigue/drowsiness and may also cause blurred/abnormal vision after instillation - avoid driving or operating machinery until these symptoms have cleared.

    Side Effects

    Abnormal vision
    Allergic reaction
    Blurred vision
    Burning sensation
    Conjunctival blanching
    Conjunctival discharge
    Conjunctival follicles
    Conjunctival oedema
    Corneal erosion
    Corneal staining
    Dry eyes
    Dry mouth
    Eyelid hyperaemia
    Eyelid oedema
    Gastro-intestinal symptoms
    Nasal dryness
    Ocular hyperaemia
    Ocular irritation
    Ocular pain
    Sensation of foreign body in eye
    Taste disturbances
    Upper respiratory symptoms


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: January 2013

    Reference Sources

    British National Formulary, 64th Edition (2012) Pharmaceutical Press, London.

    BNF for Children (2012-2013) Pharmaceutical Press, London.

    Martindale: The Complete Drug Reference, 36th edition (2009) ed. Sweetman, S. Pharmaceutical Press, London.

    Medications and Mothers' Milk, 14th Edition (2010) Hale, T. Hale Publishing, Amarillo, Texas.

    Summary of Product Characteristics: Alphagan eye drops. Allergan Ltd. September 2010.

    Summary of Product Characteristics: Brymont eye drops. Blumont Pharma Ltd. Revised August 2012.

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.