Side Effects of Alphagan P (brimonidine)

Alphagan P (brimonidine) is an ophthalmic solution used for the treatment of open-angle glaucoma.

In this type of glaucoma, excess fluid in the eye leads to high pressures that damage the nerves and cause blindness.

Brimonidine reduces fluid production and increases outflow, lowering pressure in the eye. It selectively stimulates alpha type 2 receptors in the eye. It is the first drug of its class for glaucoma.

Common side effects of Alphagan P:

• dry eyes,
• red eyes,
• eye irritation,
• headache,
• blurred vision,
• sensation of a foreign body in the eye, and
• drowsiness.

Other important side effects of Alphagan P:

• corneal staining,
• increased sensitivity to light,
• eyelid redness,
• eye pain,
• tearing,
• eyelid swelling, and
• low blood pressure.

Drug interactions of Alphagan P include drowsy medications, antidepressants, and heart/blood pressure meds.

No well-controlled studies of Alphagan P in pregnant women. Use during pregnancy only if benefits outweigh risks.

Unknown if Alphagan P is secreted in breast milk. Consult doctor before breastfeeding.

Important Side Effects of Alphagan P (brimonidine)

Common side effects:

• dry eyes,
• red eyes,
• eye irritation,
• headache,
• blurred vision,
• sensation of a foreign body in the eye, and
• drowsiness.

Other important side effects:

• corneal staining,
• increased sensitivity to light,
• eyelid redness,
• eye pain,
• tearing,
• eyelid swelling, and
• low blood pressure.

Alphagan P (brimonidine) Side Effects for Healthcare Professionals

Clinical Studies Experience

Adverse reactions occurring in 10-20%of subjects:

• allergic conjunctivitis,
• conjunctival hyperemia, and
• eye pruritus.

Adverse reactions occurring in 5-9%:

• burning sensation,
• conjunctival folliculosis,
• hypertension,
• ocular allergic reaction,
• oral dryness, and
• visual disturbance.

Adverse reactions occurring in 1-4%:

• abnormal taste,
• allergic reaction,
• asthenia,
• blepharitis,
• blepharoconjunctivitis,
• blurred vision,
• bronchitis,
• cataract,
• conjunctival edema,
• conjunctival hemorrhage,
• conjunctivitis,
• cough,
• dizziness,
• dyspepsia,
• dyspnea,
• epiphora,
• eye discharge,
• eye dryness,
• eye irritation,
• eye pain,
• eyelid edema,
• eyelid erythema,
• fatigue,
• flu syndrome,
• follicular conjunctivitis,
• foreign body sensation,
• gastrointestinal disorder,
• headache,
• hypercholesterolemia,
• hypotension,
• infection (primarily colds and respiratory infections),
• insomnia,
• keratitis,
• lid disorder,
• pharyngitis,
• photophobia,
• rash,
• rhinitis,
• sinus infection,
• sinusitis,
• somnolence,
• stinging,
• superficial punctate keratopathy,
• tearing,
• visual field defect,
• vitreous detachment,
• vitreous disorder,
• vitreous floaters, and
• worsened visual acuity.

Rare reactions:

• corneal erosion,
• hordeolum,
• nasal dryness, and
• taste perversion.

Postmarketing Experience

Reactions reported after use of brimonidine tartrate ophthalmic solutions:

• bradycardia,
• depression,
• hypersensitivity,
• iritis,
• keratoconjunctivitis sicca,
• miosis,
• nausea,
• skin reactions (including erythema, eyelid pruritus, rash, and vasodilation),
• syncope, and
• tachycardia.

Apnea, bradycardia, coma, hypotension, hypothermia, hypotonia, lethargy, pallor, respiratory depression, and somnolence reported in infants receiving brimonidine tartrate ophthalmic solutions.

Drug Interactions with Alphagan P (brimonidine)

• Antihypertensives/Cardiac Glycosides: Caution advised with drugs that lower blood pressure.

CNS Depressants

• Consider potential additive effect with CNS depressants.

Tricyclic Antidepressants

• May interfere with IOP lowering effect of Alphagan P.
• Caution advised in patients taking tricyclic antidepressants.

Monoamine Oxidase Inhibitors

• Caution advised in patients taking MAO inhibitors.

Summary

Alphagan P (brimonidine) is an ophthalmic solution used for the treatment of open-angle glaucoma. Common side effects include dry eyes, red eyes, eye irritation, headache, blurred vision, feeling something is in the eye, and drowsiness. No well-controlled studies in pregnant women. Unknown if secreted in breast milk.