In the U.S.—

• Antiglaucoma agent (ophthalmic)
• antihypertensive, ocular

Brimonidine (bri-MOE-ni-deen ) is used to treat glaucoma or another condition in which pressure in the eye is too high (ocular hypertension).

This medicine is available only with your doctor's prescription, in the following dosage form:

Ophthalmic
• Ophthalmic solution (eye drops) (U.S.)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ophthalmic brimonidine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to brimonidine. Also tell your health care professional if you are allergic to any other substances, such as preservatives.

Pregnancy—Brimonidine has not been studied in pregnant women. Studies in animals have shown that brimonidine crosses the placenta, but very high doses have not been shown to cause harmful effects in the fetus.

Breast-feeding—It is not known whether brimonidine passes into human breast milk. However, it has been shown to pass into the milk of nursing animals.

Children—Studies on this medicine have been done only in adult patients. There is no specific information comparing use of brimonidine in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of brimonidine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using brimonidine, it is especially important that your health care professional know if you are taking any of the following:

• Monoamine oxidase (MAO) inhibitor activity ( isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])—Brimonidine should not be taken while you are taking or within two weeks of taking monoamine oxidase (MAO) inhibitors

• Heart or blood vessel disease or
• Low blood pressure—Although very little ophthalmic brimonidine is absorbed into the body, there is a possibility that it could affect blood pressure

• Kidney disease or
• Liver disease—Higher blood levels of brimonidine may result

• Mental depression—Use of brimonidine may make this condition worse

If your doctor ordered two different eye drops to be used together, wait at least 10 minutes between the times you apply the medicines. This will help to keep the second medicine from “washing out” the first one.

To use the eye drops:

• First, wash your hands. Tilt your head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 1 or 2 minutes to allow the medicine to be absorbed by the eye.
• If you think you did not get the drop of medicine into your eye properly, use another drop.
• To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.

Use this medicine only as directed. Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of too much medicine being absorbed into the body and the chance of side effects.

Dosing—

The dose of ophthalmic brimonidine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ophthalmic brimonidine. If your dose is different, do not change it unless your doctor tells you to do so.

• For ophthalmic dosage form (eye drops):
  • For glaucoma or ocular hypertension:
    • Adults—Use one drop in the affected eye or eyes three times a day.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

This medicine may cause some people to become dizzy, drowsy, tired, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Check with your doctor right away if you experience fainting.

If you wear soft contact lenses: These eye drops contain a preservative that could be absorbed by soft lenses. Wait at least 15 minutes after putting these eye drops in before you put in your soft contact lenses.

Brimonidine may cause your eyes to become more sensitive to light than they are normally. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• More common
  • Headache;  itching of eye;  redness of eye or inner lining of eyelid;  swelling of eyelid;  tearing of eye 
  
  

• Less common
  • Ache or pain in eye;  bloody eye;  blurred vision or other change in vision;  dizziness;  fainting;  feeling of something in the eye;  increased blood pressure ;  mental depression;  muscle pain;  nausea or vomiting;  oozing in eye;  redness, swelling, and/or itching of eyelid;  runny or stuffy nose;  sneezing;  swelling of eye 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Burning, stinging, or tearing of eye;  drowsiness or tiredness;  dryness of mouth 
  
  

• Less common
  • Anxiety;  crusting on eyelid or corner of eye;  discoloration of white part of eye;  dryness of eye;  increased sensitivity of eye to light;  muscle weakness;  paleness of eye or inner lining of eyelid;  pounding heartbeat;  taste changes;  trouble in sleeping 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.