Indication

Open-angle glaucoma, Ocular hypertension

Adult dose

Adult: Ophth: Instill 1 drop 2 times/day approximately 12 hours apart. Contraindication Hypersensitivity. Patients receiving MAO inhibitor therapy. Mode of Action Brimonidine is an alpha 2-adrenoceptor agonist which works to reduce aqueous humor production and increase uveoscleral flow. Timolol is a non-selective beta-adrenergic receptor blocker. It does not have significant intrinsic sympathomimetic activity, direct myocardial depressant activity or local anaesth activity. Exact mechanism of ocular hypotensive effect is unclear, but it is thought to be related to reduction of aqueous humour formation. beta-blockade also causes lowering of BP. Precaution Patients wearing soft contact lenses should wait for at least 15 min after instilling brimonidine tartrate before inserting soft contact lenses. Renal or hepatic impairment. CV disease. Use with caution in patients with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension or thromboangitis obliterans. Pregnancy, lactation. Lactation: use caution Side Effect 5-15% Allergic conjunctivitis,Conjunctival folliculosis,Conjunctival hyperemia,Eye pruritus,Ocular burning,Stinging 1-5% Asthenia,Blepharitis,Corneal erosion,Depression,Epiphora,Eye discharge,Eye dryness,Eye irritation,Eye pain,Eyelid edema,Eyelid erythema,Eyelid pruritus,Foreign body sensation,Headache,Hypertension,Oral dryness,Somnolence,Superficial punctate keratitis,Visual disturbance Pregnancy Category Note Pregnancy Category: C Lactation: use caution Interaction Brimonidine Tartrate: Possibility of an additive or potentiating effect with CNS depressants e.g. alcohol, barbiturates, opiates, sedatives or anaesthetics. Caution when used with ?-blockers (ophthalmic and systemic), antihypertensives or cardiac glycosides. TCAs can affect the metabolism and uptake of circulating amines. Timolol: Concomitant admin w/ reserpine may increase hypotension and bradycardia. Additive effects w/ other antihypertensives (e.g. hydralazine, methyldopa). Increased ?-adrenergic blockade (e.g. decreased heart rate) w/ quinidine. Rebound HTN due to abrupt withdrawal of clonidine. Hypotensive effect may be antagonised by NSAIDs (e.g. indomethacin, ibuprofen).

Contraindication

Hypersensitivity. Patients receiving MAO inhibitor therapy.

Mode of action

Brimonidine is an alpha 2-adrenoceptor agonist which works to reduce aqueous humor production and increase uveoscleral flow. Timolol is a non-selective beta-adrenergic receptor blocker. It does not have significant intrinsic sympathomimetic activity, direct myocardial depressant activity or local anaesth activity. Exact mechanism of ocular hypotensive effect is unclear, but it is thought to be related to reduction of aqueous humour formation. beta-blockade also causes lowering of BP.

Precaution

Patients wearing soft contact lenses should wait for at least 15 min after instilling brimonidine tartrate before inserting soft contact lenses. Renal or hepatic impairment. CV disease. Use with caution in patients with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension or thromboangitis obliterans. Pregnancy, lactation. Lactation: use caution

Side effect

5-15% Allergic conjunctivitis,Conjunctival folliculosis,Conjunctival hyperemia,Eye pruritus,Ocular burning,Stinging 1-5% Asthenia,Blepharitis,Corneal erosion,Depression,Epiphora,Eye discharge,Eye dryness,Eye irritation,Eye pain,Eyelid edema,Eyelid erythema,Eyelid pruritus,Foreign body sensation,Headache,Hypertension,Oral dryness,Somnolence,Superficial punctate keratitis,Visual disturbance

Pregnancy category

Note : C Lactation: use caution

Interaction

Brimonidine Tartrate: Possibility of an additive or potentiating effect with CNS depressants e.g. alcohol, barbiturates, opiates, sedatives or anaesthetics. Caution when used with ?-blockers (ophthalmic and systemic), antihypertensives or cardiac glycosides. TCAs can affect the metabolism and uptake of circulating amines. Timolol: Concomitant admin w/ reserpine may increase hypotension and bradycardia. Additive effects w/ other antihypertensives (e.g. hydralazine, methyldopa). Increased ?-adrenergic blockade (e.g. decreased heart rate) w/ quinidine. Rebound HTN due to abrupt withdrawal of clonidine. Hypotensive effect may be antagonised by NSAIDs (e.g. indomethacin, ibuprofen).