Indication

Open-angle glaucoma, Ocular hypertension

Administration

Shake well before use If more than 1 ophthalmic drop is administered, the drugs should be administered at least 5 minutes apart

Adult dose

The recommended dose is one drop in the affected eye(s) 2-3 times daily.

Child dose

<2 years: Safety and efficacy not established >2 years: Instill 1 drop in the affected eye(s) 2-3 times daily.

Contraindication

This eye drops are contraindicated in patients who are hypersensitive to any component of this product.

Mode of action

Brinzolamide is a carbonic anhydrase inhibitor that decreases secretion of aqueous humor thus reducing intraocular pressure. Brimonidine is an alpha 2-adrenoceptor agonist which works to reduce aqueous humor production and increase uveoscleral flow.

Precaution

Hepatic and renal impairment; pregnancy. Efficacy has not been established in angle-closure glaucoma. Ensure an interval of at least 10 minutes between admin of different ophthalmic solutions. Patients wearing soft contact lenses should wait for at least 15 min after instilling brimonidine tartrate before inserting soft contact lenses. General Brimonidine ophthalmic solution 0.2% should be used with caution in patients with known hypersensitivity to other alpha-adrenoceptor agonists. Although brimonidine had minimal effect on blood pressure and heart rate of patients in clinical studies, caution should be exercised in treating patients with severe cardiovascular disease. Lactation: Unknown whether distributed in human breast milk; do not breast feed

Side effect

>10% (brimonidine) Somnolence in children (50-83%),Xerostomia (10-30%),Ocular hyperemia (10-30%),Burning and stinging (10-30%),Headache (10-30%),Blurring (10-30%),Foreign body sensation (10-30%),Fatigue/drowsiness (10-30%),Conjunctival follicles (10-30%),Ocular allergic reactions (10-30%),Ocular pruritus (10-30%) 1-10% (brinzolamide) Blurred vision (5-10%),Dysgeusia (5-10%),Blepharitis (1-5%),Dermatitis (1-5%),Dry eye (1-5%),Foreign body sensation (1-5%),Headache (1-5%),Hyperemia (1-5%),Ocular discharge (1-5%),Ocular discomfort (1-5%),Ocular keratitis (1-5%),Ocular pain (1-5%),Ocular pruritus (1-5%),Rhinitis (1-5%) 1-10% (brimonidine) Corneal staining/erosion (3-9%),Photophobia (3-9%),Eyelid erythema (3-9%),Ocular ache/pain (3-9%),Ocular dryness (3-9%),Tearing (3-9%),Upper respiratory symptoms (3-9%),Eyelid edema (3-9%),Conjunctival edema (3-9%),Dizziness (3-9%),Blepharitis (3-9%),Ocular (3-9%),Irritation (3-9%),Gastrointestinal symptoms (3-9%),Asthenia (3-9%),Conjunctival blanching (3-9%),Abnormal vision (3-9%) Muscular pain (3-9%),Lid crusting (<3%),Conjunctival hemorrhage (<3%),Abnormal taste (<3%),Insomnia (<3%),Conjunctival discharge (<3%),Depression (<3%),Hypertension (<3%),Anxiety (<3%),Palpitations/arrhythmias (<3%),Nasal dryness (<3%),Syncope (<3%) <1% (brinzolamide) Allergic reactions,Alopecia,Chest pain,Conjunctivitis,Diarrhea,Diplopia,Dizziness,Dry mouth,Dyspnea,Dyspepsia,Eye fatigue,Hypertonia,Keratoconjunctivitis,Keratopathy,Kidney pain,Lid margin crusting or sticky sensation,Nausea,Pharyngitis,Tearing,Urticaria

Pregnancy category

Note : C Lactation: Unknown whether distributed in human breast milk; do not breast feed

Interaction

Brinzolamide: Concurrent use w/ oral carbonic anhydrase inhibitors may lead to additive systemic effects. Concurrent use w/ high-dose salicylates may lead to toxicity. 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.