Usage and Side Effects of Brimonidine

December 20, 2019
Brimonidine are eye drops that are administered ophthalmologically. Medical professionals usually indicate it for the treatment of open-angle glaucoma. How does it work? What are its adverse effects? Read on to find out!

The active component of brimonidine is used to reduce intraocular pressure (IOP). Therefore, medical professionals recommend it for patients with ocular hypertension and also for the treatment of open-angle glaucoma. Find out about the usage and side effects of brimonidine in this article.

Glaucoma is the main risk factor of ocular hypertension, which can then lead to so much pressure in the eye that it can damage the optic nerve and cause severe and irreversible vision loss.

What is brimonidine?

Brimonidine belongs to a class of drugs called alpha-adrenergic agonists and acts to decrease the amount of fluid inside the eye.

Alpha-adrenergic agonists are substances that have similar or identical effects to adrenaline. In addition, they’re also known as sympathomimetic drugs, meaning they mimic the sympathetic nervous system.

The sympathetic nervous system is one of the divisions of the autonomic nervous system. It’s responsible for unconscious functions such as:

  • Pupil dilation
  • Decreased saliva production
  • Increased heart rate
  • The inhibition of digestive organs

This article may interest you: 5 Things Your Eyes Say About Your Health

How should I use brimonidine?

A woman using brimonidine eye drops.

Brimonidine is available as ophthalmic eye drops. In adults and elderly patients, the recommended dose is one drop in the affected eye twice a day, with an approximate 12-hour interval between doses.

Instructions and recommendations for use

Please note that you shouldn’t use this drug if the cap seal is broken. It’s important to wash your hands thoroughly before opening the bottle.

  • First of all, tilt your head back and look at the ceiling.
  • Then, gently pull your lower eyelid down.
  • After that, place the bottle upside down and squeeze until you get one eye drop in the affected eye.
  • Then close your eye.
  • For optimal use, and to avoid possible systemic absorption, medical professionals recommended pressing the lacrimal sac for one minute after the application of each drop. Furthermore, if patients use more than one ophthalmologically-applied drug, they should administer each one with approximately 15 minutes gap between each application.
  • Once the patient opens the drug, they should use it within the next 28 days.

Usage and side effects of brimonidine

The most common adverse reactions are:

  • Dry mouth
  • Ocular hyperemia
  • Ocular burning and itching
  • Headache
  • Sleepiness

However, these are usually transient side effects that aren’t as severe as to require discontinuation of brimonidine.

Some uncommon side effects include:

  • Eyestrain
  • Photophobia or sensitivity to light
  • Swollen eyelids
  • Asthenia
  • Although rare, heart palpitations or arrhythmia may occur.
A man with a headache.

Headache and light sensitivity are some of the possible side effects of this drug.

If the following symptoms occur, then contact your doctor immediately:

  • Rash
  • Difficulty breathing
  • Fainting
  • Dizziness
  • Nausea

Read on to learn more: Four Exercises For Eye Health

Contraindications of brimonidine

Brimonidine treatment is contraindicated in cases of:

  • Hypersensitivity to the active substance or any of the excipients.
  • Babies and children under the age of two
  • Patients treated with monoamine oxidase inhibitor (MAOI) antidepressants.
  • Patients treated with antidepressants that affect noradrenergic transmission (tricyclic antidepressants, for example)

Can I use brimonidine if I’m pregnant?

Some animal studies show that brimonidine doesn’t cause teratogenic effects. However, studies that were conducted in rabbits, where higher brimonidine levels than those during treatment in humans were detected, showed reduced postnatal growth.

The safety of this drug during pregnancy in humans hasn’t been clearly established as of yet. However, the use of brimonidine isn’t recommended during pregnancy.

Medical professionals will only consider it if the potential benefit to the mother justifies the potential risk to the fetus. Moreover, they don’t recommend its use while breastfeeding.

Brimonidina: ¿para qué sirve y cómo utilizarlo?

  • Agencia Española del Medicamento y Productos Sanitarios (AEMPS). CIMA. Ficha técnica brimonidina. https://cima.aemps.es/cima/dochtml/p/70471/P_70471.html
  • McLaurin E, Cavet ME, Gomes PJ, Ciolino JB. Brimonidine Ophthalmic Solution 0.025% for Reduction of Ocular Redness: A Randomized Clinical Trial. Optom Vis Sci. 2018;95(3):264–271. doi:10.1097/OPX.0000000000001182
  • Cantor LB. Brimonidine in the treatment of glaucoma and ocular hypertension. Ther Clin Risk Manag. 2006;2(4):337–346. doi:10.2147/tcrm.2006.2.4.337
  • Acces medicina. Brimonidina: oftálmicos. https://accessmedicina.mhmedical.com/content.aspx?bookid=1552§ionid=90367797
  • Sethi HS, Naik M, Gupta VS. Management of glaucoma in pregnancy: risks or choices, a dilemma?. Int J Ophthalmol. 2016;9(11):1684–1690. Published 2016 Nov 18. doi:10.18240/ijo.2016.11.24