Brimonidine Tartrate

The typical dosage of Brimonidine Tartrate for ophthalmic use depends on the formulation:

• Ophthalmic Solution for Glaucoma: One drop in the affected eye(s) three times daily, approximately 8 hours apart.
• Topical Gel for Rosacea: Apply a thin layer to the affected areas of the face once daily, avoiding the eyes and lips.

Brimonidine Tartrate is contraindicated in patients with:

• Known hypersensitivity to Brimonidine or any component of the formulation.
• Patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of a hypertensive crisis.

Patients using Brimonidine Tartrate should be advised to:

• Use the medication exactly as prescribed and not exceed the recommended dosage.
• Avoid driving or operating heavy machinery until they know how Brimonidine affects them, as it can cause drowsiness or blurred vision.
• Wait at least 5-10 minutes before using any other eye drops to ensure proper absorption of each medication.
• Inform their healthcare provider if they experience any severe side effects, such as eye pain, vision changes, or persistent redness or irritation.
• If using the topical gel for rosacea, avoid contact with the eyes and lips, and wash hands thoroughly after application.

Ophthalmic Solution:

• Eye redness or irritation
• Dry mouth
• Drowsiness or fatigue
• Blurred vision
• Burning or stinging in the eyes

Topical Gel:

• Redness, burning, or stinging at the application site
• Flushing or skin warmth
• Dry skin

• Severe allergic reactions, such as rash, itching, swelling, or difficulty breathing
• Persistent eye pain or vision changes (for ophthalmic use)
• Severe skin reactions or worsening of rosacea symptoms (for topical use)

Patients should seek immediate medical attention if they experience severe or persistent side effects.

CNS Effects: Brimonidine can cross the blood-brain barrier and may cause central nervous system effects such as drowsiness, fatigue, or sedation. Patients should be cautious when engaging in activities that require alertness until they know how the medication affects them.

Cardiovascular Effects: Although rare, Brimonidine can cause changes in blood pressure or heart rate. Patients with cardiovascular conditions should use Brimonidine with caution and under close supervision.

Allergic Reactions: Some patients may experience hypersensitivity reactions to Brimonidine, particularly with long-term use. Discontinue the medication and consult a healthcare provider if signs of an allergic reaction occur.

Brimonidine Tartrate may interact with other medications, including:

• Monoamine oxidase inhibitors (MAOIs): Concurrent use is contraindicated due to the risk of hypertensive crisis.
• Central nervous system depressants: Such as alcohol, sedatives, or opioids, which may enhance the sedative effects of Brimonidine.
• Beta-blockers: Used concurrently in the eye (e.g., timolol), which may have an additive effect on lowering intraocular pressure.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.

Alternative treatments for glaucoma or ocular hypertension include:

• Prostaglandin analogs: Such as latanoprost or travoprost, which increase the outflow of aqueous humor to lower IOP.
• Beta-blockers: Such as timolol, which reduce aqueous humor production.
• Carbonic anhydrase inhibitors: Such as dorzolamide or brinzolamide, which decrease aqueous humor production.
• Combination eye drops: That include multiple active ingredients, such as Combigan (brimonidine/timolol).

For rosacea, other topical treatments include:

• Metronidazole: A topical antibiotic effective in reducing inflammation and redness.

Azelaic acid: A topical gel that helps to reduce redness and bumps associated with rosacea.