Generic Name: Brimonidine Tartrate 0.2 %
Manufacturer/Distributor: Popular Pharmaceuticals Ltd.
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Indications of Brimo Ophthalmic Solution
Brimonidine 0.2% ophthalmic solution is indicated for lowering intraocular pressure in patients with open-angle glaucoma or ocular hypertension.
Pharmacology of Brimo Ophthalmic Solution
Brimonidine is a 2 adrenergic receptor agonist, which is more selective for α2 adrenergic receptors than for α1 receptors. Topical administration of brimonidine tartrate eye drops reduces intraocular pressure (IOP) in humans. When used as directed, brimonidine tartrate is effective in reducing elevated IOP with minimal effect on cardiovascular parameters. Brimonidine tartrate eye drops have a rapid onset of action, with the peak of the ocular hypotensive effect occurring two hours after administration. The duration of the effect is 12 hours or more. Fluorescence studies in animals and humans suggest that brimonidine tartrate has a dual mechanism of action. Brimonidine tartrate eye drops reduce IOP by decreasing water production and improving uveal outflow.
Dosage & Administration of Brimo Ophthalmic Solution
The recommended dose is one drop of Brimonidine Tartrate ophthalmic solution 0.2% in the affected eye(s) three times daily, approximately 8 hours apart. Brimonidine Tartrate ophthalmic solution 0.2% may be used concomitantly with other topical ophthalmic drug products to lower intraocular pressure. If more than one topical ophthalmic product is being used, the products should be administered at least 5 minutes apart.
Interactions of Brimo Ophthalmic Solution
Although no specific drug interaction studies have been performed with brimonidine tartrate 0.2% ophthalmic solution, the potential for adverse effects or potentiation with CNS depressants should be considered. alcohol, barbiturates, opiates, sedatives, or anesthetics). Alpha antagonists, as a drug, can lower heart rate and blood pressure. Caution should be exercised with the concomitant use of drugs such as beta-blockers (ophthalmic and systemic), antihypertensive, and/or cardiac glycosides. Tricyclic antidepressants have been reported to reduce the antihypertensive effect of systemic clonidine. It is not known whether co-administration of these drugs with brimonidine tartrate 0.2% ophthalmic solution in humans could interfere with the IOP-lowering effect. There are no data on circulating levels of catecholamines following administration of 0.2% brimonidine tartrate ophthalmic solution. However, caution should be exercised in patients receiving tricyclic antidepressants which may affect the metabolism and absorption of circulating amines.
Contraindications
Brimonidine tartrate allergic patients should not use 0.2% brimonidine tartrate eye drops. Patients receiving monoamine oxidase (MAO) inhibitors are also contraindicated.
Side Effects of Brimo Ophthalmic Solution
Approximately 10% to 30% of subjects experienced adverse events (in descending order of incidence) including dry mouth, eye congestion, burning and tingling, headache, blurred vision, foreign body sensation, fatigue/drowsiness, conjunctival follicles, eye Allergic reactions, and itchy eyes. Events that occurred in approximately 39% of subjects (in descending order) included corneal staining/erosion, photophobia, eyelid erythema, eye pain/pain, dry eyes, tearing, upper respiratory tract symptoms, eyelid edema, conjunctival edema, dizziness, Blepharitis, eye irritation, gastrointestinal symptoms, fatigue, pale conjunctiva, abnormal vision, and muscle pain. Less than 3% of patients reported the following adverse reactions: eyelid crusting, conjunctival bleeding, abnormal taste, insomnia, conjunctival secretions, depression, high blood pressure, anxiety, palpitations/arrhythmia, dry nose, and syncope.
Pregnancy
There are no adequate and well-controlled studies in pregnant women. In animal studies, brimonidine crossed the placenta and entered the fetal circulation to a limited extent. Brimonidine tartrate 0.2% ophthalmic solution should be used during pregnancy only if the possible benefit to the mother is equal to the possible risk to the fetus. It is not known whether this medicine is excreted in human milk; In animal studies, brimonidine tartrate was excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Precautions
Although brimonidine tartrate 0.2% ophthalmic solution had minimal effect on patient blood pressure in clinical studies, caution should be exercised when treating patients with severe cardiovascular disease. Brimonidine tartrate 0.2% ophthalmic solution should be used with caution in patients with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension, or thromboembolic disease.
Storage Conditions
Store below 30°C in a cool and dry place protected from light. Keep out of reach of children. Do not touch the dropper tip to surfaces since this may contaminate the solution. Do not use it after 30 days of the first opening.
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