Brimonidine Tartrate

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jan 25, 2024

Warnings


Brimonidine (Alphagan P) Risks, Warnings, and Complications


Brimonidine tartrate ophthalmic solution can cause serious medical problems in some people. Talk to your doctor about other options to treat open-angle glaucoma or ocular hypertension if you are at increased risk of complications from this medication. Some of the risks of brimonidine use include:

  • VASCULAR INSUFFICIENCY: Brimonidine has vasoconstrictive effects (it causes the narrowing of blood vessels) and can, therefore, increase the likelihood of vascular insufficiency (low blood flow). This medication should be used with caution in people with certain medical conditions such as depression, orthostatic hypotension, Raynaud’s phenomenon, cerebral or coronary insufficiency, thromboangiitis obliterans, and severe cardiovascular disease. Give your doctor a complete medical history before starting treatment with brimonidine.

  • CONTAMINATION: The use of eye drops that come in multiple-dose containers, such as brimonidine ophthalmic, carries the risk of contamination. This can lead to bacterial eye infections such as bacterial keratitis. The risk of eye infections is higher in people with corneal disease or a disrupted ocular epithelium (the outer protective covering of the eye). Follow hygiene precautions carefully when using brimonidine to lower the risk of contamination and infections.


Precautions (Alphagan P) Before Starting Brimonidine

Tell your doctor if you have had an allergic reaction to the active ingredient brimonidine, any of the inactive ingredients in brimonidine eye drops, or any other drugs. Your pharmacy can give you a list of ingredients.

Tell your doctor if you have a pre-existing medical problem. Brimonidine tartrate ophthalmic solution may not be safe for people with certain health conditions, such as postural or orthostatic hypotension (feeling dizzy when going from lying or sitting to standing), depression, circulation problems such as thromboangitis obliterans or Raynaud's disease, blood flow problems in the heart or brain, heart disease, kidney disease, or liver disease.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions between brimonidine ophthalmic and your other medicines.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breastfeeding.

Precautions During Use of Brimonidine (Alphagan P)

Keep all your healthcare appointments while taking brimonidine. Your doctor may want to adjust your dose and monitor you for any adverse reactions.

If you are using other eye drops, including eye drops for elevated intraocular pressure, make sure you apply them at least 5 minutes away from brimonidine.

If you wear soft contact lenses, remove them before using brimonidine tartrate ophthalmic solution. Wait at least 15 minutes before putting your contact lenses back in.

Tell your healthcare professional if you become pregnant while on brimonidine. Do not breastfeed while using this medicine.

Let your doctors know that you are using brimonidine ophthalmic before any surgery, including dental procedures. 

If you have eye surgery, an eye infection, or an eye injury while on brimonidine eye drops, ask your healthcare professionals if you can continue using the same bottle of brimonidine eye drops.

Brimonidine ophthalmic can cause drowsiness and temporary blurring of vision. Do not drive, operate machinery, or do other activities that require clear vision until you can see clearly.

Avoid drinking alcohol while using brimonidine. Alcohol can worsen the drowsiness caused by brimonidine.

Brimonidine (Alphagan P) Drug Interactions

Concomitant administration of brimonidine eye drops with certain other medicines can affect how the medicines work. Possible drug interactions between brimonidine and other medicines can also increase the risk of severe adverse events. Your doctor may change the dose of your medications, switch you to a different medication, or monitor you carefully for side effects if there are known interactions between brimonidine and your other medicines.

Some of the medications that can interact with brimonidine include:

  • Antidepressants belonging to a drug class called monoamine oxidase (MAO) inhibitors and tricyclic antidepressants
  • Certain antibiotics, such as linezolid
  • Certain chemotherapy drugs, such as procarbazine
  • Opioid pain medications and other CNS depressants
  • Muscle relaxants
  • Antihypertensives and cardiac glycosides

The above list does not contain all the drug interactions of brimonidine. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, non-prescription medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.