click here for details           Alphagan-P  (U.S.N.L.M.)
Dosing Package instructions:    0.1%  or  0.15%   tid 8hrs apart (monotherapy)
bid (1st dose on awakening, 2nd dose after 8 hrs.),commonly as adjunctive therapy.
Chem Specs brimonidine  0.1%,  0.15%, ( 0.2% B&L )
Quantities 5, 10, 15ml
Cost 182.00/15ml   (Falcon, B&L 0.2%)
Class Relatively selective alpha-2 agonist. Clonidine derivative.
Action Inhibits adenylate cyclase reducing aqueous outflow.
Enhances trabecular and the uveoscleral outflow.
Activity Peak ocular hypotensive effect occurres at 2 hours post-dosing.
Usage Indicated for the lowering of intraocular pressure in patients with
open-angle glaucoma or ocular hypertension.
Some studies have shown less field defect progression1 and better contrast
sensitivity outcomes2 in normal tension glaucoma when compared to timolol.
Additive IOP reduction with beta-blockers and cai's. Caution with severe cardio-
vascular disease, depression, and cerebral or coronary insufficiency.
Contraindications MAO inhibitor use is listed as a contraindication with the 0.2% formulation but not with
the lower concentrations. Hypersensitivity to brimonidine or any of its components.
Pediatric use > 2 years
Pregnancy Category B
Brimonidine (as alphagan or combigan) can cause follicular conjunctivitis
Allergic reaction is common (10% - 20%).
"P" = Purite® preservative.    0.2% Brimonidine with BAK is available from B&L
(see literature for side effects of 0.2% with BAK.)
Brimonidine causes marked conjunctival vasoconstriction; also miosis similar to dapiprazole
0.25% and has been used for dilation reversal and blur reduction post cataract surgery.
1. Ophthalmology. 2005;112:376-385.  2. Br J Ophthalmol. Dec 2003; 87(12): 1463–1465.