| 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 | 166.22/15ml (Falcon, B&L 0.2%) |
| Class | Relatively selective α 2 receptor agonist. Clonidine derivative. |
| Action | Inhibits adenylate cyclase reducing aqueous outflow. Reduces aqueous production and increases 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. 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. 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. Additive IOP reduction with beta-blockers and cai's. Caution with severe cardiovascular 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. 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. No teratogenicity in rats at 360 times the normal human dosage. |
| Brimonidine (as alphagan or combigan) can cause follicular conjunctivitis. Allergic reaction is common (10% - 20%). Brimonidine caused anterior uveitis has been reported infrequently.3 |
|
| "P" = Purite® preservative. 0.2% Brimonidine with BAK is available from B&L (see literature for side effects of 0.2% with BAK.) 0.15% also available as BAK free generic (Falcon etc.) |
|
| 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. 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. |
2. Br J Ophthalmol. Dec 2003; 87(12): 1463–1465.
3. https://pubmed.ncbi.nlm.nih.gov/26399160/ N.L.M. DailyMed page for Alphagan-P PDR page for Alphagan-P