Brimonidine Tartrate 0.2% ophthalmic solution is used to reduce intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

Brimonidine Tartrate 0.15% ophthalmic solution is indicated for controlling intraocular pressure in patients with chronic open-angle glaucoma or ocular hypertension.

Brimonidine Tartrate 0.025% ophthalmic solution is used to relieve eye redness caused by minor eye irritation.

Brimonidine Tartrate ophthalmic solution is an alpha-adrenergic receptor agonist. It produces its maximum intraocular pressure–lowering effect approximately two hours after administration. Studies in both animals and humans indicate that it works through a dual mechanism by decreasing aqueous humor production and increasing uveoscleral outflow.

A preservative-free sterile eye drop formulation with an ophthalmic squeeze dispenser (OSD) has been introduced in Bangladesh for improved convenience and safety.

Brimonidine is a selective α₂-adrenergic receptor agonist with greater affinity for α₂ receptors than α₁ receptors. When applied topically, it reduces intraocular pressure (IOP) by decreasing aqueous humor production and increasing uveoscleral outflow, with minimal effects on cardiovascular parameters. It has a rapid onset of action, with peak IOP-lowering effect occurring about two hours after dosing, and the duration of action lasts for approximately 12 hours or longer.

Although dedicated interaction studies with Brimonidine Tartrate ophthalmic solution are limited, potential additive or enhanced effects may occur when used with central nervous system (CNS) depressants such as alcohol, barbiturates, opioids, sedatives, or anesthetics. Alpha-agonists may lower pulse rate and blood pressure; therefore, caution is advised when used alongside beta-blockers (topical or systemic), antihypertensives, or cardiac glycosides. Tricyclic antidepressants may reduce the hypotensive effect of clonidine. It remains unclear whether concurrent use of these medications affects the intraocular pressure–lowering effect of Brimonidine in humans. There is also no available data on circulating catecholamine levels following administration. Caution is recommended in patients taking tricyclic antidepressants that may interfere with the metabolism and uptake of circulating amines.

Brimonidine Tartrate ophthalmic solution is contraindicated in patients with known hypersensitivity to Brimonidine Tartrate. It is also contraindicated in patients receiving monoamine oxidase (MAO) inhibitor therapy.

Common adverse reactions (approximately 10–30% of patients) include dry mouth, ocular redness, burning or stinging sensation, headache, blurred vision, foreign body sensation, fatigue or drowsiness, conjunctival follicle formation, allergic eye reactions, and itching. Less common reactions (approximately 3–9%) include corneal staining or erosion, sensitivity to light (photophobia), eyelid redness, eye pain, dryness, tearing, upper respiratory symptoms, eyelid swelling, conjunctival edema, dizziness, blepharitis, ocular irritation, gastrointestinal disturbances, weakness, conjunctival blanching, abnormal vision, and muscle pain. Rare reactions (less than 3%) include eyelid crusting, conjunctival hemorrhage, altered taste, insomnia, conjunctival discharge, depression, hypertension, anxiety, palpitations or arrhythmias, nasal dryness, and syncope.

There are no sufficient, well-controlled studies in pregnant women. Animal studies have shown that Brimonidine can cross the placenta and enter fetal circulation to a limited extent. Therefore, Brimonidine Tartrate ophthalmic solution 0.2% should be used during pregnancy only if the expected benefit to the mother outweighs the potential risk to the fetus. It is not known whether Brimonidine is excreted in human breast milk; however, animal studies indicate that it is present in milk. A careful decision should be made whether to discontinue breastfeeding or stop the medication, considering the importance of the treatment to the mother.

Although Brimonidine Tartrate ophthalmic solution has minimal impact on systemic blood pressure, caution should be exercised in patients with severe cardiovascular disorders. It should also be used carefully in patients with depression, cerebrovascular or coronary insufficiency, Raynaud’s phenomenon, orthostatic hypotension, or thromboangiitis obliterans.

Drugs for miotics and glaucoma

Store below 30°C in a cool, dry place protected from light. Keep out of reach of children. Avoid touching the dropper tip to any surface to prevent contamination. Do not use the product beyond 30 days after first opening.