Brimonidine: Uses, Side Effects, Dosage, Interactions and Warnings

It is a prescription medicine used to lower eye pressure.

Specifically, these eye drops are approved to treat high eye pressure in people with open-angle glaucoma or ocular hypertension.

This medicine works by decreasing the production of fluid in the eye and increasing the drainage rate from the eye.

Are there any side effects?

As with any medicine, brimonidine can cause side effects. However, not everyone who uses the drug will experience side effects. Most people tolerate it quite well.

If side effects do occur, in most cases, they are minor and do not require treatment or are easily treated by you or your healthcare provider. Serious side effects are less common.

Side effects of brimonidine

Blurred vision, headaches, and drowsiness are among brimonidine drops’ most common side effects.

In most cases, the side effects are mild and easily treated. However, some potentially severe reactions require medical attention.


Notify your healthcare provider right away if you develop shortness of breath, unexplained skin rash, or low blood pressure.

This article covers many, but not all, of the possible side effects of brimonidine. Your healthcare provider can discuss a complete list with you.

Serious side effects of brimonidine

Some side effects with brimonidine, although they occur infrequently, are potentially serious and should be reported immediately to your healthcare provider. Such side effects include, but are not limited to:

  • Low blood pressure (hypotension)
  • Worsening of depression
  • Worsening of Raynaud’s disease.
Signs or symptoms of a severe allergic reaction
  • Generalized itching or hives.
  • An unexplained rash.
  • Wheezing or other shortness of breath.
  • Swelling of the mouth, lips, tongue, or throat.

Of course, any eye drop can cause problems (such as an eye infection) if contaminated, so be sure to avoid touching the dropper tip on any surface, including the eye’s surface.

Tell your healthcare provider about any signs of an eye infection (such as severe pain, swelling, or redness).

What is brimonidine used for?

Brimonidine is prescribed to lower eye pressure in people with various eye conditions, such as open-angle glaucoma or ocular hypertension. However, a healthcare provider may also specify the “off-label” use of brimonidine to treat angle-closure glaucoma.

This eye medication is approved for adults and children two years of age and older.

Brimonidine tartrate is a prescription eye medication used to lower pressure in the eyes (medically known as intraocular pressure). Specifically, it is approved to reduce eye pressure in people with the following conditions:

  • Ocular hypertension (high pressure in the eye that is not accompanied by changes in vision or damage to the optic nerve, as would occur with glaucoma).
  • Open-angle glaucoma.

Not all people with high eye pressure have glaucoma, although high eye pressure can lead to glaucoma. Effective treatment of high eye pressure can help prevent glaucoma.

Glaucoma is a group of diseases that share specific characteristics, such as:

  • High pressure inside the eye (intraocular pressure).
  • Damage to the optic nerve.
  • Loss of peripheral (side) vision.
  • Possible blindness.

Of all the different types of glaucoma, open-angle glaucoma is by far the most common.

Although there is no cure for open-angle glaucoma, symptoms can usually be controlled, and further damage can be prevented or reduced. The most common glaucoma treatments are:

  • Medicines.
  • Traditional surgery.
  • Laser surgery

Brimonidine can be used alone or, if necessary, combined with other types of glaucoma medications or treatments.


When treating high eye pressure or glaucoma, there is only one standard dose of brimonidine: one drop in the affected eye three times a day.

This dosage amount is the same for each of the various brimonidine products. If this medicine does not adequately control your eye pressure, your healthcare provider may recommend an additional eye medicine.

There is only one standard dose of brimonidine tartrate, regardless of your age, weight, or the severity of your eye condition.

As is always the case, do not adjust your brimonidine dose unless specifically instructed to do so by your healthcare provider.

The standard dosage for brimonidine

Brimonidine has the following strengths and forms:

  • Brimonidine Tartrate 0.2% (in generic form only) – available in 5, 10 and 15 ml bottles.
  • Alphagan P 0.1% (brand form only) – available in 5, 10 and 15 ml bottles.
  • Brimonidine Tartrate 0.15% – available in bottles of 5, 10 and 15 ml.

The strengths and preservatives are the differences between Brimonidine Tartrate 0.2% and Alphagan P products.

The recommended dose of brimonidine to treat glaucoma or high eye pressure is one drop in the affected eye three times a day, with approximately eight hours between doses, using any concentration or form of the products (including the original brimonidine or the strength of Alphagan P).

Increasing the dose beyond the standard recommended amount is generally not recommended, even if the eye pressure is still high.

If this dose does not adequately lower the pressure in the eye, your healthcare provider may add another type of eye medication.

All brimonidine products appear to be similar in terms of effectiveness.

What other drugs does brimonidine ophthalmic affect?

Using brimonidine ophthalmic with other drugs that make you drowsy or slow your breathing can increase these effects.

Ask your doctor before using brimonidine ophthalmic with a sleeping pill, narcotic pain reliever, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all the medicines you use and the ones you start or stop using during your treatment with brimonidine ophthalmic, especially:

  • Digoxin, digital.
  • Antidepressants: amitriptyline, bupropion, clomipramine, desipramine, doxepin, duloxetine, fluoxetine, imipramine, nortriptyline, paroxetine.
  • An MAO inhibitor: isocarboxazid, linezolid, others.
  • Heart or blood pressure medicine: amlodipine, methyldopa, nifedipine, quinidine, verapamil, etc.

This list is not complete. Other drugs can interact with brimonidine ophthalmic, including prescription and non-prescription medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Cautions and warnings

Because brimonidine can interact with certain medications, inform your healthcare provider of any medications before using the eye drops.

The warnings and precautions for brimonidine should also be discussed with your healthcare provider, as it is essential to be aware of potential side effects and other potential problems. For example, brimonidine can make heart disease or low blood pressure worse.

What should I tell my healthcare provider?

You should talk to your doctor before using brimonidine tartrate if you have:

  • Raynaud’s disease.
  • He had a stroke.
  • Low blood pressure (hypotension)
  • Depression.
  • Heart disease.
  • Tromboangeítis obliterante.
  • Liver disease, such as liver failure, cirrhosis, or hepatitis.
  • Kidney disease, such as kidney failure (kidney failure).
  • Any allergies, including allergies to foods, dyes, or preservatives.

Also, tell your healthcare provider if you are pregnant or planning to become pregnant or breastfeeding.

Tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.