From the Guidelines
The standard dosage of brimonidine eye drops is typically 1 drop in the affected eye(s) three times daily, approximately 8 hours apart, with the 0.2% concentration being most commonly prescribed. Brimonidine tartrate is available in concentrations of 0.1%, 0.15%, and 0.2% 1. When applying the drops, tilt your head back slightly, pull down your lower eyelid to create a small pocket, and place the drop into this pocket without touching the dropper to your eye or any surface. After application, gently close your eyes for 1-2 minutes and press lightly on the inner corner of your eye to prevent the medication from draining into your tear duct. If you're using multiple eye medications, wait at least 5 minutes between applications. Brimonidine works by reducing the production of aqueous humor and increasing its outflow, thereby lowering intraocular pressure, making it effective for treating glaucoma and ocular hypertension 1. Common side effects include eye redness, itching, and dryness. If you experience severe reactions like vision changes or allergic symptoms, contact your doctor immediately. It's worth noting that brimonidine has been shown to be as effective as apraclonidine in preventing immediate IOP elevation after laser trabeculoplasty 1.
Some key points to consider when using brimonidine eye drops include:
- The importance of proper application technique to ensure the medication is effective and minimize side effects
- The potential for interactions with other eye medications, and the need to wait at least 5 minutes between applications
- The common side effects of brimonidine, and the need to contact a doctor if severe reactions occur
- The effectiveness of brimonidine in lowering intraocular pressure and treating glaucoma and ocular hypertension, as supported by studies such as those published in Ophthalmology 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION: The recommended dose is one drop of brimonidine tartrate ophthalmic solution 0.2% in the affected eye(s) three times daily, approximately 8 hours apart. The recommended dosage of brimonidine eye drops is:
- One drop of 0.2% solution
- In the affected eye(s)
- Three times daily, approximately 8 hours apart 2
From the Research
Dosage of Brimonidine Eye Drops
- The typical dosage of brimonidine eye drops is 0.2% twice daily 3, 4
- A newer formulation, brimonidine-Purite 0.1%, has been developed with a higher pH to improve ocular bioavailability and is preserved with Purite(R) to enhance ocular tolerability 4
- Brimonidine can be used as monotherapy, adjunctive therapy, or replacement therapy in open-angle glaucoma and ocular hypertension 3, 4
- When used in combination with other glaucoma medications, such as prostaglandin analogs, brimonidine has been shown to be effective in reducing intraocular pressure (IOP) 5, 6
Combination Therapies
- A fixed combination of brimonidine and timolol is available in some countries and has been shown to be effective in reducing IOP 4
- Brinzolamide/brimonidine combination suspension has been shown to be effective in reducing IOP and is well-tolerated by patients 5, 6
- The combination of brinzolamide 1%/brimonidine 0.2% fixed-dose combination (BBFC) with a prostaglandin analog (PGA) has been shown to be effective in reducing IOP in patients with open-angle glaucoma or ocular hypertension 6
Safety and Tolerability
- The most common side effects of brimonidine are conjunctival hyperemia, allergic conjunctivitis, and ocular pruritus 3, 4
- Brimonidine is generally well-tolerated, but can cause changes in systolic and diastolic blood pressure and heart rate, although these changes are not typically clinically significant 3
- Brimonidine is not contraindicated in patients with cardiopulmonary disease, but should be used with caution in individuals with severe cardiovascular disease 3