Patients wearing soft contact lenses should wait for at least 15 min after instilling brimonidine tartrate before inserting soft contact lenses. Renal or hepatic impairment. CV disease. Use with caution in patients with depression, cerebral or coronary insufficiency, Raynaud's phenomenon, orthostatic hypotension or thromboangitis obliterans. Pregnancy, lactation.
Lactation: use caution
Indication
Open-angle glaucoma, Ocular hypertension
Contra Indication
Hypersensitivity. Patients receiving MAO inhibitor therapy.
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Brimonidine is an alpha 2-adrenoceptor agonist which works to reduce aqueous humor production and increase uveoscleral flow.
Timolol is a non-selective beta-adrenergic receptor blocker. It does not have significant intrinsic sympathomimetic activity, direct myocardial depressant activity or local anaesth activity. Exact mechanism of ocular hypotensive effect is unclear, but it is thought to be related to reduction of aqueous humour formation. beta-blockade also causes lowering of BP.
Interaction
Brimonidine Tartrate: Possibility of an additive or potentiating effect with CNS depressants e.g. alcohol, barbiturates, opiates, sedatives or anaesthetics. Caution when used with ?-blockers (ophthalmic and systemic), antihypertensives or cardiac glycosides. TCAs can affect the metabolism and uptake of circulating amines.
Timolol: Concomitant admin w/ reserpine may increase hypotension and bradycardia. Additive effects w/ other antihypertensives (e.g. hydralazine, methyldopa). Increased ?-adrenergic blockade (e.g. decreased heart rate) w/ quinidine. Rebound HTN due to abrupt withdrawal of clonidine. Hypotensive effect may be antagonised by NSAIDs (e.g. indomethacin, ibuprofen).
Pregnancy Category Note
Pregnancy Category: C
Lactation: use caution
Adult Dose
Adult: Ophth: Instill 1 drop 2 times/day approximately 12 hours apart.
Child Dose
N/A
Renal Dose
N/A
Administration
N/A
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