BRIMONIDINE TARTRATE (ALPHAGAN)Product code SKU16194

Brand Name(s) : Alphagan


BRIMONIDINE TARTRATE USES

What is it used for?

 Brimonidine is used to treat raised pressure inside the eye due to open-angle glaucoma or ocular hypertension. It can be used on its own in people who can not take other similar drugs (alpha agonists), or with other drugs when one drug is not enough to lower the pressure.
 It is a type of alpha-adrenergic agonist, or alpha-agonist.
 It is used to lower the pressure inside the eye by reducing the amount of watery fluid in the eye (aqueous humour). It does this by constricting blood vessels, which reduces the amount of fluid that filters out of the vessels to form aqueous humour.
 In general this drug is used to reduce elevated pressure inside the eye due to open-angle glaucoma or ocular hypertension.
 Benefits of being on this drug can include:
 Decreasing the damage caused by high pressure in the eye.

Listed below are the typical uses of brimonidine:

 Reduction of high pressure inside the eye in patients with open-angle glaucoma or ocular hypertension

On occasion your doctor may prescribe this medicine to treat a condition not on the above list. Such conditions are listed below.

 None known.

HOW TO USE/TAKE

How often do I take it?

 Take brimonidine exactly as your doctor has told you. The usual dose is one drop in each affected eye, given twice a day with approximately 12 hours between doses.
 Use this medication for the duration of the prescription in order to get the most benefit from it.
 Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
 Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

 Dosage is based on your age, gender, medical condition, response to therapy and use of certain interacting medicines.

Do I need to avoid anything?

 Brimonidine may cause blurred or abnormal vision, which may appear to be worse at night or in reduced light. It may also cause tiredness or drowsiness in some people. If this happens, do not drive or operate machinery until the symptoms have gone away. Consult your doctor or pharmacist for more details.

When can I stop?

 Always complete the full course as prescribed by your doctor.

Details

BRIMONIDINE TARTRATE INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

 Drugs for depression called monoamine oxidase inhibitors, such as phenelzine, tranylcypromine and isocarboxacid
 Drugs for depression called tricyclic antidepressants, such as amitriptyline and imipramine
 Other drugs for depression, such as mianserin.

If you are currently using any of these medications, tell your doctor or pharmacist before starting brimonidine.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

 Pain killers, especially opiates
 Drugs which make you relaxed called sedatives
 Drugs called barbiturates that are used to control fits and convulsions and to help people who are unable to sleep
 Regular consumption of alcohol
 Going to have an operation with an anaesthetic
 Drugs to treat heart problems or to lower high blood pressure (hypertension)
 Drugs that can affect metabolism, such as chlorpromazine, methylphenidate and reserpine
 Drugs which work in the same way in the body as brimonidine, such as isoprenaline and prazosin.

This information does not contain all possible interactions. Therefore, before using brimonidine, tell your doctor or pharmacist of all the products you use.


BRIMONIDINE TARTRATE SIDE EFFECTS

 Headache
 Drowsiness
 Eye irritation
 Allergic reactions, such as burning, stinging, itchiness, small white lumps on the eyeball, and a sensation that something is in your eye
 Blurred vision
 Dry mouth
 Changes to the surface of the eye
 Inflammation and redness of the eyelids
 Inflammation or whitening of the cornea (the transparent layer that covers the surface of the eye)
 Problems with your sight
 Sticky eyes
 Sensitivity to light
 Aching or pain of the eye
 Dry eyes
 Damage to the surface of the eye or staining
 Watery eyes
 Dizziness
 Cold-like symptoms
 Stomach and digestion problems
 Abnormal taste in the mouth
 Feeling weak.

If any of these persist or you consider them severe then inform doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms:

 None known.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the UK you may report side-effects to the MHRA


BRIMONIDINE TARTRATE OVERDOSE

There is no experience of adults using too much brimonidine. However, there have been reports of infants and babies being given too much brimonidine eye drops or swallowing the drug, with symptoms of slow heart beat (bradycardia), loss of consciousness, muscle weakness, a dangerous drop in body temperature (hypothermia), blue coloration of the skin because of a lack of oxygen, and stopping breathing. If these symptoms happen, contact your doctor or nearest hospital emergency department immediately.

If an adults swallows brimonidine eye drops, they may experience light-headedness and dizziness caused by low blood pressure (hypotension). If this happens, contact your doctor or nearest hospital emergency department immediately.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of brimonidine or intentional overdose is suspected, contact your local hospital, GP or if in the UK call NHS Direct on 0845 4647.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.


BRIMONIDINE TARTRATE PRECAUTIONS

Before taking brimonidine, tell your doctor or pharmacist if you are allergic to it; or to other alpha agonists; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of:

 An allergy (hypersensitivity) to brimonidine tartrate or any of the other ingredients
 Depression, and are taking drugs for thise called monoamine oxidase inhibitors, tricyclic antidepressants or mianserin
 Breastfeeding issues
 Use in infants and babies under 2 years of age.

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following:

 Diseases involving the heart and blood vessels (cardiovascular disease)
 Depression
 A condition called Reynaud's phenomenon that causes painful, pale, cold fingers and toes
 A condition with decreased blood supply to the heart (coronary insufficiency), such as angina
 A condition with decreased blood supply to the brain (cerebral insufficiency), such as in people who have had a stroke
 Feeling dizzy and light-headed when moving from lying down to sitting or standing (orthostatic or postural hypotension)
 A condition with recurring blood clots and inflammation in the blood vessels of the hands and feet called thromboanglitis obliterans or Buerger's disease
 Liver problems
 Kidney problems.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

 Alcohol may make this drug have a greater effect or more unwanted side effects.

Pregnancy and breastfeeding - please ensure you read the detailed information below.

PREGNANCY

The safety of brimonidine has not been established during pregnancy. Ask your doctor or pharmacist if you have any doubts or questions about this.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

It is not known whether brimonidine passes into breast milk. The manufacturer therefore states that it should not be taken if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.


BRIMONIDINE TARTRATE WARNINGS

Brimonidine should be used with caution in:

 Diseases involving the heart and blood vessels (cardiovascular disease)
 Children aged 2 to 7 years, especially those weighing less than 20 kg
 Patients with depression
 A condition called Reynaud's phenomenon that causes painful, pale, cold fingers and toes
 A condition with decreased blood supply to the heart (coronary insufficiency), such as angina
 A condition with decreased blood supply to the brain (cerebral insufficiency), such as in people who have had a stroke
 Feeling dizzy and light-headed when moving from lying down to sitting or standing (orthostatic or postural hypotension)
 A condition with recurring blood clots and inflammation in the blood vessels of the hands and feet called thromboanglitis obliterans or Buerger's disease
 Liver problems
 Kidney problems
 Wearers of soft contact lenses.

It should not be used in:

 People with an allergy (hypersensitivity) to brimonidine tartrate or any of the other ingredients
 People taking drugs for depression called monoamine oxidase inhibitors, tricyclic antidepressants and mianserin
 Infants and babies under 2 years of age
 Women who are breast-feeding.

Also see list of precautions and interactions.

STORAGE

Store brimonidine below 25°C.